Tips for multicloud public health IT operations
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Preparing data, applications and staff for a multicloud environment is critical to maintaining a secure, integrated public health IT ecosystem, experts say.
The future of public health IT may depend on multicloud solutions.
Major benefits of a cloud ecosystem include cost containment and scalability, allowing public health agencies to focus on paying only for services they use, said Jerry Britcher, chief information officer at Washington state’s Health Care Authority (HCA), at the 2023 State Healthcare IT Connect Summit in Baltimore.
A proper implementation plan will set agencies up for success. An ideal starting place is with cloud solutions authorized by the Federal Risk and Authorization Management Program, or FedRAMP, and those services that already have vetted security controls, said John Harding, senior vice president of managed services at CNSI, a health care management solutions company. But agencies should further configure their systems to ensure the health data they handle is properly protected and complies with privacy laws such as HIPAA, he added.
Over the last four years, Washington’s HCA migrated its Medicaid management information system (MMIS), a platform public health agencies use to administer Medicaid-related benefits. The new service, called ProviderOne and operated by CNSI, streamlines payment systems for Medicaid and other health care provider claims.
HCA has implemented a variety of cloud platforms including AWS Public Cloud, Azure, Oracle Cloud Infrastructure, Oracle Cloud at Customer and others, Britcher said. Its multicloud ecosystem has 18 modules and subsystems that are integrated via automated interfaces with other state programs such as the Department of Social and Health Services’ automated client eligibility system, he said.
One way agencies can take advantage of cloud’s potential is to make existing applications cloud-native so they can run on any cloud service—not just one, Harding said.
Additionally, agencies should consider “architecting upgradability” when building cloud environments by breaking down modules into smaller pieces. That way, customers can choose which services they use as well as add or remove services without having to tear up the front-end applications, he said.
Finding the right cloud involves agencies determining their data load and what it could cost to manage a large number of data exchanges, Britcher said. That’s where cloud’s autoscaling features can give agencies a leg up.
“With a cloud-based environment that you build with autoscaling.… You can grow when you have peak usage periods then shrink it back down, which helps manage costs,” Britcher said. Another way to reduce expenses is to leave some data flows behind. For example, a closed-circuit TV system gets no value from the cloud, so it makes more sense for it to remain on-prem, he added.
Despite initial hesitancy, HCA was able to transition to multicloud with its existing IT staff. A change management framework can help leaders plan a response to resistance from staff who prefer to “stick to what they know,” Britcher said. For example, employees may prefer a lift-and-shift approach, but agencies should look for cloud-based tools that can make the migration process more efficient at a lower cost, he said.
Some companies such as AWS offer no-cost training to upskill staff, which allow people to develop cloud skills at their own pace for a smoother migration, he said. For the HCA migration, when all was said and done, no employees left, and no new staff members were needed.
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