Nicole Allan, global solutions director, argues there are many benefits to moving to cloud hosting with AWS; as some of Orion Health’s English and Scottish customers have already discovered. 

What is cloud hosting? 

Cloud hosting is not a new concept but, to recap the basics, it’s about using shared servers on hosted infrastructure to deliver data to multiple, internet connected computers or devices. There are several benefits to doing this. One that is gaining in importance is that cloud computing has a role to play in supporting efforts to address the climate crisis. 

The big, commercial cloud providers have done a lot of work to find ways to power their data centres using renewable energy, and they tend to run their servers at full capacity. If you are running servers on-premises, it can be hard to turn on and then turn off test and deployment environments. In the cloud, it is easy to spin them up and dial them down again, which delivers a significant efficiency saving. 

What are the benefits for Orion Health customers? 

The direct benefit to our customers is two-fold. The first is uptime. If a server goes down, no capacity or information is lost, because we can spin up another server to replace it at need. That’s much harder to do if software is hosted on-premises, because it takes time to get new infrastructure in place. 

The second is scaleability. Cloud hosting makes it much easier to put our applications into the hands of new users, and that’s important for our shared care record customers as they look to extend their reach to new areas, such as ambulances or community services or the high street. 

As an example, the Care and Health Information Exchange in Hampshire and the Isle of Wight has been able to roll-out to care homes by giving their staff access over the internet, with identity handled by the kind of two-factor authentication that we’ve all become used to in banking and retail.

Who is Orion Health’s cloud partner? 

We have a partnership in place with AWS. We will work with other cloud providers. If one of our customers has a cloud partner in place, we will work with them. But we feel our customers gain a lot of additional benefit from our partnership with AWS, in the form of consultancy, and access to cloud-based tools and reporting. 

Are there UK customers on board already? 

The Care and Health Information Exchange is hosted on AWS, and all of our recent

shared care record deployments have been on AWS. That means the new customers we welcomed as part of the government’s drive to get a ‘basic’ shared care record in place at every integrated care system. 

Derbyshire, Cambridge and Peterborough, and Devon and Cornwall, which has just been picking-up press attention for its go-live are all hosted on AWS. In Scotland, the North of Scotland Care Portal has moved onto AWS; and we’d love our other customers to follow suit. 

Why has the NHS been slow to adopt cloud computing? 

Cloud computing, and internet-first access to IT systems, has been government and NHS policy for a long-time, but there are some practical challenges. Everybody who works in healthcare technology is aware that they are handling critical patient data, and that it has to be handled exceptionally carefully. 

Until quite recently, I think that some NHS organisations felt that having their data hosted on-premises was safer, but there has been a growing recognition that cloud hosting can deliver uptime and security benefits. Against that, there is a lot of sunk investment in NHS IT infrastructure, and it can be difficult for organisations to move away from that. 

What are the drivers for the NHS to adopt cloud computing now? 

As I mentioned earlier, the big drivers are up-time and scaleability. Traditionally, shared care records have been supplementary systems; something that clinicians use alongside their core patient records. 

Now, they are becoming more important, as they are extended to 24/7 services used to underpin joined-up care initiatives and integrated care pathways. That means they need the same kind of up-time as other electronic patient records and cloud hosting is one way to help guarantee that.   

Also, going back to the sunk infrastructure point, organisations are finding it harder to find the capital and staff required to maintain systems on-premises. Customers can secure economies of scale by moving to the cloud. For example, instead of having to run their own SQL server, they may be able to share one with a neighbour in the cloud. 

They can also give staff the chance to use or learn new skills. Many leading companies use AWS.

This,  opens up new avenues for recruitment, or enables existing staff to do interesting things that could also help them in their future careers. 

What is the future for cloud computing in the NHS? 

We are encouraging all of our UK customers to move to AWS and to upgrade to our latest technology stack at the same time, because we have done a lot of work to make it run really well on the AWS platform. 

That way, if a customer wants to bring on another 1,000 users, we can do it really quickly. Whereas, with traditional infrastructure, it is going to take weeks or even months, particularly if there is a procurement to run and lots of training to be done first. 

I think that our UK customers get the argument, because I’m hearing fewer and fewer negatives about moving. It’s finding the resources and making the time to make the switch that seem to be the barriers. Increasingly, everybody gets the benefits. The challenge is getting it done.