It’s time for healthcare to modernize its architecture

In the hyper-competitive world that is today's healthcare industry, organizations such as insurers, providers, service providers, suppliers, among others, need to become as operationally effective and efficient as possible.

Doing so can provide the kinds of processes and approaches that improve everything from patient health outcomes to profitability. Not doing so, however, can create a long list of technical and operational problems that can be difficult to recover from. That's why it's important for healthcare organizations to embrace the kind of technology architectures – application, data, reference, etc. - that provide the foundation for future innovation and growth. Cloud platforms like Microsoft Azure, recently used as a part of a consulting engagement for a healthcare company client, are a good place to start.

The reasons and advantages for moving to any cloud services platform are by now well-rehearsed. On-premise platforms and applications disadvantage healthcare organizations by their centralized, unresponsive, and inflexible nature, among many other negative attributes. Where once on-premise was desirable and advantageous, it has become one of the main innovations and technical impediments to modernizing a company's business and process capabilities. More specifically, the move to modern cloud platforms allows healthcare organizations better technology flexibility and responsiveness with the ability to efficiently mix and match large and small-scale data technologies for rapid scaling to meet shifting market needs.

Using Azure as an example of the kinds of benefits that a modern cloud platform can bring to the table. One of the bigger benefits may be that implementing and migrating to such a cloud platform can be the quickest way to move from inflexible legacy systems to the kind of platform that brings pay-on-demand processing and storage, and therefore better responsiveness to business opportunities. Additionally, Azure and other cloud platforms come with their integrated security infrastructure, automated self-management, parallel and asynchronous processing and are designed for elastic scalability. The platform also includes robust data handling, including automated backups and replication and self-healing capabilities for applications and data storage.

An important consideration when migrating to a platform like Azure is deciding on an architectural style. When architecting solutions in the cloud, several variables need to be taken into consideration early on as they will constrain which products are available. The first question that healthcare organizations need to answer is how much control over the underlying infrastructure does any solution require for optimal effectiveness. Control over the infrastructure can be both a blessing, regarding control and scalability, and a curse, in operational costs and the chance for human error. One of the industry drivers for migrating on-premises resources to Azure is the potential reduction of operational costs. One way to approach that is to implement a serverless architecture. By removing all non-managed infrastructure from the organization, any healthcare organization’s DevOps team can spend more time developing new solutions to new business problems instead of upkeeping unseen and expensive infrastructure. Of course, this comes at the cost of relinquishing financial and technical control over the underlying hardware.

Next, due to the stringent compliance requirements in the healthcare sphere, a sound security approach is required that can be integrated completely throughout the entire platform. While this can be a challenging task in most systems, Azure Active Directory's (Azure AD) full integration with many compute resources and Managed Service Identities (MSI), makes this much easier by essentially eliminating the human risk of accidentally granting security access via source control. MSI removes the need for any person to ever handle secure credentials within code or configuration when implementing new services. By combining Azure AD, Azure Compute and MSI, healthcare organizations can effectively manage one of the weakest links for security in any organization—their people.

Lastly, to reduce time to market and developmental complexity, a (micro) services architecture is a good approach for healthcare organizations. The main work effort in this kind of methodology is setting up a modular architecture where each piece of functionality is self-contained. Each module acts as a self-contained HTTP(s) service that can only access its private resources, rendering it agnostic to the rest of the system. Each module contains its own set of compute, storage and monitoring resources. A global orchestrator handles consolidating log and other data from each module into a central data repository.

Evan Hines Xby2 article diagram

The benefits of an Azure architecture, or any similar cloud platform approach, are many. In the case of Azure, there is a robust ecosystem of tools, integration points and communication services. There is also a strong community of architects, developers and DevOps specialists that have used and implemented Azure and are only too happy to share their experiences. That makes for a helpful and supportive community of experiences and perspectives to draw from. Beyond those benefits, such things as pre-built infrastructure and ease of scalability in real-time contribute to deployment speed and sustainability. Those are the kinds of things that lead to tangible business benefits like speed to market, new product implementation and efficiently onboarding customers.

While working within the unique constraints of any given cloud provider can be frustrating, Azure brings a powerful offering of products for creating secure and scalable healthcare analytics solutions. Also, even with the inevitable difficulties, a modern architecture will provide better performance, new Hadoop functionality for scalability, and reduced time to market - all while improving automation and reducing operational costs. That’s more than enough of a healthy payback of time, money and resources for any healthcare organization interested in improving operational and market performance.

Author Bio:
Evan Hines is a Software Consultant at X by 2, a technology consultancy focused on the practice of application and data architecture in the insurance industry. Hines specializes in healthcare data solutions, and he is a Microsoft Certified Professional (MCP) with a focus on data warehousing solutions. When not working in data, Hines concentrates on new cloud technologies with an emphasis on microservice architectures and distributed systems. Hines holds a BS in Mathematics and Computer Science from Wayne State University.

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