How interoperability and cloud transformations can support healthcare organizations [podcast]

Join us for a discussion covering the technical components of the cloud transformation with host Kevin Erdal, managing director and practice leader of Digital Health (Nordic) and panelists Saran Sonaisamy, director of Advisory Services (Nordic), Reza Chapman, managing director of Cybersecurity (Nordic) and Jimmy DeLurgio, Senior Solution Architect (AWS).

Interested in learning more about interoperability solutions in healthcare? Nordic will be at ViVE in Miami March 6 – 9, 2022.

Show Notes

[00:00] Intros
[05:43] Modernization: Where to start?
[07:09] AWS services available to support the data transition
[10:00] Methods for reallocating applications
[13:52] What are the costs of cloud transformation?
[17:29] Budgeting tools and savings plans available via AWS (during cloud transformation)
[20:47] What impact does this transition have on current internal teams?
[23:54] Re-skilling and up-skilling: helping teams best understand these new programs
[25:41] Automation and operational excellence
[26:56] What can a CIO and organization get out of a move to the cloud?
[29:32] What capabilities allow a health organization to monetize assets like data or IP?
[31:23] How can we protect our data and IP?
[33:53] What are we most excited about in 2022 and beyond?
[39:15] Big wins and innovation in 2021 and into 2022


Intro: Welcome to the InteropNow! Podcast, where it's all about health data interoperability and the technology solutions that will transform your business. We bring you the information you need to find the right solutions to exceed federal requirements, improve patient satisfaction, and increase your bottom line. We will talk to leading industry experts about using APIs to unleash, repurpose, and scale healthcare data. And now your host, interoperability maven Sandy Vance.

Sandy Vance: Hi, everybody. It's Sandy Vance. And on today's podcast, Kevin Erdal will guest host a panel of thought leaders as they discuss how Nordic's team of experts can help your healthcare organization navigate cloud transformation. A trusted partner like Nordic can help your organization know where to begin, how to determine which innovations will maximize your return on investment, and how to protect your assets from a cybersecurity perspective. Kevin Erdal has been Nordic's managing director and practice lead for digital health for about three years and has an extensive healthcare background. Thank you, Kevin, and to the rest of our panel for being here today to share with our listeners. And now, I invite you to kick things off.

Kevin Erdal: Perfect. All right. Thanks, folks. First and foremost, I want to thank everybody for taking a minute out of your busy day to dial into the podcast here. We have a couple of compelling topics that we think are going to be helpful, not only from a early planning stage but also from a continuous improvement phase as well. So, I know everybody's busy. I want to just recognize the fact that there's a lot going on and you took 30 minutes out of your day to listen to us. We greatly appreciate it.

Kevin Erdal: So, there's two topics we really want to dive into here today: the concept of the cloud transformation activity that's prevalent within the healthcare space today, and then also cybersecurity and the role that plays as we start to talk through modernization and some of the activities that we know is going across the healthcare spectrum in today's world. So, with that, we're not really just talking about database from on-prem to database on cloud, we really want to focus in on how can we modernize and leverage some of the net new tools that Big Tech is bringing to the market and help us with a modernized activity, along with some of the innovative solutions that we know folks are building and really enhancing the activity around collaboration, both internally to organizations but then also externally to organizations.

Kevin Erdal: While we do that, we want to make sure that, obviously, we're protecting ourselves from some of those bad actors in the world today, so making sure that, while we're modernizing, we're also protecting ourselves from some of the folks outside of our organizations, also making sure we're not at risk of losing data and things of that nature.

Kevin Erdal: These are two topics that are near and dear to my heart. When I started my career almost 15 years ago at Mayo Clinic, had the opportunity to help with some application support, get hands-on data from an operational reporting perspective to support clinical operations and revenue cycle and, really, the whole gamut across the healthcare spectrum, which was really exciting and a great way to learn what the power of technology can bring to the healthcare systems in today's world. Also had an opportunity to look at what an EHR implementation at scale can really do for an organization but also recognizing that there are a number of systems outside of the EHR that we need to think through. So, having an opportunity to participate as part of a large EHR implementation over a three-year period, getting the opportunity to step back and figure out what is the data strategy we can think of proactively to really support the activity around not only the EHR implementation but also the rest of the organization itself.

Kevin Erdal: And last but not least, had a great opportunity to spend about three years with the Mayo Clinic's Unified Data Platform, proactively integrating data to support things like clinical research and enterprise-level analytics. So, really understanding the complexity of integrating data from those disparate systems and understanding what the power of technology can do to not only make that a little bit easier but, by proactively positioning data, can really start to help the clinical research groups of the world but then also data science and other activities around that.

Kevin Erdal: So, we're really excited to dive into the details with a few of our experts here today, who I'll introduce here in just a second. We are going to cover a lot of content. By all means, reach out to any one of us at any time. We're only a phone call away. A couple of us are going to be in Miami at ViVE as well, so we'd love to be able to up with you at that point. So, without further ado, let me introduce a panel here. I'm going to start off with Jimmy, who's joining us from our AWS team. And Jimmy's been a global senior solution architect within the EHR space for the last couple years, but has 15 years of experience within IT, and 10 of which have been within healthcare. So a lot of hands on experience to bring to the topic of hands here today. Thanks for joining, Jimmy.

Jimmy DeLurgio: Yeah, no problem. Thanks, Kevin.

Kevin Erdal: Absolutely. Next, we have Saran, who's joining us from our Nordic Cloud practice team here at Nordic, who's been with us for a couple years, really helping set the vision around this concept of modernizing infrastructure. And Saran brings over two decades of experience to the conversation here today, has really had hands-on experience not just within healthcare but also outside of healthcare, so has a perspective of what a modern platform can really do for organizations and how we can start to leverage some of these set new services and these new tools to make sure that our IT teams are positioned well for the here and now but also the future. Saran, thanks for joining us.

Saravanan Sonaisamy: Pleasure to be here, Kevin. Thank you.

Kevin Erdal: Yes. And last but certainly not least, we have Reza joining the party here. Reza brings almost three decades of experience to the table, specifically around cybersecurity, vast majority of which has been within healthcare. So, Reza, I know you've been doing this for a long time, and excited to hear some of your thoughts around topics at hand today.

Reza Chapman: Thanks for having me. Great to be here.

Kevin Erdal: Absolutely. All right, folks. I want to kick off with this concept around modernization and really getting into some of the details of how we've helped customers in the past or how we're seeing people successfully move from some of the on-prem activity that we see within healthcare but really leveraging net new tools as we continue to move forward into some of these cloud environments. The first thing that I hear oftentimes from some of the customers and some of my friends and colleagues I talk to is, "Where do I start? Do I start with applications? Should I start with the security makeup? Do I start with a data platform?" And I don't know that there's a wrong answer, but I think it's a nice topic that folks are thinking through today. So, Jimmy, wondering if you would kick us off here and give a little lens in terms of how you help customers think through means in which we can start the activity and really lead towards this modernized platform.

Jimmy DeLurgio: Yeah. Thanks, Kevin. The customers that we're typically working with in the healthcare domain, we're typically taking the approach that we work backwards, where we want to meet in the middle with... A lot of the healthcare organizations, from what we're hearing at AWS, are really focusing on data, to begin with data. And these organizations express having several data silos across their enterprise. So, a lot of organizations, their IT departments have matured. They created all these data silos and they have no good mechanism in place to aggregate that data. So, they're really challenged with that.

Jimmy DeLurgio: And what AWS is trying to bring forward to alleviate those issues is bringing about the concept of a AWS data lakehouse. And essentially, what we have is several AWS services that can help facilitate the data ingestion. One specifically is the AWS Database Migration Service, which actually allows organizations to replicate their data into AWS. And it can be their entire database or a subset of their data. But really, what it provides them is the capability to actually look at native AWS services, for example, like S3, Aurora, or Redshift. And now all those platforms provide the capability to aggregate that data into one data lakehouse.

Jimmy DeLurgio: Once that data's available in AWS, there's a lot of other services that become useful for these organizations that go down the innovation route, one of them would be in QuickSight, which allows organizations to understand data by asking questions in natural language, exploring through interactive dashboards, and analyzing patterns and outliers powered by machine learning. Another service that a lot of healthcare organizations, especially in the research domain, are bringing up is building ML models on top of their data. One service that has been brought about recently is the SageMaker autopilot functionality. And really, what that allows organizations who aren't familiar with building ML models is that you can actually use... SageMaker autopilot points to that data once it's in AWS and can actually build and train machine learning models based off your data.

Jimmy DeLurgio: So, in the innovation space, it's a two-part question. How to get the data in, we have services that can help there. But then also, what do you do with the data once it's in AWS? And that's where QuickSight and SageMaker are becoming very popular.

Kevin Erdal: Yeah, that's awesome. Thanks, Jimmy. I know you folks have been innovating for a while, so it's good to see some of these tools come to life. Saran, I want to build on this a little bit, based off of what Jimmy just mentioned. Oftentimes, we hear from our customers that it could be anywhere from 300 to 700 applications in a specific healthcare location. Do you approach something like that from a, "Hey, this application is near end of life," or potentially from a hardware standpoint or data or all the above? Do you have any thoughts to add to some of the tools that Jimmy just referenced?

Saravanan Sonaisamy: Absolutely. Absolutely, Kevin. I mean, application modernization, right? I mean modernization or innovation. So, application modernization has been an integral advantage. I mean, the cloud is really shaping up. Quite a few organizations have seen it in different ways. Earlier, it has been from a lift-and-shift, applications that have been lift-and-shifted to cloud. But today, with the native cloud tools and modernization mechanisms, we don't really have to look from a lift-and-shift perspective.

Saravanan Sonaisamy: There are a lot of methods we can reallocate to the entire applications. Organizations have started utilizing serverless concepts. The last we attended with AWS, quite few critical services that Jimmy outlined are all serverless concepts. But that helps most of the application team to not necessarily lift certain applications, cut down the application footprint, and also get more productivity increases by re-architecting the overall design patterns, right? And what that means is we are simplifying the workflows. When we migrate an application, while we are trying to save the cost but we are also trying to improve the workflows. So, I think I certainly see from a point of view that application modernization, cloud gives the real enablement from a tools perspective, from a use case perspective, and most importantly, with the industry cloud segment that both AWS offers today. From a healthcare perspective, you get the blueprint of application modernization. Certainly, it's a great component today.

Kevin Erdal: Absolutely. No, I appreciate that. And you hit on one component cost that I'm going to come back to here just a second. But before I do that, Reza, I want to call on you. And if I'm CIO, I'm going be concerned about this "I'm living in two worlds" concept, it feels like. As I work through this transformation, it feels like I now have to protect two environments, or it feels like there might be a period of time where I'm more vulnerable than others from a security standpoint. What's your experience there? How do you manage that transition?

Reza Chapman:

No, that's a, a great question. And building on what Jimmy and Saran had said around where to start with the data in the applications and going serverless, I think it's the great opportunity for CIOs and CISOs of these organizations to do the best job upfront of planning for what that landing zone, so to speak, or that core infrastructure in the cloud is going to look like from a security perspective. Get that dialed in correctly from the start.

Reza Chapman: What I'd seen years and years ago, before this true serverless migration where we were doing lift and shift and all of this, is there'd be an enormous amount of waste in terms of time and slow to market, of security teams getting an application that wants to go into the cloud. They do some sort of a risk analysis on that. They return a 70-page document to the team who's trying to get this application or solution live. And then what was going to be a two-month migration or transformation now is, all of a sudden, on the order of a year, right? And so, as we move into the newer world with serverless, we really can start from the top, put the security controls in place from a network perspective, from application tiers and API tiers and data and identity, put that in place together for what the organization knows to be their standard or their requirement. And so, therefore, any other application team or data team or business team that's going to migrate or create solution on top of that environment, by default, will then inherit the security properties of that environment, right?

Reza Chapman: And so, all of that to say, yes, let's spend the time upfront to get that defined properly, implemented properly. And then all subsequent activity that goes into that environment is going to follow that security pattern.

Kevin Erdal: I love that. So, it sounds like we're really modernizing our security structure while also modernizing some of our infrastructure almost at the same time, creating a more secure environment. I love that.

Reza Chapman: Indeed.

Kevin Erdal: Great. We did hit on a cost component that is almost always the next thing I hear when talking through some of these modernizing activities. First is, "Where do I start? How do I begin and appreciate the insights there?" The second then becomes, "This feels like a really big, expensive project. It feels like we have to bite off everything all at once." Saran, you started to touch on it a little bit. I'm wondering if you can dive a little deeper into how can we look at maybe starting small or cost-savings activities, or how do we have the conversation and help our CIOs on the phone today? Think through the cost aspect of something like this.

Saravanan Sonaisamy: Absolutely, Kevin. Return on investment is a key component when we think about any transformation exercise, whether we move to cloud or we get an application or different application tier. But it didn't have investment on cloud. It's a well-seen, well-experienced outcome from cloud perspective. Well, there are two approaches to it: one, there is certainly a long-term benefit from a return on investment. While we move from a traditional infrastructure to cloud, there is a lot of potential costs from a maintenance perspective, right? All those things are getting saved as we move on to cloud. There's a shift from an ownership, right? And the tiers of ownership have been an infrastructure provider versus the enterprise's and the layer shipped from it.

Saravanan Sonaisamy: But most importantly, when you standardize the cloud modernization, there are many methods to standardize a cloud modernization. Our organization would look for more innovation, right? I mean, in traditional infrastructure, you are going to build up more infrastructure to get more innovative outcomes, but in cloud, that is already embedded. So, there's a significant savings that you are really bringing in from an investment perspective and you look at in the innovation standpoint.

Saravanan Sonaisamy: The other area is from end-of-life modernizations. Organizations typically go with a three-year, five-year hardware plan, right? Over three years to five years, you have to re-engineer your hardware, you have to re-engineer softwares. We have seen databases getting virtualized. We have seen applications getting virtualized. So, what is key here in cloud is that you are typically approaching an end-of-life situation. And you can convert that as an opportunity to kind of re-architect your application, like we just spoke earlier about some of the methods we can re-architect applications. You can certainly achieve license savings. Of course, we can achieve the cost savings on license procurements and other areas. Hardware investments is a great area where we can look at cloud point of view.

Saravanan Sonaisamy: But you have other potential questions about, "Where should I start? How should I start this from a cost-saving perspective?" You can segment strategies either by an end up like approach or by a environment based approaches where we can look at and lower environment getting migrated. While there are many ways where we can approach it from a storyboard perspective, we have playbooks which we have done, and we have helped many customers in variety of situations, right? We have met them in a point where they are and helped them transition from where they are to cloud. Okay.

Saravanan Sonaisamy: The last point on this, Kevin, is it's also about how you will do the budget controls. That's a significant thing, right? I mean, when you move on to cloud, one perception is that, "I do not know how much the cost. I'm going to keep investing it," right? Well, there is an obvious cap in savings and all. But there is a great budget controls. So, you can limit your budgets, you can set controls, you can have even triggered activators, right? So, those are certain methods where we can look at cloud migration planning, Kevin.

Kevin Erdal: No, that's great. I want to hit on that budget control. And Jimmy, I know you folks have a number of great tools at AWS to help maybe identify opportunities, maybe use a different storage strategy, if you will, for some of the legacy-type data sets. Can you expand on any examples where maybe you've helped a organization make the transformation that Saran is hitting on, and then leverage those budgeting tools to identify opportunities to maybe even save more money?

Jimmy DeLurgio: Yeah. No, that's a great question. So, AWS currently has AWS Budgets, which one of the first things you have to do when you set up AWS Budgets is actually set a threshold of how much spend you want to utilize. And if you exceed that spend within a certain timeframe, you can actually set up notifications to be sent out to a specific list of individuals that want to be notified on that spend. So, that's a really powerful tool. The other thing that we recommend is use Cost Explorer. So, Cost Explorer has the capability to look at all your service spend and actually get down to fine-grain details on what you're spending on various AWS services. If you couple that with tagging, you can get very familiar with just looking at the Cost Explorer output. These instances are tagged for this application or for this specific database. Then you can really get into that fine-grain control and visibility into your spend.

Jimmy DeLurgio: So, that's one of the big tools to actually look into costs. But however, one of the key points I want to outline too are some of the savings plans options that AWS provides. So, saving plans are used for organizations who are going to commit to a certain amount of spend. And they can get discount on those services. So, those do come in one-to-three-year terms. And they're great options if customers are going through this digital transformation, they know they're going to use cloud resources, and they want to get discounting and they want to commit to AWS for one-to-three-year terms to actually get that discounting on specific sets of services.

Jimmy DeLurgio: So, those are some of the options, but if we really want to go even further, storage is another option that we can look at with customers too, because a lot of this data that we bring in, applications, they're going to utilize storage. And there's a lot of good tools with AWS Backup, AWS S3 Glacier, Glacier Deep Archive that really have competitive price points and actually have the ability to send your backup data to different tiers of AWS storage to bring those lower costs. So, we're always thinking about costs. It's one of our pillars for the well-architected framework. And when we're with customers, we always want to make sure that they're optimizing their costs on AWS.

Kevin Erdal: Excellent. I love the multidisciplinary mindset there, Jimmy. It's not just about storage or the services that you're utilizing, but really the comprehensive view, I think, is a great strategy for organizations to consider as they not only go through the activity but also maintain and manage. I want to shift gears here a little bit. We've been talking about a lot of the great benefits, I think, of moving towards some of these cloud-based activities. But now I want to focus more on my team internally.

Kevin Erdal: So, for the CIOs or the CISOs on the call with us today, or even any of the operational owners, what does it look like for my internal team who's been great for years? But they know the tools they know. That's a reality. How do we talk through maybe a reskilling activity or some form of training? And Reza, I want to start with you, because I think this could have the biggest impact on some of the security professionals with us today. What kind of strategies or how should we be thinking about reskilling our existing team members or possibly bringing in other agencies to help with training? Can you talk through what you've seen successful?

Reza Chapman: Sure thing, Kevin. So, when we look at this in today's, again, kind of climate, we have to remember back to the olden days, back when security was called information security and not cybersecurity, right? And so, back in those days we had significant ramp up of teams. Each individual, what I would call a security discipline area, typically, in an organization had its own leadership. It had its own team managers. It had analysts and so forth. And so, over time, what began to happen is there was what we would call calcified spend for running security within your organization, right? You had these enormous amounts of teams. Meanwhile, the technologies are advancing, they're evolving. In many cases, they're being made obsolete or redundant with other technologies, but yet always the teams remained. Very inefficient use of resources and capital in that world.

Reza Chapman: Again, as we think about now transitioning and pivoting into the current cloud-type environments like AWS provides and so forth, we really have an opportunity to take advantage of the automation and take advantage of the fact that, once we can configure our services and our sets appropriately and monitor them, again, utilizing in many cases the native tools that are available to us through those platforms, we experience a tremendous amount of saving. And so, what we see now is organizations pivoting a lot of their talent, not just to manage the security-related elements in their cloud deployment but taking on higher-order responsibilities. For example, participating more specifically on understanding what are the risks associated with this new business model we're tackling or for these user stories or these personas that we're solving for? What can go wrong, right? And then being able to proactively with the application teams to start thinking through those aspects, rather than, again, watching a screen when alerts fire and so forth.

Reza Chapman: So, that's what I'm seeing a lot happen today. Great opportunity for teams to start to uplift their security teams to do higher-order value for their business.

Kevin Erdal: Yeah. I love that concept of getting folks the type of license that you mentioned, Reza, as we make some of these transitions as well. Saran, I've seen you firsthand help some organizations make the transition as well, and you have the two-in-the-box mindset and really help bring folks along with an implementation. Could you talk maybe just for a minute or so about how you've seen others be successful re-skilling while we implement mindset, if you don't mind?

Saravanan Sonaisamy: Certainly, Kevin, because this is a key component. When we help our customers move on to cloud, it is a very key component to enable them, get the awareness, get the understanding of how the entire ecosystem is going to work. And before I even answer, I want to let you know that cloud is an evolving innovation. That means next year, when you come and see it, there's going to be 200 more services. And there can be 100 less services, right? So, our team has to be prepared enough not just to take care of the current operation, but also have a mindset from an innovative perspective. And that all comes back to the skillsets, right? And the team skillset, the ecosystem of the team that we need.

Saravanan Sonaisamy: So, two areas, reskilling and upskilling, there's certainly a key need when we help a customer go to the cloud. So, when we engage with the customers, the one thing which we do is there are methodological programs that are very clearly available. We do a lot of reinvent like programs Jimmy and I did for variety of our customers. We do immersion programs where we bring in the customer's team, identify areas for them to be learning, start with the tools, start with some of the operations procedures. And Jimmy articulated about the well-architected framework being the base of how we would run the operation. So, we look at areas to upskill and reskill.

Saravanan Sonaisamy: But most importantly, what is also important from a customer perspective is technology areas. Cloud is all about automation, like Reza was talking about, right? It's all about automation and operational excellence. So, that means everything is going to be on the code-based activities, right? I mean, we can do many of the things from a command-line interface perspective. So, that allows the developers to be giving them more freedom to innovate, right? Which in traditional a on-premises environment, you are dependent with the technology limitations. Here, it is not. So, I would recommend looking at areas from a development perspective, looking at skillsets of having Python. And those kind of skills will really elevate the team standards. While we have methodology programs to reskill, upskill, but certainly, these areas will help the customers build their own strengthened team, Kevin.

Kevin Erdal: I love that, Saran. And seeing some of your immersion events and framework around that, getting developers to talk to developers is always so powerful. That's always been true, right? It's great to continue as we progress. I want to shift to one of the biggest questions that is sometimes out there, not so much maybe in today's world, but certainly three or four years ago. And Jimmy, I would love to hear your perspective on the why behind some of this.

Kevin Erdal: So, we know that we can start with the cloud platform implementation, modernizing. We know we can start small, we're going to get some value. We've talked about rescaling the team. But there's sometimes that mindset of, "Why should I do it? Why should I do it now? I've been running possibly on-prem for 30 years successfully." So, could you talk to some of the value props and some of the ads that you've seen from your customers, Jimmy, and talk through the ever evolving “why” behind these conversations?

Jimmy DeLurgio: Yeah. Thanks, Kevin. I think, for the "why" perspective, a lot of the customers we're hearing from are indicating that they want to get out of the data center operations business. So, they really want to focus more on their core missions and not so much operating data centers. Now, due to the evolution of the cloud and when it became available, we do understand that, 20 years back, there was no concept of the cloud, and that organizations were tasked with creating their own data centers, deploying their own applications, and then maintaining those data centers. So, once the cloud became available, it was providing them another opportunity to look at moving, getting out of that data center operation business, and being more focused on their core mission. So, that's what we're hearing a lot from the healthcare organizations.

Jimmy DeLurgio: But the other piece of the “why” that we've seen is the infrastructure provisioning cycles that we're seeing with our customers, where every three to seven years, they're looking at buying a lot of hardware. So, it always becomes an opportunity to actually look at the AWS cloud to actually utilize the new processors we're releasing, the new storage services, the new EC2 instance types for them to utilize, as opposed to waiting for a hardware vendor to actually deliver that, install it, and take time to get that operational in their data centers. So, that's one thing.

Jimmy DeLurgio: I would also mention, too, that another part of the “why” is a lot of the machine learning space has really been taking off, and organizations are tasked with figuring this all out. At AWS, we're trying to make that a little bit more streamlined with SageMaker, to actually tap insights into their data that can just can support their core mission with their organization. So, I'd say, around the “why”, they don't want to operate the data centers. They're looking at a quick way to scale their infrastructure and then also tap into some kind of new services that we have available for their use.

Kevin Erdal: Excellent. I love to hear the evolving story, Jimmy. It's fascinating. I can't wait to see where we are five years from now as well. I think that story will continue. I want to go to a unique component, I think, in healthcare right now, and that's the monetization of some of what we might be able to do by enabling this innovation that you just referred to, Jimmy. And Reza, want to get your perspective on, as we're maybe building something... Jimmy, you mentioned some of the machine learning or we might have some net new models coming from our organization, and maybe we'll want to offer that to other organizations in healthcare. What should we be thinking of, Reza, when we're going down that path and really wanting to not only protect our data but also possibly our IP.

Reza Chapman: It's a great question. And I think it hits on what has been problematic for the industry since meaningful use and interoperability started to really make its way into the organization, right? And so, I think, like so many other things, it's a thoughtful approach across a couple of different or several different areas, right? The first of which is from a policy and governance perspective, right? What can we do with the new model that we're implementing? What authorizations need to be recorded when we put this into place with organizations that we're going to integrate with or do business with or who are going to utilize these new services, right? And so, that's a careful discussion with the legal group and the compliance team to understand, "Here's what we're trying to accomplish. What does the legal framework and policy framework look like for this?" So, I think that's one key area.

Reza Chapman: The other area or another key area is, obviously, in terms of... Well, once we understand what are the use cases we're solving for, well then, okay, well, how are we going to protect that? Right? How can we be certain that the use cases we're implementing are being accessed by the correct individuals or correct parties? How can we be certain that the data and the processes involved are the correct data and processes, that we haven't given away too much information, for example? And so, I think concerning ourselves again with, "What are the security aspects of this model," right? We talk about identity. We talk about the secure nature of the transactions.

Reza Chapman: Again, I think many on this call will probably have been hearing for some time now "zero trust," which is essentially the transition from defense in depth, right? Which is the term of art years and years ago, of protecting our systems and data. And now we're migrating necessarily to more of a zero trust architecture, zero trust framework. Again, it's: how do we know these components that we're pulling together are the correct components to be speaking, and that they have the necessary security services on there to do the authentication and authorization that we need to have done for these services? So, again, as I think about it, again, it's a framework comprised of a number of different elements that need to be considered as we then expose these to business partners and to the public moving forward.

Kevin Erdal: Excellent. Having that conversation early helps everybody, right, Reza, if I understand that correctly? Make sure you get information security and contracting all the folks involved right out of the gate can help in the long run.

Reza Chapman: It's always less expensive and more efficient to do it upfront, 100% of the time.

Kevin Erdal: Very good. I think I'm going to quote that. Love it. So, I think we have time for one more question before we wrap up here today. And for me, this is one of the most impactful as we continue to help those around the healthcare IT ecosystem think through these activities, and that is this concept of, "Why does it take so long to build the architecture, to build some of this up?" And I've heard each one of you three reference doing it right early is the most important, playing off of what you just stated, Reza.

Kevin Erdal: So, Saran, if you wouldn't mind starting off with: what are you maybe most excited about in 2022 or even as we get into 2023, when it comes to this concept of being able to gain that value? And I'll leave you with an analogy going into the conversation here. It's that highway concept to say, "I'm on this interstate, but I don't have an offramp to get to my favorite restaurant that's right there. It's just on the other side of the barrier, if you will." So, can you talk through some of the things you're maybe excited about to keep us on the highway yet allow for those offramps and go get some of that value as we progress?

Saravanan Sonaisamy: Absolutely, Kevin. I mean, technology is really, really into the rapid speed, I will call it as, right? I mean, we all have witnessed as a consumer, as a beneficiary, when pandemic hit, right? I mean, everything went on as stuck mode. Our organization have to really look for new methods of business, new methods of consumer services, et cetera. While earlier, before pandemic and after pandemic is what I will take it up, right to see innovation, all technologies and big innovations are. Earlier, before pandemic, drive through somewhere, you'll see it. But after pandemic, this becomes the normal. So, how does enterprises look into those kind of avenues to bring in those service offerings to customers, because the technologies stacks aid the digital, right, and probably had a leg on cloud.

Saravanan Sonaisamy: So, if I fast forward that from there and what the key lessons that the pandemic has given for technologies to all of us is: how do we really recommend advice or customers rightly, wisely, right? To help them move on to and accept modernization as the face of the roadmap, right? Earlier scenarios, people looked for modernizations once in three years. But today, it does not. We spoke about how many cloud services have been modernized month after month, right? I mean, I say modernization, it's not about complication. It's simplifying the workflows, right? So, as for technologies, what I really believe is we should guide our customers to rightly invest and rightly look towards these modernization opportunities, it’s not only modernizing the technology stack but it is, one, keeping them ready towards new avenues of services. Two, it also simplifies their workflows, right?

Saravanan Sonaisamy: And what I also like about earlier, that Jimmy and Reza touched upon, is the AIML capabilities, right? I mean, in cloud, the AIML capabilities are within, right? It's embedded. Every service has something called an event-triggered actions, right? We are talking about it can scale up when there is a huge demand. It can scale down when there is no demand. So, this is a significant thing from a CIO perspective, to control tasks but also give productivity, right?

Saravanan Sonaisamy: And the second area which I'm thinking is the first priority for CIO will be to enable its one business teams, right, to empower them with everything they want. "I would need a 10TB of storage." "Yes. On a click, I give it to you." Right? "I would need 100 more VMs." "Yes. I'm going to give it to you." Right? And again, everything is a methodologic approach. There is a guided best practices. There is a guided approach. There is a great level of automation. That means, like Jimmy was talking about, provisioning time before. So, there is no provisioning time, right?

Saravanan Sonaisamy: So, what we are trying to do from this, capitalizing these technology advancements and using some of the process references that we have, the best factors of the references we have, we are not only monitoring the technologies, but we are bringing in new avenues such as AIML and other analytical capabilities, real time analytical capabilities. In result, enabling CIOs to go confidently commit to that business units that come ask more, and we are there for you. So, that is what I see, Kevin. I think the road is limitless. And we have a great role to play in helping our customers build towards those modern digitalization’s.

Kevin Erdal: Oh, that's excellent, Saran. And I have to recognize one statement you just made there before Jimmy provided you the opportunity to chime in. And that is you referenced folks asking for more. So, we're going to gain efficiency and we're going to reduce some of the maybe existing administrative burden. But what that enables us to do is more innovation, right? We're able to do more development. And what a fantastic concept. And how exciting for the developers in the world today, right, to be able to say, "I'm doing less of my admin work and I'm innovating more." Hopefully, that's as exciting for everybody on the phone as it is for me. Jimmy, anything you want to add? What gets you most excited about where we're going right now in 2022 or 2023 and some of the new capabilities you folks are working on?

Jimmy DeLurgio: Yeah. I'm going to hit on a point that Saran made about the pandemic and the big move we saw in healthcare to the cloud. That was very accurate, Saran, and totally agreement on that move that we saw as well. What I'm curious about in 2022 is now we have a big move to the cloud, healthcare organizations upskilling on the cloud, becoming familiar with the cloud. Now they're a little bit more mature with the cloud. What is that going to bring in 2022?

Jimmy DeLurgio: So, we did have some big wins in 2021. We had customers in the South that created a voice ambient service that could integrate in the clinical room, that could actually write that data back into the HR, which was a big win. We had a customer in the Midwest who actually had the ability to create like a COVID-19 data analytics hub by taking all these different data formats, converting them into Fire, and putting them in Health Lake and making it available to all their hospital systems in the Midwest. And then also a customer out West who did a big virtual desktop integration to meet the needs of the remote workforce as the pandemic hit.

Jimmy DeLurgio: So, there was a lot of innovation that happened in 2021, but with all those customer examples, there's a lot of organizations that just were starting to explore with the cloud, get familiar with it. So, I expect in 2022, we're going to see a lot of innovation in healthcare when it comes to the cloud, just due to the fact that they've had some time to grow into it. And now I think it's going to be that next phase.

Kevin Erdal: Yeah. That's extremely exciting. It's been fun to see what's been going on around, to your point, Jimmy, the last couple years. But where we're going, for me anyway, is even more exciting than seeing everybody upskill in the industry and becoming certified. To prepare for that is fantastic. Love to see the, the movement in that direction.

Kevin Erdal: So, with that, folks, I want to wrap up. And first and foremost, Jimmy, Saran, and Reza, thank you so much for providing some of your input and bringing your expertise to the podcast. I really hope it was available for the CIOs, the CISOs, the operational folks on the phone with us here today. And as a reminder, we know we hit on a lot of different topics here. So, anybody tuning in, if you have more specific questions or if you just want to have an informal conversation, please, by all means, reach out, or like I said, look us up while we're in Miami at the ViVE Conference. Thanks, everybody. Have a good rest of your day.

Sandy Vance: Kevin, great job. Thank you very much. And thank you to all our panelists today. We so appreciate you taking the time to do this.

Outro: Hey, if you enjoy listening to this podcast, you have to come check out InteropNow! at ViVE. Through interactive demonstration, we will take all the concepts and products from the podcast, and help you see in real time how to apply them to meet your goals. Come learn how to take your business to the next level with the premier interoperability solutions in healthcare. Find more information at

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