JMIR Publications

ABSTRACT

Background:

The use of cloud computing (involving storage and processing of data on the internet) in healthcare has increasingly been highlighted as having great potential in facilitating data-driven innovations. Whilst some provider organizations are reaping the benefits of using cloud providers to store and process their data, others are lagging behind.

Objective:

We aimed at exploring and understanding existing challenges and barriers to the use of cloud computing in healthcare settings and investigate how perceived risks can be addressed.

Methods:

We conducted a qualitative case study of cloud computing in healthcare settings, interviewing a range of individuals with diverse perspectives on supply, implementation, adoption and integration of cloud technology. Data were collected through a series of in-depth semi-structured interviews exploring current applications, implementation approaches, challenges encountered and visions for the future. Interviews were transcribed and thematically analyzed with the help of NVivo 12 software. We coded the data based on a sociotechnical coding framework developed in related work.

Results:

We interviewed 23 people between September and November 2020 with professionals working across major cloud providers, healthcare provider organizations, innovators, small and medium-sized software vendors, and academic institutions. Participants were united by a common vision of a cloud-enabled ecosystem of applications and by drivers surrounding data-driven innovation. Identified barriers to progress included cost of data migration and skills gaps to implement cloud technologies within provider organizations, the cultural shift required to move to externally hosted services, a lack of user pull as many benefits were not visible to those providing frontline care, and a lack of interoperability standards and central regulations.

Conclusions:

To facilitate the implementation and exploitation of cloud-based infrastructures and to maximize returns on investment, implementations need to be viewed as digitally-enabled transformation of services, driven by skills development, organizational change management and user engagement.