This is the second installment in a 3-part blog series, discussing the opportunities that cloud computing offers in healthcare. I present futuristic scenarios from each healthcare contingent’s vantage point:   patients, providers and payers.     A myriad of technologies exist today.   It will be up to healthcare organizations of all types to get their data ready to meet the demands for data integration, security, portability, transparency and accountability in this brave new world.   Mature data governance systems and enterprise-wide data integration will be critical in this endeavor.

II:   Providers

It’s 11:30pm on a Sunday night, and I’m working a double shift in the Emergency Room.   It’s been a little slow tonight, so I’ve been online researching some reasons why we’ve been seeing more Somali children here recently.   The hospital keeps the latest demographic figures on the intranet.   Turns out that at first just a few families settled here, but more relatives are joining them and many of the children are orphaned.   When they came through immigration, though, they were given medical checkups and those records are available for each of the kids I have treated recently, since they were each given a universal medical record number.   I can see the results of any tests they had, and whether they were given any medications or treatment.   There’s also a public health database through CDCP that tracks the incidence of infectious diseases, and some primary prevention steps we should prescribe at the time we treat these kids.   It’s very helpful stuff.   I’m going to share what I learn through the local Health Information Exchange (HIE) with the social workers in the neighborhood clinics.

Whoa!   Suddenly things are picking up!   There’s a little old lady with severe dementia who fell and knocked out her tooth, and a teenager who got into a brawl with a black eye.   Where are his parents!?   First I try talking to the lady, but she’s confused.   At least she is wearing an ID tag, so I look up her name (Dorothy Xu) in the HIE portal.   She’s never been to this hospital, but I see that she has spent some time in a local nursing home, and was recently discharged to the care of Dr. Jones.   We start a new hospital record for her, instantly downloading the data from the nursing home and Dr. Jones’ office.   I also see that her daughter lives nearby and that her husband died less than a year ago, so I get her daughter’s telephone number and give her a call.   I’m surprised that the ambulance techs didn’t do this already, but they were making sure she didn’t have any other injuries.   When her daughter arrives, she has brought a list of all of Dorothy’s medications, and one of her favorite nightgowns.   I send an email requesting an urgent appointment with one of the dentists in her insurance network first thing in the morning, and then make sure she has a prescription for some pain medications to get her through the night.   Poor thing.   Also, I talk to her daughter about whether Dorothy has seemed depressed since her husband’s death.   I give her daughter a printout of some good psychiatrists in in the local area, and then she takes her Mom home.

So what about this black eye?   Jason is 15 and it looks like he already has a police record.   He refuses to talk to me, so we get his fingerprint and match it to his medical record.   He doesn’t want the police to know he was in another fight, but I’m going to have to call his parents to pick him up.   He seems concerned, but refuses to say anything more.   I scan through his chart and his Mom’s, and I see that she has also been treated for a fractured wrist and a black eye about 4 weeks ago.   Either this family is really clumsy, or something is going on here!   Apparently, a social worker at school also noted a few things in his record, and the pieces are beginning to suggest some family abuse problems.

When his Mom arrives, we talk privately for a few minutes.   I tell her I am concerned, but don’t really have very much information.     As we talk, she becomes visibly upset.   Eventually, she admits that her husband, who was recently laid off, has been taking his anger out first at her son, and also at her.   I ask if she needs any other assistance or resources, but she refuses.   So I treat her son’s eye and send them on their way.   I also make note in the husband’s record that he may have some history of abusive behavior, and I notice that he was recently in the hospital as a result of a car wreck.   At least this information will be available to the nurses in case they are treated here again.

Offloading disparate datasets to integrated Cloud servicers that will also perform basic analytics can greatly empower healthcare providers with ready access to data.   Remotely hosted Health Information Exchanges will empower social workers, schools and hospitals, even law enforcement authorities, to work together in assisting their local communities.     This is the profile of the new healthcare provider as a result of Cloud technology.

photo by dawvon via Flickr (Creative Commons license)

Carol Newcomb is a Senior Consultant with Baseline Consulting. She specializes in developing BI and data governance programs to drive competitive advantage and fact-based decision making. Carol has consulted for a variety of health care organizations, including Rush Health Associates, Kaiser Permanente, OSF Healthcare, the Blue Cross Blue Shield Association and more. While working at the Joint Commission and Northwestern Memorial Hospital, she designed and conducted scientific research projects and contributed to statistical analyses.