by Scott Whyte
Advisory Board Member
This is the first in a series of essays for healthcare business, clinical and IT leaders exploring IT trends that will affect their strategy, execution and bottom line.
Business, clinical and IT leaders in healthcare are pressured by an increasing need to strategically innovate due to cost and quality pressures, as well as the entrance of digital disruptors into healthcare. Whether you are a payer, a provider, life sciences or health IT solutions organization, you are facing increased competitive and cost pressures coupled with decreasing reimbursements, and mounting pressures from regulators. With all of these pushing and pulling at your bottom line, you and other business and clinical leaders need to implement change very quickly, making it necessary to move away from implementing big monolithic software changes as had been done in the past. The market now requires changes to be smaller and faster. Change management today means designing your business logic to continuously adapt to a changing marketplace rather than be tethered to systems and infrastructures that take months or years to pivot.
This change to faster, smaller change implementations has already taken hold in other industries. Now it’s healthcare’s turn to ask “How do we make computer applications more adaptable, make developers more productive, and continue to update our systems without having to bring the whole system and all the users down with it?” The answer that has surfaced is this: microservices. Developers use microservices to break up applications into smaller pieces or components. The immediate advantage to business leaders is one small component can be updated quickly, without having to take down the whole application, thereby reducing down time and also make the roll out of new features or bug fixes much faster and more effective.
In the past, moving fast was difficult because you would have to have someone (or multiple team members) dedicated to understand the dependencies within your app, the Operating System (OS), libraries, etc., all of which required frequent patching and maintenance of the OS and other infrastructure components. With microservices, you can take those interdependent pieces and put them into a container, or box, with the needed libraries and move the whole box together. With continuous deployment you need to make sure all of these pieces move together, and containers make that possible. Imagine you were moving overseas for a new job and you wanted to bring everything in your condo. Rather than sending dozens of independent boxes overseas, it would be more effective to put all of these interdependent smaller pieces into one container and ship it. It’s loaded quickly and unloaded quickly, and the pieces that need to be together stay that way.
But as containers have gained in popularity and become more widespread, there is a need to coordinate their timing and implementation. Enter Kubernetes. Earlier this year you may have thought it was a buzzword that would pass, but it’s not just buzz…it’s smart business. Here’s what you need to know about Kubernetes: It is a container orchestration tool. It makes sure all of these containers can be put in place, maintained easily and properly, and work together across clusters of servers.
The name Kubernetes is the Greek word for helmsman of a ship. We’ve all seen container ships in ports – this is essentially the job of Kubernetes, to understand what each container has in it, where it’s going, and when.
For example, if you are a business leader within a payer organization, you might have an application that services providers as well as an application that serves your members. With Kubernetes, you can implement and enhance these apps more quickly, while also increasing their resilience, making them less likely to fail. And, if the app needs to expand, you can scale much faster, adding storage and memory extremely fast. There are also security benefits: you don’t need to patch for vulnerabilities. Instead, you can regularly refresh the system by applying a new app and OS instead of having OS dependencies where you have to keep patching. And if you discover a flaw, you can easily shut down a container and create new ones out there so there’s less exposure and vulnerability.
From the cost savings perspective we all must address these days, Kubernetes lets you have less personnel dedicated to system administration, less people who are either coordinating or managing patches, and less worry about whether your OS and utilities are working compatibly together. This provides you with a coveted business advantage – the opportunity to shift your resources and personnel to things that impact your customers. It is game changing when you get your business to a place where you can use your resources to innovate and enhance your business rather than using resources to maintain your operations.
Additionally, with Kubernetes you aren’t tied to a single type of hardware or a single type of cloud. Founded in the open source movement, Kubernetes was designed to be portable across on-premise, private cloud or the public clouds. It can be moved, which means you as a business leader aren’t being held hostage by your infrastructure. Want to switch clouds or go multi-cloud? Kubernetes is packed and ready to make the trip with you.
But like so many solutions developed in technology, Kubernetes was developed horizontally to serve multiple industries, and out of the box Kubernetes is not going to have all of the specific security, privacy and compliance configurations it needs to address healthcare’s complex regulatory environment. That’s where ClearDATA’s healthcare exclusive, HITRUST certified expertise comes in. ClearDATA has conducted significant analysis on microservices in the healthcare vertical, and can provide an environment for Kubernetes that is HIPAA compliant. This can include being able to encrypt data at motion and at rest, meet healthcare’s stringent logging requirements, as well as being able to trace PHI across microservices.
We have several customers using Kubernetes. One offers an extensive EHR for physician services and also has secondary portals for patient services and for providers. With Kubernetes they are able to quickly make changes to their portals, making their application more resilient. They can also roll out upgrades across their infrastructure with zero downtime.
Another recurring scenario is that of mergers, acquisitions and consolidations – an ever- increasing event in healthcare this year. Rebranding or reskinning an application after a merger can be costly and time consuming, unless you have compliant microservices, containers and Kubernetes. With Kubernetes, you can isolate the components of the app to change the way you authenticate users or reskin the app to new branding, all while maintaining the underlying business logic of the app.
As your IT team brings you into discussions about Kubernetes, I hope you can use some of what I shared here to join that conversation to help inform the unique business advantages Kubernetes can provide to your organization. Additionally, ClearDATA can provide the expert third-party support you’ll need to make it all come together, in a secure compliant environment.
You can learn more about Kubernetes here.