Floating in the cloud

1 February 2013

KATHY HOLLOWAY answers the question: just what is cloud computing again?

Cloud computing – what is it and how do you use it? If you use Facebook, Twitter, iTunes, or Hotmail, you are a cloud computer user already. Should you have concerns about this?

Cloud computing conjures up images of large chunks of computer information sitting in space somewhere just waiting to be accessed. Interestingly, the term “cloud computing” is thought to have arisen from the diagrams of clouds used to represent the interaction of mainframe computers and terminals in textbooks in the 1950s.

What is it really? Rather than clouds in space, data – including applications – are, in fact, stored in ‘server farms’ (warehouses) primarily in wealthy, cooler parts of the world far from floodplains and flight paths. Primarily these are in the United States and Europe, although there is growth in facilities in Asia and Australia. The underpinning purpose is to give the user with internet access connection to anything, anywhere, and at anytime.

How would you use it? Consider the Dropbox store and sync service (free to download) as an example. There are around 50 million users saving one billion files every couple of days on the cloud servers. All of that data is encrypted and kept on Amazon’s Simple Storage Service in multiple data centres (aka the cloud) across the US. The idea is that you work away on your PC at home normally, but every file or folder you link to Dropbox is automatically and constantly backed up to a Dropbox server. Make changes to a document worked on by any another device linked to the specific Dropbox account and that version now becomes the version accessible on your desktop PC. This is excellent for group projects where you can all be certain to be working on the latest version of a project document.

What are the applications for healthcare? The electronic health record (EHR) is potentially a strong user of cloud computing, with as many as 20 per cent of US health service providers predicted to be utilising it to store data by 2017. Healthcare support software is frequently being marketed through a cloud solution rather than individual practices investing in hardware infrastructure.

Being able to access your health records wherever and whenever in the world you are has potential benefits for efficient and effective healthcare treatment. Currently, the New Zealand National Health IT Board (2012 position statement) requires that all New Zealand health information is kept onshore unless an exemption is granted. There is also a New Zealand government cloud programme (http://ict.govt.nz/gcio/gcio-news/government-cio-announces-new-zealand-government-cloud) that seeks to provide a national cloud solution for all of government.

What are the risks? Most information that is stored in clouds is not sensitive or valuable to anyone but ourselves (regardless of how interesting we think we are!) and is therefore safely protected by normal security measures. Healthcare data, however, has specific legal and regulatory requirements such as security, confidentiality, availability to authorised users, traceability of access, and long-term preservation. Cloud computing health data providers must demonstrate their ability to meet requirements for privacy and security through encryption and protection of any health data. There are a few cases in the US of cloud-based health information privacy being compromised, which suggests the process is not yet perfect.

The bottom line is that your privacy (in healthcare and also in any social media) requires that you understand the risks and evaluate the mitigations whenever you are placing your data in another’s hands – for with awareness comes informed choice. ✚

Dr Kathy Holloway is dean of the Faculty of Health at Whitireia Community Polytechnic.


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Free open access e-journal - BMC Nursing


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