Pros, Cons, and Strategies for Implementing Healthcare Multicloud


Healthcare multicloud is becoming an attractive way for organizations to deal with the explosion of digital health data in electronic health records, connected devices, Internet of Things, and healthcare apps.

As more healthcare organizations embrace cloud computing, they are increasingly turning to a mixture of public, private, and hybrid cloud services and infrastructure. In fact, 90 percent of healthcare organizations plan to use multiple cloud vendors over the next few years, according to IDC Research.

While having multiple cloud vendors can give organizations more flexibility and redundancy, managing multiple clouds can be a challenge.

It can lead to cloud sprawl, unauthorized cloud use (known as shadow IT), disjointed cloud solutions, inefficiencies, and waste.   

What is multicloud?

Multicloud is the use of multiple cloud computing and storage services in a single heterogeneous architecture, according to Gartner.

Multicloud differs from hybrid cloud, which is the combination of public, private, and/or legacy cloud architecture. Multicloud refers to the use of a single type of cloud service, typically the public cloud, but organizations contract with more than one service provider.  

For example, a health system may have contracts with Amazon Web Services (AWS) for some of its data assets but also utilize storage or computing tools from Google, Microsoft, or IBM for other purposes.

Cloud Management Platforms Support Multiple Cloud Environments

Understanding Healthcare Multicloud Challenges, Requirements

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Healthcare multicloud: Pros and cons

According to Gartner, a multicloud approach offers a number of benefits to healthcare organizations: avoiding vendor lock-in, overcoming latency, mitigating risk, providing flexibility, and controlling costs.

With multicloud, organizations avoid the problem of being locked in to a single cloud provider. Using only one cloud provider could constrain growth if the provider is unable to meet the organization’s next-level needs.  

Organizations that engage with multiple vendors have the flexibility to choose the best options from among cloud providers. One cloud provider might be best at app storage while another might be better at hosting virtual machine instances. With a multicloud approach, organizations can mix and match the best cloud providers.

Because public cloud providers use geographically disparate locations, latency can also be an issue. Multicloud enables organizations to choose cloud providers that are closer to users and business IT systems, thereby reducing latency.  

Using multicloud, organizations can spread risk across multiple cloud environments, providing redundancy and improved disaster recovery.

In terms of cost control, a healthcare organization can select cloud vendors based on the best price for a particular service or capability.

At the same time, multicloud has some drawbacks, including the need to secure data in multiple storage locations, which could increase attack surface. 

A CISO responsible for monitoring multiple clouds simultaneously could find it an overwhelming task. The CISO and IT team may be less proactive about practicing good security hygiene, such as timely patching of vulnerabilities, leaving health data vulnerable to attack.

Providers also need to address legacy system integration with multiple cloud databanks, and may run into challenges with process and policy changes and employee training.

Legacy system integration can be a technical challenge in a multicloud environment, particularly integrating data from those systems. According to an MIT Technology Review/VMware survey of 1,350 C-suite executives and senior IT leaders at large companies in a range of industries that have adopted cloud, 62 percent of respondents identified legacy system integration as their biggest challenge.

A majority of respondents identified changes to processes and policies as major challenges in moving to and managing a multicloud environment.

Survey respondents also cited difficulties of finding, training, and keeping staff, especially through the stressful startup period of multicloud deployment.

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What is the best strategy for healthcare organizations considering multicloud?

Gartner recommends that executive leaders clearly define the main objectives for the organization in going down the multicloud path.

CIOs should decide which multicloud capabilities they need, such as single pane of glass management, which integrates information from different sources across multiple applications and environments into a single display; network connectivity; workload motion across clouds; cloud storage and archiving; identity federation; workload bursting; backup and disaster recovery; and application programming (API) integration.

“A multicloud strategy gives you a single pane of glass to identify and monitor the data in your various clouds,” explained Dave Dimond, chief technology officer and distinguished engineer at Dell EMC’s Global Healthcare Business.

“If you have something that ties all those threads together for you, then you can start moving workloads, see what’s available, and manage the temperature and flow of data. If you’re in IT and you have a service catalog, you can provision across multiple clouds based on policy. If you’re in research, you can manage the provenance of your data so it’s reproducible,” Dimond told HITInfrastructure.com.

Gartner advises that CIOs develop a multicloud strategy that addresses the following critical components:

  • Scope of the multicloud initiative: What cloud vendors does the organization currently use and what resources and applications are allocated to those vendors? What should the initiative achieve? Are there specific capabilities the organization wants to focus on? What are the potential problems implementing the initiative? Solutions?
  • Expected business outcomes: What are the key business benefits the organization is seeking in using multicloud? Which business outcomes/goals should be prioritized?
  • Decision framework for using public and private cloud services for new applications: Should new applications be developed and operated in the public cloud or private cloud? Should customer-facing web applications be placed in the public cloud?
  • Decision framework for existing legacy applications: Which legacy applications will be migrated to the cloud (public or private), reengineered, or replaced?
  • Management, security, and governance: Are there data security, governance, and regulatory requirements that may favor private cloud over public cloud? Will this depend on where the facility is located?
  • External provider evaluation strategy: What are some of the key strengths and weaknesses of vendors and how do these strengths and weaknesses fit into the organization’s goals in adopting multicloud? Should the organization employ a multicloud management platform vendor? Which one?
  • Investment required and timeframe/milestones for strategy execution: What core tools and platforms will be needed? How much will they cost? When will they be ready for deployment? When will specific tasks be completed and what is the final deadline?
  • Architectural standards and considerations to drive reuse, agility, and cross-cloud provider migration: What is the organization seeking in its future architecture? How does the organization best integrate applications, devices, and data in the architecture? What workloads will be moved to the cloud?

“A key aspect to be considered when defining a cloud strategy is how the users will securely reach the different IT environments allocated in different clouds and how different environments interact in a reliable way. A combination of private communication services to public clouds and co-allocation of clouds must be considered in order to achieve the goal of having a truly hybrid or multicloud environment,” Gartner noted.

ESG Research, in a report sponsored by HPE, analyzed organizations that are achieving multicloud success, so-called “transformed” organizations. Based on the analysis, ESG recommended that organizations considering multicloud deployment take the following actions:

  • Invest in converged/hyperconverged infrastructure (CI/HCI) for on-premises workloads. Most transformed organizations have deployed CI/HCI platforms in their environment to support legacy workloads, and many have done so for newly developed applications.
  • Automate IT operations so staff can focus on other areas. Most transformed organizations report that virtual machine provisioning, application deployment, and performance/problem monitoring are either completely or mostly automated, freeing up staff to focus on other initiatives like supporting application development or rearchitecting legacy applications.
  • Invest in cloud management tools. These tools manage and monitor cloud costs and give consistent capabilities and user experiences regardless of where a workload runs. Transformed organizations are twice as likely as other organizations to consolidate management under one IT team for public cloud and on premise resources.
  • Make informed workload placement decisions and be sure to optimize workloads before moving them to public cloud infrastructure. Nearly half of transformed organizations fully customized applications prior to migration.

How to Plan for a Healthcare Muilticloud Environment

Healthcare Multicloud Supports Unique Cloud Infrastructure

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Implementing a multicloud environment

As multicloud environments become more complex, healthcare organizations should consider a cloud management platform (CMP), which provides tools to configure, provision, monitor, and optimize multiple cloud services.

“Multicloud management innovators are assisting enterprise IT and DevOps teams in managing multiple clouds by supporting collaborative governance, automating provisioning using reusable, standardized process, tools, and SLAs, providing advanced, predictive performance analytics and capacity management, and streamlining chargeback, showback, and cost management activities,” authors of an IDC Research report on multicloud stated.

CMP providers can help healthcare organizations ensure that health data is secured across all cloud deployments. They also support cloud infrastructure configuration, application performance monitoring, policy management, log analytics, scheduling, migration, and optimization.

Gartner forecasts that the number of commercially available CMPs will more than double by 2021.

The market research firm identified seven functional areas to consider when evaluating CMPs: provisioning and orchestration; service request management; inventory and classification; monitoring and analytics; cost management and resource optimization; cloud migration, backup and disaster recovery; and identity, security and compliance.

The MIT Technology Review/VMware survey identified three time periods for multicloud implementation: first year, years two through five, and years six and beyond.

Organizations in the first year of multicloud adoption tend to be skeptical of vendor claims and worried about data security and privacy. They must confront more technical challenges than they anticipated, including data migration, integration with legacy systems, data management, data planning, data backup, and complexity.

Organizations in their second through fifth year face challenges with people and process changes, including changes to staff composition and data management and policies. At the same time, they begin to see the benefits of multicloud, such as increased efficiency by finding the best combination of cloud services at the lowest cost and automation through orchestration of data, applications, and infrastructure across different cloud environments.

Perhaps surprisingly, respondents said that multicloud provides strong data security and privacy.

Organizations in their sixth year and beyond emerge digitally transformed, with more agility and efficiencies.

Organizations in their final stage see benefits such as reduced costs, increased efficiencies, rapid deployment and updating, ease of scalability, increased agility, stronger data security and privacy, and improved app development and use.

These organizations are implementing new business processes, such as planning and project management, to level the new cloud capabilities. They take a cloud-first approach and are prepared for machine learning, artificial intelligence, Internet of Things, and other technological innovations.

“Cloud is making it easy for data to come out of silos. This lays the foundation for large scale analytics and AI to have a positive impact on medicine. There is a real hunger for seamless solutions that incorporate devices, data, and productivity experiences,” said Google Cloud Head of Product, Health and Life Sciences Joe Corkery

“The cloud is truly the only strategy that can create that intuitive environment for end-users while maintaining the high level of security required to make it work. I think we’re going to continue to see a huge push towards cloud as more and more organizations embrace machine learning and start viewing their data as an actionable asset,” he told HITInfrastructure.com.

Healthcare organizations are being overwhelmed by data, devices, and apps and disjointed, multiple cloud services. Well-heeled multicloud can provide a unified cloud model that provides greater control and scalability at reduced costs.

Healthcare leaders should take a measured approach to deploying multicloud to ensure that having multiple cloud vendors doesn’t lead to cloud sprawl. A well-thought-out strategy and a trusted cloud management platform provider are essentials for multicloud success.

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