The coronavirus pandemic has meant a number of NHS trusts have had to quickly adapt to new ways of working. Jennifer Trueland investigates how Covid-19 has brought home the benefits of cloud.

Rapid adoption of new working practices due to the pandemic has underlined the case for cloud technology in UK health services. The shift to remote consultations coupled with the working-from-home revolution has demonstrated the need for systems that are both robust and flexible – and has brought home the benefits and efficiencies of cloud.

But many believe that the NHS was already on a journey not just to greater acceptance of cloud, but to the tipping point where cloud-first becomes the default. And while most would agree that Covid 19 has had an influence, it is certainly not the only factor driving the move, with others including security issues highlighted by the Wannacry attack, and also the growth in collaboration across larger regional health and care economies, requiring flexibility and agility.

“I think we were already on this journey towards cloud,” says Chris Scarisbrick, sales director with Sectra.

“There’s been slow acceptance, but I do feel that we’d kind of broken the camel’s back on that one when Wannacry happened. I think the biggest Zeitgeist shift, it you like, towards cloud was down to Wannacry, not Covid. I think we’d already passed the event horizon, as it were and were on our way towards cloud before Covid happened, but it certainly helped to refocus some of the conversations.”

Adapting to new ways of working

New ways of working due to the pandemic had a different impact on organisations depending on their digital maturity.

“It certainly helped to identify some of the problems that individual sites have with their structures and access to said infrastructures,” Scarisbrick adds.

“We did see a number of sites that raised the red flag and, say look, our VPN infrastructure isn’t what it should be: we’ve now got a huge cohort of radiologists and so on that need to work remotely, yet the infrastructure that we have in place in terms to access to our on-premises systems simply isn’t up to what it needs to be to support this sudden, massive move from on-site working to remote.

“Other sites, because of investment they had already made in things like remote access infrastructure, were not in that place. But it did throw a little bit of focus on to cloud in terms of the benefits it can demonstrate, such as ubiquitous access, from anywhere, over the internet.”

Speeding up the change

Ryan Braddock, vice president and sales director with Philips Speech, says that clients were already talking about moving to cloud.

“The Covid scenario has really sped up the change. Our roadmap and portfolio has been heading in this direction anyway, but [the pandemic] has been the catalyst to speed things up,” he says.

“I think there’s a lot more change that’s been brought about because of the situation that we’re now in – I think there’s a bit more acceptance of the technology than there was before. Maybe it’s opened people’s eyes because they’ve had to consider different things, and accept that changes in technology are here to stay, and that they’re applicable to all sectors.

“The reason I say that is that maybe the healthcare market has been late adopters to this technology and have been sitting on the periphery, and this has changed opinion and made people look at this technology and consider it sooner than they were willing to, or expected to before.”

Not all good news

That’s not to say that the pandemic has been universally a positive for cloud adoption – with scarce IT resources flat out trying to facilitate working from home and remote access to healthcare, there’s been little in the way of time (or funds) to focus on new deployments.

“It’s like pushing your foot down on the gas pedal while holding the brake,” says Chris Windham, director for global healthcare services with Hyland.

“There’s a dichotomy. We acknowledge the need to move to a remote care and a remote provider experience for our patients – it’s something we have to do, not just in the immediate near term, but I think it’s the expectation of patients generally. But at the same time we weren’t prepared for it, and we weren’t exactly sure how to approach it, so organisations are struggling with cashflow and the immediate need to try to take care of their patients in a pandemic world.

“I think it has heightened the awareness that cloud is not the emerging future, but the real future, especially for IT applications, but we’re kind of hampered by the fact that buying cycles have extended – buying and implementing new software and solutions is not necessarily our highest priority, nor is it a funding priority, necessarily. So yes, it’s a catalyst, yes it’s a motivator, but it’s being held back by its own situation.”

According to Justin Whatling, vice president for global population health at Cerner, the pandemic has shown up the need for rapid usable aggregations of population-wide data from healthcare providers and broader social sources.

“Clients that have data intelligence and population health management platforms in place have been able to leverage a readily available, rapidly scalable facility for the processing of that data in response to the pandemic,” he says.

“North London Partners’ work supporting vulnerable and at-risk patients and supporting health and care staff is a great example of this. Others who do not have these tools in place yet have seen the pandemic add to the need for establishing such platforms.”

Growing need for collaboration

A growing need for collaboration across wider local and regional health and care systems is also enhancing cloud adoption.

Steve Haines, managing director PSC health and care at Civica, says there’s an increased drive towards system level working – by which he means ICS (integrated care systems) and STPs (sustainable and transformation partnerships).

“There’s a sense that you don’t have to be in your silos; it’s moving towards ICS, STP regime,” he says.

“You have to be more agile about working with other entities in your health economy, not just the people in your trust. I think there’s another dynamic there that’s starting to accelerate the use of cloud because we want people to have access to these systems from potentially across the health economy, the system – not just from the trust.

“I do think we’ve seen an acceleration towards it because of Covid, and because people working from home want to be able to access not just the systems of their own trust, but also information that needs to be shared across a whole health economy.”

Cloud makes it easier give access to individuals with appropriate security across the system, rather than restricting them to their own trust’s network.

“It shouldn’t matter where you’re sitting – you should be able to access the information to be able to do your job, whether it’s information from your own trust or the wider system,” Haines adds.

Working better together

The pandemic has also encouraged organisations to work better together, says Ronke Adejolu, a key member of the Shuri Network and a digital lead.

“The speed at which NHS frontline staff have had to rapidly adopt the use of cloud services to support operations, provide and deliver care remotely during the pandemic speaks to the extraordinary collaboration across NHS organisations on a scale never seen before,” she says.

“Covid-19 in very unfortunate circumstances has been a key game changer, an enabler, has helped to adjust attitudes towards digital/technology with frontline staff leveraging cloud technology and services like Office 365, SharePoint, Microsoft Teams, Zoom and more. The question is what took us so long? what have we learnt throughout this and what can we do better?”

Taking a virtual direction

According to Dr Mark Davies, chief medical officer at IBM, the pandemic and the need to control the spread of the virus has driven much of healthcare in a virtual direction – making the limitations of geographical location less relevant as working practices have been delivered at distance.

“As a consequence ‘available anywhere’ solutions that can be deployed quickly, often via cloud services, and provide resilience have become more important,” he says.

“In addition the virus has taught us the value of being more connected and interoperable with our data to find treatments and evaluate connected pathways – this is much easier in a cloud environment.

“Thirdly the response to the virus has been an extinction event for siloed thinking – the insights we have from understanding this disease have come from new forms of collaboration and ecosystems. Cloud solutions that are open by design are specifically designed to foster these kinds of collaborations.”

Shifting the landscape

Healthcare is shifting significantly to a more connected, integrated and inclusive view of the world and patients’ needs which is difficult to support with on premises solutions, adds Andreas Haimböck-Tichy, director of healthcare and Life Sciences at IBM.

“As we shift from a focus on organisations to a focus on populations the technology and data that supports that view needs to be location agnostic, open by design and secure – that is cloud,” he says.

“It allows patients to be able to participate more in their care – seeing and contributing to care plans that cross organisational boundaries. Staff are able to make the most of emerging innovations and technology advances because the systems are inherently easier to interoperate with and lastly organisation are freed from the cost and expense of maintaining legacy systems with all the complexity and risk entailed in that.

“In short cloud-based solutions for healthcare are critical to supporting us shift from where healthcare has been to where it needs to be in the future.”