In this day and age, you can easily share photos through Dropbox, notes in Evernote, or spreadsheets via Google Drive with anyone. But good luck helping two doctors at two different hospitals to see the same patient records online. Instead, when a patient goes to a medical center for the first time, they often have to repeat tests they've undergone before—such as a computerized tomography (CT) scan, which uses X-ray technology to produce cross-sectional images of the body.
"The holy grail of medical informatics right now is to have a cloud-based place where patients' info can live," says Dr. Alexander Baxter, an assistant professor of radiology at NYU who practices at Bellevue and NYU hospitals in Manhattan. "So that if you go to one hospital, and you get a CT scan and you go to another hospital, you don't have to get the same CT scan again. This happens all the time at Bellevue." That doubles the cost and the dose of radiation.
GE Healthcare just introduced its candidate for that holy grail: a service called GE Health Cloud that will link up medical devices around the world, process the data, and store patient records securely online so they can be viewed from anywhere. The company, which promises Health Cloud meets U.S. HIPAA privacy requirements for healthcare records, is launching the new service in late spring of 2016 with radiology devices like CT, ultrasound, and MRI scanners, and starting off with 500,000 of GE's machines. The company plans to expand the service to cover other aspects of healthcare, says Jan De Witte, president and CEO of GE Healthcare IT.
Health Cloud is the first industry-specific project using GE's new Predix Cloud for connecting and mass-processing data from industrial machines online. Health Cloud promises not only to allow people to access radiology records from anywhere (even on mobile devices), but also to pool resources from GE's 400 computing centers to crunch data radically faster than the desktop computers that hospitals are currently using.
That could save time and money—and could also save lives, says De Witte. A patient with an ischemic stroke—a clogged blood vessel in the brain—can often survive without major damage if diagnosed and treated within three to four hours, says De Witte. But an important diagnostic tool that turns CT scans into a 3-D animation of blood flow can take four to five hours to render on a desktop computer. Health Cloud can do the same job in five minutes, he says. It also gives doctor's more flexibility. "You can let loose two or three algorithms on the same data set, where before you could only do one," says De Witte.
Health Cloud isn't limited to GE devices, says De Witte. It may not be so easy to overcome rivalries, though. "What all these [radiology] companies want to do, as far as I can tell, is dominate a single hospital, so that everything they buy is from GE or Siemens or Toshiba or…Philips," says Baxter, who has no affiliation with any healthcare equipment or software companies. Signing on to a rival's cloud service and making devices interoperable won't necessarily serve this goal.
One thing in GE's favor: The bar for UI design isn't set very high in the medical record world, according to Baxter, who notes the frustration he experiences with electronic health record systems from companies such as Epic and McKesson. "These things were invented to justify billing for medical procedures," he says, "and their interface is terrible, just appallingly bad." For example, he usually has to navigate past tons of unimportant nursing notes just to get to the specific record he needs.
Currently, it's also a hassle to view scans from other hospitals, even when a patient is lucky enough bring him a copy on CD, since each scan requires its own proprietary viewing software. "Every time I look at [the records] I have to figure out how to operate [the software], and I've never seen it before," says Baxter.
GE promises to avoid this problem with Health Cloud by making data available in standard formats such as the DICOM image file (radiology's version of a JPEG) that any company's software can read. The cloud-based apps (made by GE and third parties) will be viewable in any web browser without requiring special software. Health Cloud will also be accessible in apps for Android, iOS, and Windows mobile devices.
De Witte says that medical centers will pay for Health Cloud either per item, such as for each 3-D rendering, or subscribe to a volume of activities, like a certain number of scans uploaded per month. He claims Health Cloud will more than pay for itself due to savings on purchasing and running computing systems in each hospital. And the service brings high-end computing power to smaller facilities that can't afford to buy their own equipment.
Health Cloud also allows these satellite centers to bring in experts from major hospitals in the same network. In the U.S. especially, hospitals are moving to a hub-and-spoke system, says De Witte, with specialists in the main medical centers on call to assist teams at the smaller facilities.
Medical centers can keep copies of data on their local machines and also download it from Health Cloud at any time, but De Witte envisions them increasingly moving everything to the cloud. That raises the issue of reliability. As any company that runs on Amazon Web Services or other outsourced IT systems knows, cloud outages happen. "You really need to have enormous reliability and redundancy for these things," says Baxter. "No one is going to want to hear, oh our system is down, you can't get anything for the next five hours."
GE is yet to specify the level of reliability it will guarantee its clients, though De Witte says he expects it to be at least 99.9%. He boasts that GE can do a better job than a typical hospital can. "The argument to the CEO of a hospital is, do you really think that the server that's running in your basement has a better performance, has a better uptime, and has better cybersecurity than the cloud services you can buy from big, capable cloud operators?" he says.
Baxter calls Health Cloud "a good idea," and says that GE is a capable company. "They are quite good. They have a lot of money and good engineering." But getting enough medical centers to sign up for the service will be a major challenge. "One hospital may want to pay for it, another may not want to pay for it," says Baxter. "Unless you have something that all hospitals have to connect with, by law, it's very hard to imagine any kind of a cloud system working truly well for all people in America
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