Originally published August 28, 2018 by Elizabeth O’Dowd at hitinfrastructure.com

“Healthcare app development should be developed with privacy, security, and compliance in mind,” says ClearDATA’s Chris Bowen.

 – The evolution of healthcare IT still poses challenges for organizations going through digital transformations. As applications and continue to develop, organizations are looking to new methods and partners to get the most out of their healthcare app development.

“The idea that now software development can move into the cloud and offer new capabilities is moving to the forefront,” said CloudCare CTO Josh Siegel told HITInfrastructure.com. “Frankly, it’s a change that needs to happen.”

Organizations now have a clearer opportunity to use the cloud for developing and deploying applications because of the way it has evolved. The healthcare cloud customer base is more comfortable with the way enterprise IT controls have standardized around cloud technology, according to Siegel.

“New tools need to be taken advantage of,” said Siegel. “If you’re staying on the same technology set, like the large monolithic database that is a traditional web server, the type of solutions and innovations that are going be powered by machine learning and predictive analytics will run against each other.”

The flexibility of the cloud is one of the things that prevents applications and tools running against each other, as well as the scalability to expand as a health system grows bigger.

“The cloud enables healthcare organizations to expand,” ClearDATA Founder and Chief Privacy and Security Officer Chis Bowen told HITInfrastructure.com. “They can expand quickly within a week instead of going out and procuring their own data center and filling it with equipment they own.”

“What we’re seeing is faster and more secure deployment,” he continued. “If you look at how a customer or software provider would deploy, they don’t necessarily go hatch a server like they used to. Instead, they may tear down 1,200 servers or virtual servers within a night and have them re-deployed the next day with a whole new set of functionalities. The deployment of software is different now.”

Organizations can use healthcare cloud service providers to add automation and safeguards into a multi-tenant data platform. This platform aggregates data from across multiple systems including payer data, pharmacy data, clinical trial data, so organizations can build software on top of that.

The more familiar an organization is with the cloud, the more they are able to innovate up the stack on their own in their own development shop. This gives them flexibility if their needs begin to change.

“Development became more automated to where we now have innovation around what we call a continuous deployment or continuous integration strategy,” Bowen explained. “Developers can push massive enhancements very quickly using their productivity expense cycles and the edge on technologies.”

Healthcare software development also depends on the maturity of EHRs.

“The level of sophistication medical providers have around what EHRs tools are capable of doing has caused them to have seen two or three different versions of the software,” said Siegel. “They have ideas on how things can be accessed and used.”

CareCloud and ClearDATA are trying to allow provider groups to use what’s available through open API standards. These data standards can help organizations develop more customizable apps.

“We’re really trying to meet the technology capability of our users and customers,” said Siegel. “We want the developers to be able to pick up where our software leaves off because the data is available or interoperable so they can add that next layer of customization. It’s very domain specific and it might solve a very narrow problem, like asking particular follow-up questions through a patient engagement application.”

“That’s not necessarily something that makes sense as a commercial product on its own,” he continued. “But if you have the data and you have the idea that IT and development is a resource that can be cultivated by healthcare organizations; now there’s a vehicle to actually put that into production. A small company that might have very limited IT resources from the management side can use these development techniques to really realize a lot of value very quickly.”

While these techniques for software and application development have a lot of benefits for healthcare organizations, there are still challenges organizations need to consider and overcome before putting apps into development.

“There’s a lot of things to think about from a security compliance perspective,” said Bowen. “Healthcare organizations should have their own internal discussion around the cloud, know they’re going to adopt it, and choose a strategy to make that happen.”

“We’ve seen successful healthcare organizations leverage their services and the tools,” he continued. “But it’s a learning curve, and organizations need to focus on staying ahead of the learning curve.”

Organizations are able to use development and cloud tools to customize applications like EHRs and practice management tools.

“Developing software in your own sandbox requires a certain type of project management and software development strategy,” said Siegel.

Choosing a tool that that was created to support software that is delivered and hosted in the cloud will help organizations prepare for more advanced tools.

“It’s an opportunity for organizations to re-examine the way that they’re solving problems with their IT teams and their software development teams,” Siegel continued. “But when it’s done well, it’s a big advantage.”

As app development continues to advance, organizations can expect artificial intelligence and interoperability standards to play a more significant role in app and software development.

“We’re going to see a move to less servers, and more server-less technology,” Bowed predicted. “That could be a container approach, or simple functions that speed up the deployment of certain micro services. We’re also going to see some amazing innovation around machine learning and artificial intelligence in healthcare.”

“From my perspective as a security professional, it’s exciting to see how those kinds of technologies can be applied to behaviors within the system,” Bowen continued. “Understanding how we can tear down and re-deploy a system before a threat is big enough, so that we can avoid things that may be a significant threat to that data.”

Healthcare interoperability may also be powered by the more advanced technologies and tools being developed.

“Cloud-scale services with IT controls are really what you need to offer interoperability at scale,” said Siegel. “Multiple healthcare organizations can share data with very stringent controls and access rights. This makes real, valuable clinical data available in near real-time. That’s up to the new generation of applications to figure out how to leverage this and make it a real advantage for providers and patients.”

“That revolution is now,” he continued. “We’re at a point where machine learning is beyond simply being something cool and things move into being predictive and in very practical ways. Machine learning can make sure that documents containing sensitive information coming into the system are flagged immediately before the first person has a chance to look at it.”

As healthcare organizations approach a more advanced way to develop applications, it’s important to start small.

“When looking at the sea of data that’s at our fingertips and the number of tools and capabilities offered across the various cloud platforms, it’s very important to start with a specific goal in mind, and really focus on trying to solve those business problems instead of just throwing all of the technology against the wall,” Siegel advised.

“Healthcare applications should be developed with privacy, security, and compliance in mind, as well as clearly outlined objectives,” Bowen concluded.