Joanna Smith, CIO at Royal Brompton & Harefield NHS Foundation Trust and ranked 34 in the 2017 CIO 100 list, has embraced the cloud at her trust. Key results from taking a cloud-first approach include reducing the number of physical servers by around 50%, moving several clinical systems on to the cloud, the provision of disaster recovery as a service, and a lower total cost of ownership of key IT services across the entire trust. She notes:
The ability to rapidly provision services is a huge advantage of the cloud. For example, we can have a server up and running within an hour, with benefits for clinical end users; for example, we set up a new clinical laboratory system to support a new genetics service quickly and easily, without the need to go through lengthy specification processes. The IT function can now start to focus on more value-add opportunities rather than routine day to day tasks.
We can respond quickly to organisational requirements, and support productivity and transformation programmes. Using the cloud means I no longer have to spend a lot of time on issues such as capacity or storage to support these efforts. Now I can focus on how digital will solve the problems the organisation faces.
We are using the cloud to transform our disaster recovery function. We have around 50 million records on a hybrid cloud. We can recover files in under an hour, using a disaster recovery as a service (DRaaS) approach that is delivered at a cost of around £10,000 per year. We can switch on our development and training environments when we need them, rather than having to maintain and pay for these around the clock. Services can be much cheaper, with true cloud providers up to 10 to 20 times cheaper than other hosting providers.
The cloud can help the wider NHS as it moves to more integrated care; organisations that are combining functions may want to decommission or adapt services quickly. The cloud makes this change easier and more straightforward. Information sharing and collaboration can better be supported by using a single platform, rather than multiple different systems.
It does not make sense for NHS organisations to manage their own data centres. The cloud can provide the system-wide infrastructure that can underpin key initiatives such as integrated care. I worked in pharma, and there was a drive for data centre consolidation some years ago. For many reasons, healthcare has not traditionally made such similar investments in infrastructure over time. However the arrival of the cloud means it now leapfrogs the data centre consolidation process that other global industries have gone through and look towards a single infrastructure. We can go from mailboxes with 100Mb of storage to ones with 100Gb.
Technology is evolving, as it has always done. It can be easy to stay with what you know in terms of the technology you use. However the cloud presents an opportunity on which we need to build. The cloud means IT staff may have to do things differently, which can bring about concerns. However whilst the cloud may require some new skillsets, this does not have to mean new staff; it’s a great opportunity for existing staff to acquire new skills and capabilities. The knowledge and experience of existing staff is still vital in helping drive forward NHS IT. By supporting staff with these new approaches, we can all help deliver the benefits of this technology.
Each healthcare organisation is different, and will have different experiences. But I think the more normal using the cloud becomes, the more we will break down barriers and realise the full potential of this exciting technology.