TECHNOLOGY: Your journey to the cloud

Mike Collier and Tony Thorne discuss how the cloud offers an array of benefits to pharmacy, from an improved security posture to a level of systems availability…

Over the past 12 months, the acceleration in digital transformation that has taken place throughout the NHS has challenged perceptions and addressed many legacy technology constraints. The use of the cloud, for example, allowing for anytime, anywhere access to shared patient records has been essential in supporting Covid-19 vaccination clinics and pharmacy operations.

Digitisation of services is now a priority and is transforming the way services are developed and implemented. The NHS now has a ‘Cloud First’ strategy – which means digital services should transfer to the cloud (hosted in the UK) ‘unless there is a clear reason not to do so’. The goal is evident – public cloud services not only change the pace with which new services can be deployed and ensure they can be quickly scaled up in line with demand, they also offer the availability and accessibility essential for the federated delivery of healthcare and community services that underpin NHS strategy.

Managing data

The wider IT healthcare ecosystem also benefits from unprecedented access to data and services through using the public cloud – something that will be essential in enabling the innovation required to deliver healthcare that is secure, efficient and suitable for 21st century needs.

The sheer scale of the expertise and intelligence provided by the large public cloud providers, accelerates the speed with which new services and solutions are being developed and supports the migration of existing solutions to the cloud.

Companies such as Amazon Web Services (AWS) provide a remarkable array of services, tools, migration help and advice. The service includes nearly 200 tools that support software developers to unlock innovation, for example through leading machine learning and artificial intelligence technologies.

These tools can provide risk stratification within patient cohorts and support healthcare professionals with easy to consume diagnostic insight-all critical resources in an increasingly federated model that will reduce the dependence upon personal relationships between pharmacists and patients. Combining the ability to manage considerable amounts of data in the cloud with incredibly powerful analytic tools will give pharmacists new and instant insight that has the opportunity to transform patient outcomes.

Understanding strategies

However, it is crucial to understand the journey to the cloud and the role that suppliers play within this. While NHSX guidance is transparent, that digital services should be delivered from the public cloud-there are issues. For example, if service level characteristics, such as availability or recovery time objective (RTO) times, or cyber/ information governance cannot be met by the public cloud, a replacement model – such as a private cloud hosted by the supplier - is allowed.

This is important because there will be challenges related to a wholesale shift to the public cloud within a healthcare sector that depends upon large quantities of diverse services and solutions, both recent and legacy.

In fact, many of these technologies are outstanding. There is no need for the complete replacement of all technology with brand new digital solutions designed from scratch for the public cloud- even if the budget was obtainable.

It is also not practical to move all legacy applications into the public cloud – without the right migration model solutions this could become costly and inefficient. The ‘pay as you go’ public cloud model does not fit with many legacy designs, such as traditional desktop applications which rely on local hardware and data storage.

All of these thoughts place the focus on suppliers to take the right approach to make sure the NHS is using solutions that are both cost effective and productive. Indeed, this public cloud cost of delivery has been a problem for certain suppliers: having announced a wholesale move to public cloud, the commercial reality has led to a swift reversal of cloud strategy.

This creates considerable concerns for any NHS organisation: trust in suppliers is fundamental at any time, but during this rapid digital transformation it is important to have confidence that suppliers are 100 per cent committed to a development roadmap.

Enabling collaboration

Which is why it is vital to comprehend how a supplier’s cloud strategy is being delivered. Does it need products to be reengineered? Will the use of public cloud technology incur additional costs? How will data privacy and cyber security protocols be guaranteed? How will cloud strategies help drive innovation? It is this amount of insight that is crucial to building confidence in cloud strategies.

The cloud technology strategy of a supplier should be firmly aligned to NHS aspirations and positioned around a clear vision for the future of healthcare. It starts with an idea of placing tools in modern apps to enable pharmacists and patients to select a device of their choice on which to use apps and access data; and extends to cover adoption of internet first and public cloud technology alongside open standard APIs and the best cyber security layers.

Best practice would also suggest working closely with both public cloud providers and NHS bodies to ensure products and applications are intelligently re-architected and re-engineered to deliver the optimal cloud model for each solution.

It is also vital to consider the fact that this emphasis on the public cloud is just one part of the wider story of creating a patient centric model that encompasses both health and care services. Interoperability is a vital part of the model, which is where the use of open standards, such as the FHIR, developed by Health Level-7, are key. Application Programming Interfaces (APIs) that use this standard ensure that health and care information can be shared between providers and systems.

This both enables collaboration between healthcare professionals based on shared care records and also overcomes many of the development constraints that have previously restricted innovation. When suppliers open up their systems and data, everyone-from providers to pharmacists and patients – benefits from an acceleration in digital transformation.

Conclusion

The journey to the cloud offers a remarkable number of benefits for NHS organisations, from an upgraded security posture to a level of systems availability – typically 99.999 per cent – that would be unfeasible to achieve on premise.

From a strategic perspective, the combination of cloud and open standards are the basis for an extraordinary journey of digital transformation that will introduce new ways to deliver care. A successful transition to the cloud can help realise the true power of a digital NHS and is the next vital step in unleashing that potential.

Mike Collier and Tony Thorne are directors at Cegedim Healthcare Solutions.