“When you have a hammer, everything looks like a nail.”
This old saying is continually relevant in the world of evolving technologies, and something we need to be constantly aware of when planning how to apply technology for private, community, statewide, and national HIEs.
For example, cloud computing is one of those great ideas whose underlying concept has proven successful for decades. The model has evolved from shared computing in the ’70s and ’80s (e.g., Shared Medical Systems) to Application Service Providers (ASP) in the ’90s and now is referred to as cloud computing in the 21st century, but it is basically the same idea of sharing resources and applications to improve price, performance, and resource requirements. Of course, with each generation, improvements in the underlying technology are made, such as the use of service-oriented architectures to enable cloud computing to offer a high degree of modularity and flexibility.
There is this emerging belief that cloud computing is the answer for HIEs of the future. I believe that this is true because we’ve always had the concept of cloud computing. But to see it as a Grand Unification Theory is a bit like the hammer and nail. Cloud computing is great for remotely hosted applications and HIE services like registries, community portals, MPI, RLS, and others. But it is insufficient to accomplish all of the technology needs required of an HIE by itself.
The reality is that applications and services running in the cloud must be seamlessly connected to applications, services, and devices running on the ground. In other words, cloud computing needs a complementary technology that handles the “ground operations.”
Enter the concept of client cloud computing. This is a term that refers to a system that embraces the use of cloud computing architectures but adds a client technology that runs locally on a device and can interact with local applications and resources.
Traditionally, a computing client was a component of a larger system that supported the application logic and connected to a server that housed the application data. Over the years, the nature of clients has evolved from dumb mainframe terminals, to connected clients (e.g., client-server systems), to thin clients (e.g., Citrix servers and Web browsers), to intelligent clients (e.g., software agents). As clients have evolved, they have become more independent of the server to the point where they can now operate autonomously and interact with many different servers to perform their functions.
A client cloud computing environment introduces a new approach to building an HIE. It moves from the current model based on centralized or federated data concepts, to a mesh model that incorporates different technologies that better meet the needs of the HIE community. This includes not only the information management needs, but also addresses the workflow considerations that often provide the greatest value to users in early-stage HIEs.
I will dig deeper into the concept of client cloud computing over my next few blogs and introduce several new concepts that many will find interesting. So, please stay tuned.
