The latest issue of ON Magazine describes use cases for three early "cloud adopters": the National Business Center, Hill Air Force Base, and Beth Israel Deaconess Medical Center (BIDMC).
In particular I learned a lot from the BIDMC use case. John Halamka is the CIO at BIDMC and in the article he sheds a good deal of insight into the transition from a static and rigid medical data center into a more fluid and dynamic private cloud configuration.
The previous configurations at BIDMC were not virtualized; medical applications ran on servers that were directly connected to clustered storage. This configuration was becoming problematic due to the
".....strict ties between an application and the underlying servers and storage systems on which it runs".
The "strict ties" of medical applications to their data center infrastructure results in a fairly familiar set of problems:
- MDs experienced difficulties connecting to this infrastructure in an anytime, anywhere fashion.
- Upgrading the server infrastructure required application downtime and/or reduced server availability.
- Increasing clustered storage capacity and making it available across medical applications was labor-intensive and error-prone.
BIMDC decided to build their own "medical software-as-a-service" private cloud infrastructure that uses the following building blocks:
- They deployed electronic medical records software from eClinicalWorks. Instead of doctors connecting directly into a physical server environment, they now securely connect into a cloud via their web-connected tablet PCs.
- The centralized IT server infrastructure for their private cloud is provided by VMware. IT administrators can easily move, power up, and power down these VMs while being much more abstracted from the deployed server hardware.
- The server infrastructure sits on top of an EMC Storage Area Network (SAN).
When a new revision of eClinicalWorks came out that required more memory and storage, the IT department spent $30,000 on the upgrade, saving an estimated $270,000 in the process.
Public Cloud Futures
One of the more oft-advertised capabilities of private cloud is the ability to convert to a hybrid or public cloud model. BIMDC is not only well-positioned for this possibility, but they are anticipating that federal stimulus funding will drive their cloud to be more public very quickly:
"The Obama administration wants 90 percent of all clinicians and 70 percent of hospitals off of paper by 2011—and has designated $44 billion in stimulus dollars as a bit of encouragement."
“One of the things you’ll see coming out of the Obama administration is a real sense of urgency for sharing data—with patient consent, of course—doctor to doctor, doctor to public health agencies, to immunization agencies, to quality measurement organizations. So a lot of our work will be about building more connectivity so the data that’s in the cloud can be shared, clinical care coordinated, errors reduced, and—because public health will be involved—detection automated.”
By building their own private cloud and allowing internet accessibility to medical records, BIMDC is well positioned to not only share or merge their private cloud with trusted third parties (thus making their cloud more "public"), but their choice of VMware could allow them to VMotion portions of their infrastructure to another cloud.