This Week Health

The battle for patients is heating up. Accenture has some research on how to keep them at your health system. https://www.accenture.com/content/dam/accenture/final/industry/health/document/Accenture-Humanizing-Healthcare-Experience-Payer-Provider-Health-PoV.pdf

Transcript

   

Today in health, it. Why we are leaving the cloud. My name is bill Russell. I'm a former CIO for a 16 hospital system. And creator of this week health instead of channels, dedicated to keeping health it staff current and engaged. We want to thank our show sponsors or investing in developing the next generation of health leaders, Gordian dynamics, Quill health tau site nuance, Canon medical, and current health. Check them out at this week.

Dot com slash today. If you get a chance, we have a webinar coming up, not this Thursday with the following Thursday. It's about cyber and security. And it's really about the whole concept that a cyber is now a patient safety issue. And we're going to take a look at a study , in fact, I think this Friday, I'm going to take a look at that actual study and talk about

rd,:

And we are going to touch on that today. And the story is base camp. So why we're leaving the cloud base camp had one foot in the cloud for well over a decade. And Hey has been running there exclusively since it was launched two years ago. We've run extensively in both Amazon's cloud and Google's cloud we've run on bare virtual machines. We've run on Kubernetes. We've seen all the cloud has to offer and tried most of it.

It's finally time to conclude renting computers is mostly a bad deal for medium-sized companies like ours. With stable growth. The savings promised is reduced in reduced complexity. Never materialize. So we're making our plans to leave the cloud excels at two ends of the spectrum. Where only one. And was ever relevant for us. The first end is where your application is so simple and low traffic that you really do save on complexity by starting with fully.

Managed services. This is the shining path that Heroku forged

and the one that has since been paid by render and others, it remains a fabulous way to get started when you have no customers and it can carry you for quite. A long time can carry you quite far. Then later be faced with a good problem. Once the bill grows to a stratosphere, as you should as picks up, but that's a reasonable trade-off.

The second is when your load is highly irregular. When you have wild swings or towering peaks and usage, when the baseline is a sliver and your largest needs are great. Right. Or when you have no idea whether you need 10 servers or a hundred, there's nothing like the cloud. And that is awesome. But when you're right in the middle,

Creates a problem. So he goes on, but neither of these two conditions apply to us today. They never did for base camp yet by continuing to operate in the cloud, we're At times almost absurd premium for the possibility that it could, it's like paying a quarter of your house's value for earthquake insurance.

When you don't live anywhere near a fault line. Yeah, sure. If someone, if somehow he quake two states over opens up. In the earth so wide, it cracks your foundation. You might be happy you have it, but it doesn't feel proportional. Does it? All right. So this whole argument, and by the way, I could go on it. It talks about the particulars. It talks about some of the financials. It's a pretty interesting article.

And I don't read it. , and by the way, you can find it at a world dot, Hey. Dot com H E y.com. And it's why we're leaving the cloud. And this is base camp. It's an application provider. , To say it's this project may it's project management is not the right cat, but it's in that genre of project management.

Type categories and it's cloud-based and, , available anywhere. And so they're looking at it saying, look, we're right in the middle We don't, we don't scale up and scale down very quickly. , we are paying for the features of the cloud that we're not necessarily using. , I would argue well anyway, I'm not going to argue just yet.

So they're saying it was good when you're starting up. It's good. When you have irregular workloads, we don't have either of those, therefore we're paying a premium. For things that we're not using. All right. So that's their case. That's their argument. What's my, so what my, so what to start with is you always have to be evaluating this and when you say we're moving everything to the cloud, I think that lacks, , intellectual rigor.

, not everything should be in the cloud. Some things work great in the cloud. Some things don't work well in the cloud and you have to evaluate those things and determine what makes the most sense. And he's right. There's an awful lot of things that belong in the cloud. For reasons like scalability, you need to scale up and scale down very quickly.

, there's other things like access to certain tools that you're not going to either have the expertise. , or the wherewithal to install in your local environment. And so you're going to move some things up into the cloud, maybe some data and some, , This is some workloads that you can get to programmatically, , to access AI, machine learning and other advanced technologies that you're not going to have in your local environment. So you have those capabilities that you want to get to. I think the other case for it is when you

, distributed very distributed, , workloads. For instance, if you're trying to scale up around the world. , building out this environment for the world might be easier going across AWS or Microsoft's. , cloud services or Google's cloud services, then trying to spin that up in, , eight to 10 regions around the world.

So, , so anyway, Th those, those are some of the cases. My biggest. So what here though is, , you have to use intellectual rigor around each one of the workloads to look at it and say, does this make sense? It doesn't make sense to potentially park terabytes of data up there, unless you're doing something with the data that requires you to be in the cloud.

Right or unless it creates a capability. That you need as a health system, maybe there's a Dr. Business continuity capability that you need. So having it in the cloud makes sense. But you have to determine that, just parking it up there as an alternative to parking it locally may not make any sense whatsoever.

You really have to weigh those. This is what the cloud brings. , because with the cloud does come a premium you're paying for that service. You're paying for the ubiquitous nature of it. The ability to get to it programmatically, the, the ability to scale up and scale down. , the security frameworks that th that they do offer you around that you're paying for all of those things.

And the question is, does that workload, does that application. , does that environment require those capabilities? And if it doesn't. You may look at it and say, this doesn't make sense. In fact, when we were looking at our cloud, Migration back in, , I dunno, 20 14, 20 13, and 14. , we had a matrix and the matrix was

And not the matrix. We had a matrix. That we put all the applications through and determine which ones would make the most sense to put up in the cloud. So that's what I'm, , that's what, I'm a proponent of. That's what I'm really pushing here is to say, , , moving everything to the cloud may make sense and it may not make sense, moving some things to the cloud.

, may and may not make sense and using multi-cloud may or may not make sense. You really do have to look at the characteristics of the cloud, the, the, , requirements of the workload. That you are trying to deliver on. And the benefits to the organization. Or the downsides to the organization. As you move forward, you could be saddling the organization with a very serious.

Bill. , moving forward. And as you guys know, I'm a huge fan of the cloud. I believe it has a lot of potential and a lot of things that we can do with it. And I believe that we should be looking at it very seriously for a lot of different workloads, but I also think we need to. , utilize our. I keep saying the word intellectual rigor. I think what I'm saying is use your head.

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Gordian dynamics, Quill health tau site nuance, Canon medical, and 📍 current health. Check them out at this week. health.com/today. Thanks for listening. That's all for  

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