Among the top agencies listed in Federal Chief Technology Officer Vivek Kundra’s cloud-first policy are the Departmment of Defense, Health and Human Services and the Veterans Administration. All three will turning to clouds, be those of the public, private, or hybrid variety, under Kundra’s plan.
Government Health IT Editor Tom Sullivan spoke with Aileen Black, vice president of public sector for VMware, about what the potential spread of cloud computing into government means to the federal health IT realm, the advice she has for government health IT organizations tasked with creating a cloud, and why taxpayers want the model.
Q: What does Kundra's "Cloud First" plan mean to federal health IT?
A: We need to look at in three categories: There’s the IT and infrastructure of the agencies themselves. Then there’s the infrastructure for patient care and patient records. And then there’s the mobility to gather patient information out in the field, whether it be for deployed forces or if we have a disaster. So cloud computing can have the greatest savings with just the cost of the infrastructure because there are a lot of stovepipes out there and providing that pool of resources also opens up the paradigm of being able to more easily share information, especially for deployed forces or military families that move across the country. It’s the mobility of being able to flow that person no matter where they go with the information and allow that profile to be there. This really provides that information point and that access to elastic pools of resources. An example, being able to pull down that patient profile that tells you if they broke an arm at eight years old, or if they’re allergic to certain drugs. So cloud computing offers all kinds of efficiency and cost-savings that lead, in the end, to better patient care.
Q: What particular challenges do federal health IT agencies face that others perhaps do not?
A: Healthcare providers can’t go to the public cloud because of the very nature of the data and the sensitivity around it. But what they can is get just about the same amount if not even greater returns with a private cloud. The Meritalk study (sponsored by VMware; registration required) cites three major obstacles. The first one is mission-orientation, in this case patient information, and the complexity of how to deal with that. We need to make sure that as we put out these policies like the cloud-first policy, that we put together what would be the second one, which is budget. And I think it was 64 percent of the responders said that they thought cloud computing and virtualization would help them deal with the cuts in budget. But you’re not able to spend the money to implement this if it’s in the wrong bucket, so we need to really look at different ways to allow some flexibility to do that. The third one is we need to have measurements in place to encourage people to figure out where they are on that continuum from their mission-orientation, from their security, and they tie it back into private, hybrid, or public clouds. Public cloud is not the answer for everyone.
Q: A different vendor study was published stating – and this is very specific to ITSM and ITIL – that more than half of respondents are not ready to manage cloud-based services within ITIL or ITSM. Are you seeing the same?
A: Workload is one thing, but you have to look at the mission and security orientation, and then the scalability. So if you don’t have very many workloads, then you might get some economic scale by joining together with other people in a public cloud or a hybrid cloud. However, if you have mission constraints, security constraints, or a large scale, then the economics may not be in your favor to go to the public cloud. It actually might be in your favor to build out your own private cloud. Gartner came out recently with that same statement, and public cloud isn’t everything. If you have bulk needs, you have high scale needs, then building out your own private cloud and weighing off some of the issues associated with privacy, security, mission-orientation, or the ability to be really agile and mobile, that’s where you need to have that choice of being able to build your own or maybe a hybrid cloud environment where you have secure choices, such as Terremark, or Harris, or General Dynamics, which have built out cloud services that are very, very secure because they have the corporate qualification to be able to support some of our nation’s security.
Q: What advice would you offer those federal health IT shops that have been told by Vivek Kundra that they have to replace physical data centers with clouds?
A: First off, it seems like a tall order to replace a private data center with a cloud and put your applications in it. That’s a bridge too far. So begin by identifying mission constraints to help decide which option is best. Cloud is not a destination, it’s an architecture. They need to decide how to design in their constraints, be it security, mobility, agility, these things that they need to have just like when you design a house. I have four kids, so I can’t buy a house that doesn’t have five bedrooms. Understand constraints and needs and make sure you have the ability to deal with the future, in case my parents want to come back and live with me, that I can add on or have a house with that extra bedroom. The second thing I would highly recommend is figuring out where you are in the journey to the cloud. There are a lot of good design decisions that can be made that will help you get to your cloud destination. Basically, some customers very early in the adoption phase have not as sophisticated a design. The cost-savings are dramatic every step along the way, and you and me as taxpayers want federal health IT shops to take a practical approach to cloud computing because that’s where we get the biggest bang for our buck.
