ABSTRACT Implementation of Community Cloud ...

Implementation of Community Cloud Computing Infrastructure in Pakistani Healthcare Organizations

For

MS Program

COMSATS Institute of Information Technology

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By Imran Ahmed Khan

CIIT/SP13-RPM-488/CVC MS Thesis In

Master of Science in Project Management

COMSATS Institute of Information Technology Virtual Campus - Pakistan Semester in which Thesis Submitted Fall, Year 2014

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A Thesis Presented to

COMSATS Institute of Information Technology, Islamabad In partial fulfillment Of the requirement for the degree of

MS (Project Management) Student Name (Imran Ahmed Khan) Student Registration Number (CIIT/SP13-RPM-488/CVC)

Semester & Year in which Thesis Submitted Fall, 2014

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Implementation of Community Cloud Computing Infrastructure in Pakistani Healthcare Organizations A Thesis Presented to

COMSATS Institute of Information Technology, Islamabad In partial fulfillment of the requirement for the degree of

MS (Project Management) Imran Ahmed khan Student Registration Number (CIIT/SP13-RPM-488/CVC)

Semester & Year in which Thesis Submitted Fall, 2014

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A Post Graduate Thesis submitted to the name of Department of Management Sciences as partial fulfillment of the requirement for the award of Degree of M.S/Ph.D (Project Management).

Name Imran Ahmed Khan

Registration Number CIIT/SP13-RPM-488/CVC

Supervisor Dr Sajid Haider Assistant Professor Department of Management Sciences Vehari Campus COMSATS Institute of Information Technology (CIIT) Campus. December, 2014

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Final Approval This thesis titled

Implementation of Community Cloud Computing Infrastructure in Pakistani Healthcare Organizations By

Imran Ahmed Khan (CIIT/SP13-RPM-488/CVC) Has been approved For the COMSATS Institute of Information Technology, Virtual External Examiner: __________________________________________ Dr………… ……… Supervisor:

Dr Sajid Haider Management Sciences/Virtual

Co-Supervisor (where required): _________________________________ Name Department/Campus

HoD: ______________________________________________ Name HoD (Department/ Campus)

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Declaration I Imran Ahmed Khan and CIIT/SP13-RPM-488/CVC hereby declare that I have produced the work presented in this thesis, during the scheduled period of study. I also declare that I have not taken any material from any source except referred to wherever due that amount of plagiarism is within acceptable range. If a violation of HEC rules on research has occurred in this thesis, I shall be liable to punishable action under the plagiarism rules of the HEC.

Date: 13th December,2014 ____________________________ Imran Ahmed Khan CIIT/SP13-RPM-488/CVC

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Certificate It is certified that Imran Ahmed Khan and CIIT/SP13-RPM-488/CVC has carried out all the work related to this thesis under my supervision at the Department of Management Sciences, COMSATS Institute of Information Technology, Virtual Campus and the work fulfills the requirement for award of MS degree.

Date: 13th December,2014 Supervisor:

___________________________ Dr Sajid Haider Assistant Professor

Head of Department:

_____________________________

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DEDICATION This thesis is dedicated to my parents and my wife. For their endless love, support and encouragement.

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ACKNOWLEDGEMENTS

I would like to thanks and appreciation to my thesis Supervisor Dr Sajid Haider. You have tremendous mentor for me. You have support me in all aspects of my thesis related to technical, research materials and thesis writing.

I am thankful for Dr Sajid Haider aspiring guidance and constructive criticism and friendly advices.

Thank you.

Imran Ahmed Khan (CIIT/SP13-RPM-488/CVC)

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ABSTRACT Implementation of Community Cloud Infrastructure in Pakistani Healthcare Organizations The purpose of this study is to comprise a secure infrastructure of community cloud computing in Pakistan health care organizations. Compliance and Security threats are the biggest barriers for the implementation of community cloud in Pakistan health care sector. It’s the biggest challenge to implement in Pakistan. Most the companies and organizations in the world, now functioning on community cloud. The paper guides a model for the framework of the information systems in key departments of a hospital sector. This work proposes a solution based on community cloud computing carried out for hospital systems clutching as a consequence a better management, cost effective solution community data center, high spur for the medical process, and increased degree of the medical services.

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TABLE OF CONTENTS 1.

Introduction……………………………………………….............19

1.1.

Research Questions……………....………………………………..22

1.2

Purpose of Research…........………………………………………22

1.3

Research Delimitation………………………….........……………22 Theoretical Baselines ……………………………………………..23

2 2.1

Community Cloud Computing ……………….…………………...24

2.1.1

Cloud Deployment Models in Healthcare……………… 24

2.1.2

Cloud Computing services in Healthcare ………………....25

2.1.3

Community Cloud Infrastructure in Healthcare…………..26

2.1.4

Top Healthcare Institutions in Pakistan……………….…..27

2.1.5

Community Cloud Implementation in Pakistan …………..29

2.2

Characteristics of Community Cloud in Pakistani Healthcare…...30

2.2.1

Data Sharing and Care Management………………………30

2.2.2

Examples of Community Cloud Computing……………….31

2.2.3

Status & Adoption of Community Cloud in Pakistan……..32

2.2.4

Benefits of Community Cloud……………………………...32

2.3

Data Security and Storage of Community Cloud Computing……..33 2.3.1

Opportunities in Data Security……………………………..33 2.3.1.1 Availability……………………………………….33

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2.3.1.2 Barriers ……………………………………….……..34 2.3.2 3

4

Community Cloud Storage………………………………....35

Research Strategy…………………………………………….……….36 3.1

Method Selection……………………………………………..37

3.2

Data Analysis ………………………………………………...38

Empirical Study…………………………………………………........40 4.1 Quantitative Analysis of Future Community Cloud Structure in Pakistani Hospitals...…..………………………………………………......................42

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Conclusion….........................................................................................47 5.1

Interviews………………………………………………………..48

APPENDIX A: Interview 1 Questionnaire………………………….....49 APPENDIX B: Interview 2 Questionnaire…………………..………….50 APPENDIX C: Interview 3 Questionnaire…………………..………….51 APPENDIX D: Interview 4 Questionnaire…………………..………….52 APPENDIX E: Interview 5 Questionnaire…………………………...….53 REFERENCES………………………………………………………….....54

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LIST OF FIGURES Fig 2.1 Community Cloud Infrastructure...………………………………………26 Fig 3.1 Care Coordination………………………………………………………..30 Fig 3.1 Care Coordination………………………………………………………..30 Fig 4.1 Quantitative Diagram……………………………………………………..45 Fig 4.2 Histogram…….……….…………………………………………………..46 Fig 4.3 Scatter Diagram….……….……………………………………………….47 Fig 4.4 Line Diagram..…………….………………………………………………47

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LIST OF ABBREVIATIONS C3

Community Cloud Computing

CEO

Chief Executive Officer

CIO

Communicator in Chief

DMZ

Demilitarized zone

EHR

Electronic Health Record

EMR

Electronic Medical Record

HIE

Health Information Exchange (HIE)

HL7

Health Level7

HTTP

Hypertext Transfer Protocol

IAAS

Infrastructure as Services

ICT

Information and Communication Technology

IT

Information Technology

KPIs

Key Performance Indicators

NIST

National Institute of Standards and Technology

NwHIN

Nationwide health information system

OPD

Outpatient Department

OT

Operation Theatres

PAAS

Platform as a Service.

PACS

Picture archiving and communication system

RAID

Redundant array of inexpensive disks

SAAS

Software as a Service

SMEs

Small and Medium sized Enterprises

TCP

Transmission Control Protocol 15


K electric

Karachi Electric

TB

Terabyte

UCP

Universal Communication and Power

U.S

United States

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LIST OF TABLES Table 4.1 Interview1 (Questionnaire) ........................................................................49 Table 4.2 Interview2 (Questionnaire) ........................................................................50 Table 4.3 Interview3 (Questionnaire) .......................................................................51 Table 4.4 Interview4 (Questionnaire) .........................................................................52 Table 4.5 Interview5 (Questionnaire) .......................................................................53

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Chapter 1 Introduction & Background

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Introduction & Background Healthcare information through IT is most important for the purpose of medication and diagnose of patients. Infect today Healthcare IT is useful tool for doctors.Infact now is a concept of Doctor Robot. Patient records is most important for doctors to identify the diseases and better treatment through medicine.Xray,Gamma camera,MRI machines,CT Scan,endoscopy,Opthamalogy and neurosurgery equipment are related to it technology. It’s not simple data that you can save on system easily. It required huge storage capacity to save snapshots and also files for data analysis. Now recent advancement in Oncology (Cancer) patients required complete information about chemotherapy and other cancer therapy test analysis through IT. Now most of the doctors are fully IT trained. New biomedical machines required the IT literate doctors and other paramedical staff. Gall bladder operation, angiography, angioplasty, Dialysis Unit and Kidney transplant surgical machines are properly functioned through IT technology. Now I come to the point of cloud computing how these huge medical data can save .Normally I have seen most of the doctors waste most of the data due to IT illiteracy and storage problem. Cloud computing can offer a public cloud storage to store patient confidential data. Data security is not a big issue. Data will be secure most perfectly Now in most of the Hospitals in Pakistan are wasting their money through purchasing of expensive IT equipment. I have conversed most of the IT concerns with doctors of different departments like Neurology, Nephrology, Cardiology and Oncology. They are worried how to save these high data files of patients and also at the end of data analysis. Cloud Computing has specified lot of new variety of services models to customers. Now these services models provide us a route and a method to work perfectly. Now in Hospital sector there is a need of implementation of 19


cloud. Every hospital has ER, OT and Emergency department. Major Hospital in Pakistan especially Karachi where majors incidents happen daily, requirement of cloud is mandatory. Community cloud has done a vast impact in European and American countries..Now in Canada it’s general view to the collaboration of same community data center used for all the major hospitals in Toronto Canada. I met last week an IT head of famous cement factories. I was wonder that IT head are still using the cloud technology. It’s the good sign for Pakistan. The major risk factor that people observed is the data security especially in banking and Healthcare organizations know it’s a security factor but now days it’s a simple issue not a big problem. I will advice all of the IT managers in Pakistan hospitals and Healthcare sectors that construct a common cloud infrastructure and data center. It gives us a cost-effective and excellent solution for Hospitals. Community Cloud Computing is scalable solution for Pakistani Healthcare organizations especially large and small hospitals. Same community infrastructure and EMR give the boost for most of the hospitals in Karachi especially for Pakistan Most of the IT specialist prefer to used cloud computing due to easily to implement the infrastructure and datastorage.VMware, Microsoft and Cisco gives many easy solutions for implementing common community infrastructure in banks, hospitals and financial industry. Nowadays Cloud computing is the best solution for many large and smallscale organization. Most of the organizations are moving to Cloud computing. In Pakistan most of the organizations and peoples are not aware of Cloud computing technology. I have suggested Cloud technology to most of my IT technology friends. It is scalable solution, easy installation and efficiently data migration. I have mainly considering the mechanisms to implement community cloud

infrastructure in Pakistan. I have concentrating mainly on hospitals and healthcare organizations in Pakistan. I have observed that most of the 20


hospitals are expanding portion of money in the infrastructure and software of Data center. Lot of problems are encountering by major Hospitals in Pakistan regarding HIMS (Health Information Management System) and EMR(electronic Medical Records).Most of the hospitals have not proper Data Center, storage system and software. In my point of view Community Cloud is the biggest innovation in Cloud Computing technology in the world. It allots the economic stability, flexible solution, easier to use and raise the organization performance. You can access your data through Cloud with Wi-Fi, Internet, Android and other devices. In healthcare organization patients huge data are a barrier for major organization. Community Cloud is the superior solution for Hospital data. Community Cloud is not dependant and commanded by one organization. For example if five major Hospitals in Karachi, Pakistan like Aga khan Hospital, Liaquat National Hospital,Ziauddin Hospital,NMC(National Medical Center and Patel hospital have a central Data Center which is supervised by a Vendor.Aga Khan not fully controlled and monetarize the activities of other hospital data. Data can store on separate data storage on cloud. The idea of community cloud infrastructure in Pakistan healthcare sector to serve healthcare community to support hospital community of users. A community cloud is basically a public cloud on smaller expenditure.

Goal of the thesis The core objective of this thesis is to implement the community cloud infrastructure in Pakistan healthcare sector with the mitigation of security barriers and how we start the community cloud infrastructure in Pakistan major hospitals.

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1.1

Research Questions Research Questions no 1: How can we implement community cloud in Pakistani Healthcare sector? Research Questions no 2: What are the barriers and facilitators in the implementation of community cloud in Pakistani Healthcare sectors?

1.2

Purpose of Research The purpose of the thesis is the implementation of community cloud infrastructure in Pakistani healthcare sector and point out the solution of barriers which includes security threats and a community cloud infrastructure. Finally concluding the features in terms of cost and data security, it will be a major achievement to implement the community cloud computing infrastructure for efficient use.

1.3

Research Delimitation During my research I will not specific focus on of network server devices and data network architecture of specific vendor and organization. I will not discussing any specialized software or SAAS (Software as a Service) and PAAS (Platform as Service).I will be given the idea or vision of implementation of community cloud infrastructure in Pakistani Hospitals.

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Chapter 2 Theoretical Baselines

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2.1. Community Cloud Computing Cloud computing is the collective term for a group of IT technologies which in coalition are changing the plan of how IT services are provided and gained access. Several of the supporting technologies have already been available for quite some time; furthermore it is the combination of several technologies, which enables a whole new way of using IT. The U.S. National Institute of Standards and Technology (NIST) have initiate a commitment in defining cloud computing. NIST‟s publications are generally accepted, their definition of cloud computing will be facilitated in this thesis.

2.1.1 Cloud Deployment models in Healthcare. Public Cloud The cloud infrastructure is available to the general public. Private Cloud The type of the cloud, that is available solely for a single organization. Community Cloud In this type of cloud deployment model, the infrastructure of the cloud is shared by several organizations and acknowledges a specific community with shared concern. Hybrid Cloud This is a cloud infrastructure that is a composition of two or more clouds i.e. private, community or public (Cloud Security Alliance, 2009). It should be noted that there are initiatives for deployment models that not necessarily fall inside one of the above categorizations.

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2.1.2 Cloud Computing Services in Healthcare. 

IAAS: Infrastructure as a Services:

Examples: Network, servers, virtual machines & storage 

PAAS: Platform as a Service:

Examples: Database, web servers & Execution runtime 

SAAS: Software as a Service:

Examples: Email, CRM & Virtual Desktop Service Models 

Infrastructure as a Service (IaaS)

IaaS allows an organization with the infrastructure needed to move its business. This may contain networks, computing resources, such as servers or storage, and staffing mastery. 

Platform as a Service (PaaS)

This is most common in developing software applications where engineers have access to development tools, databases and middleware as well as infrastructure software. 

Software as a Service (SaaS)

Saas assigns a remote access to users commonly through a web browser. Pathology MRI, CT scan and mammography reports in the Hospital can be approach through Cloud. Healthcare organization can allow only the application usage. SaaS can be quickly deployed and used without the need for any capital outlays, accomplishing maximum uptime and benefit from the technology.

2.1.3 Community Cloud Infrastructure in Healthcare Community Cloud architecture an essential framework of deploying in the healthcare sector. Every Healthcare organization has acquired HMIS, EMR, Supply chain management and Finance sector. If we focus to public cloud which is huge access to most of the organization. If bound the specific community likes Hospitals we can construct specific community cloud for Hospitals in Pakistan. All the major Hospitals can develop a common data 25


center which is controlled by specific vendor. Network devices like Routers, Servers, Firewall (Security device), SAN (Storage Area network) and optical Fiber can be functioned for establishing a data center. Data storage on public cloud space where they can access their data by web browser.Most of the international Hospitals are using community cloud infrastructure and preserves expense of data center usage, electricity and device cost.

(Figure2.1 Community Cloud Infrastructure Diagram by Hitachi Data Systems, 2012)

2.1.4 Top Healthcare Institutions in Pakistan 

Federal Govt. Services Hospital Islamabad, FGSH



Pakistan Institute of Medical Sciences, PIMS



National Institute of Health Islamabad, NIH



Al-Shifa International Hospital



Jinnah Hospital, Lahore



Punjab Institute of Cardiology



Services Hospital 26




Aga Khan Hospital Karachi



Liaquat National Hospital & Medical College.



Doctors Hospital & Medical Centre



Military Hospital



Combined Military Hospital



Al-Shifa Trust Eye Hospital



The Kidney Centre



Karachi Institute of Heart Diseases



National Institute of Cardiovascular Diseases



Sindh Institute of Urology and Transplantation, SIUT



Shaukat Khanum Memorial Cancer Hospital & Research Centre



Sahara for Life Trust



Integrated Health Services Pakistan(IHR)



Kulsoom International Hospital

 Quaid-e Azam International Hospital(Syed Shehanshah Muhammad Kazmi) 

Islamic International Medical Complex.



Fauji Foundation Hospital



Hope Medical Dental and Diagnostics



Rawal General and Dental Hospital Islamabad.



Faisal Memorial Hospital & Burn Unit, Islamabad.



Elahi Medical Center. 27




Khyber Teaching Hospital



Lady Reading Hospital



CMH Peshawar



Muhammad Hospital IMRC-PHF



Prime Hospital



University Teaching Hospital



National hospital Jinnah Colony



Patel Hospital, Karachi



National Medical Center(NMC),Karachi



Akhter Sultana Memorial Hospital, Multan.



District Headquarters Hospital.



Shekhupura Medical Complex.



Sind Government Hospital, New Karachi



Ziaduddin University & Hospital, Karachi.

2.1.4 Community Cloud Implementation in Pakistani Healthcare Sector Abstraction of information related to ICT (Information and Communication technology) is the major drawback in Pakistan organization especially Hospitality sector. Most of the systems in the hospital sector are manual system. Old file keeping technology in a draw which is basically patient records.HIMS (Health Information management system) can be updated manual through updated in the system.OCR (Optical Character Recognition) and ICR (Intelligent Character Recognition) are the new patient record automated form processing. These data can be easily saved in 28


cloud storage. No paper work or manual work is required. Now again the matter how we can change the mind of our peoples to migrate the Community Cloud infrastructure. I have conversed distinct IT peoples in Pakistan. Most of the IT peoples remarked that Security threat is the biggest for the implementation of community cloud in Pakistan especially in healthcare organizations.My question is that why we are not taking risk and create an research of implementation of community cloud in Pakistan specifically Healthcare Organizations? We have build a proper security zone in our inside network and outside interface of Firewall and Router. We can built and check through security softwares.International countries are taking the services from Public Cloud companies like Salesforce.com, Amazon, Microsoft, Oracle,Google,Softlayer,Terremark,Rackspace and Netsuite. Under the circumstances, the cloud computing seems to be most suitable solution for Pakistan which may address most of the issues.

2.2 Characteristics of Community Cloud in Pakistani Hospitals 2.2.1 Data Sharing and Care Management The diagram illustrates quality of life after the implementation of community cloud in Hospital.

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(Figure 2.2, Data Sharing and Care Management by Kermanshahche, 2012) Data center consists of network, security services, Computer servers, Firewall, Air-conditions, UP systems, Patch panels, Optical Fiber Patch Panels, Racks and Fire Alarm system. Also we have the storage devices of Dell or IBM.These storage devices are very expensive. Cloud computing can gives the alternate solutions for storage devices, servers and software solution. VMware and Google allow the latest solution regarding IAAS, PAAS and SAAS.

2.2.2 Examples of Community Cloud Computing Example 1 

Community Cloud for Toronto Hospitals Fourteen hospitals collude clinical application & EHR data



Community Cloud Benefits



Multi-tenant surroundings for contravene interactions.

Example 2

(Figure 2.3 Care Coordination by Kermanshahche K, 2012) 30


2.2.3

Status & Adoption of Community Cloud Infrastructure in Pakistani Healthcare. It’s not an easy-going task to handle healthcare system in a properway. Healthcare systems desires high accuracy like CT scan, Blood Report, Quematic system of Lab collection, angiography report, euro scan and X-ray etc.The Proper ICT (Information and Communication System) system in real time of any healthcare organization cans enhance their activity, customer satisfaction and also better revenue. More patients’ satisfaction can enhance the standing of Hospital. In Pakistan many Banking sectors are adapting the community cloud and private cloud computing to elaborate their clients’ satisfaction and increased productivity. I have seen enhancement in security surveillance system in Pakistan. They can keep the DVR Digital Video Records of CCTV Closed Circuit Television and IPTV Internet Protocol Television cameras on Public and community clouds. Video and snapshots of CCTV and IPTV cameras needs heavy storage space. Hence Cloud is the best choice to maintain the files and access through web browser via Internet. Now there are various services are related to research and development in the field of Health services Like HL7.HL7 can provide the health services HL7 stands for Health Level seven International is a nonprofit ANSI standards. Its provides the standards of exchanging and Health records. The main focus is to facilitate e-health services that are interoperable among numerous domains in this extent such as laboratory, Patient and other healthcare services.

2.2.4

Benefits of Community Cloud Computing Cloud computing allots lot of advancement in healthcare, banking and corporate sector. Doctor, Physicians and surgeons are utilizing multiple devices to track the patient’s data on cloud easily. Dr Robot is the best model in the International countries where OPDs, Surgical procedures and other medical procedures are functioned by Robot under the online supervision Doctor. Cloud computing can

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assigns valuable outcomes in Electronic Health records while in surgeries and OPDs. Cloud computing can gives cost effective infrastructure system where servers are not accessible. Remotely servers through vendors can saved the fixed cost and provides a cost effective solution After the implementation of community cloud computing in Hospitality sector most of the IT processes is streamlined. You can easily manage and integrate the data analysis of Healthcare records and HIMS Health Information Management Services.

Without Cloud Computing gives burden for Hospital to use more resources in Real time. Some Hospital services like CT scan needs backup images of patient parts. This high input data sometimes blockage of bandwidth and problems in storage devices. Community cloud can move the applications as per need by the Hospital. Community cloud provides cost effective solution in healthcare. Patients and healthcare organizations, Hospitals take advantages of these services. Patients want quality of service in the hospitals. There is lack of quality of services in Pakistan healthcare as well as other organizations. Best quality of services can provide the hospital reputation as well as productivity of the institution. It’s not very huge investment in community cloud infrastructure in Pakistani healthcare organizations. Community cloud provides cost-effective high integrated platform that is useful for both patients and hospitals.

2.3 Data Security and Storage in Community Cloud Computing 2.3.1 Opportunities in Data Security 2.3.1.1

Availability

Every organization must defend their confidential data through strict access for Data Center network. Healthcare Hospital of patient is secret and urges to be privacy concerns. Moving complete hospital data especially patient’s sensitive data into third parties like cloud vendor is not an easy task. More security concern about 32


the security factors of community cloud where data are stored in specific slot of community cloud. Nowadays it’s an easy task for hackers to robbed data from clouds. International Hospital especially Canadian Hospitals are functioning the community Cloud technology for storage. Most of the health organizations build their own private cloud. However the expenditure of private cloud including the cost of network devices and storage devices are huge. Community cloud can give the better option to save the data public cloud with a specific community like hospitality. Community cloud can be handling by specific vendor who has the responsibility to sort-out the data issues of Hospitals in Cloud. Doctor, Physicians and Surgeons can easily find out patient data on community cloud with a secured environment. Community cloud is shared by several organizations and supports by specific community. Most of the European countries applied community cloud computing model for government organization specially security agencies. The objective of community cloud in participating companies comprehends the benefits of multi-tenancy and billing structure. It also covers the benefits of public cloud, policy compliance and security usually associated with private cloud. The cloud infrastructure can be assigned across paramedical and other healthcare entities and mandate definite security needs and policies. This might originates applications on infrastructure that will assistance in sharing the information in secured environment and wittily. 2.3.1.2 Barriers Security concerns are headmost strong in healthcare organizations due to of patient sensitive data. Hacker attacks are the core concerns of community cloud computing. There are lots of security devices and intrusion prevention systems are there who secure the data in the cloud. It’s always impossible to hack data from cloud of large companies like Amazon and Microsoft. But 33


risk factors of natural disaster and poor encryption policy of other cloud companies are still there. It's not easy to implement the community cloud infrastructure in Pakistani Healthcare in present and future. Early initiative is to establish mindset of IT and Medical staff especially doctors and IT programmers in Hospital sector. Defense of data is the biggest barrier for the implementation of community cloud infrastructure in Pakistan. The major deformity in Pakistan is the technology unawareness. There is no planning in ICT.We have to work out in Community Cloud infrastructure in Pakistan. We have not any offer in Pakistan related to community Cloud infrastructure. It’s essential in Pakistan to make a seminar of community cloud infrastructure in Pakistan especially in Healthcare sector. 2.3.2 Community Cloud Storage. Storage in a cloud is different as compared to the physical storage devices like Dell or IBM.Cloud computing stored data logically. Cloud Vendor Company has the physical high definition network and storage devices that stored lot of data of client sides via cloud. Cloud storage companies are responsible for data availability, data security and data storage. While the major concerns of cloud storage is accessibility, supplier stability and data encryption.

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Chapter 3 Research Strategy

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3.1 Method Selection I have highlighted the implementation of community cloud in healthcare organizations in Pakistan. The topic of community cloud computing in Pakistan healthcare organization is new in Pakistan. My research strategy is to develop a questionnaire with IT expert peoples in Pakistan who have some experience in community cloud computing. Also preview of future implementation of community cloud infrastructure in Pakistani Hospitals like Aga Khan, Ziauddin,NMC National Medical Center, Patel and LNH&MC Liaquat National Hospital and Medical College for the year 2015. To decide the most appropriate approach the most important factors were evaluation goals, the questions to be addressed and the method of research adopted. If the goal was to gain an overall impression of a subject, then an informal, unstructured interview was often the best approach. However, if the goal was to get feedback about a specific issue then structured interview was better (Preece et al., 2002). My research strategy is to develop the community cloud scenarios in healthcare sector especially in the International Hospitals. This will help for the vision of implementation in Pakistan. These scenarios, models and network architecture identify the factors involving in the implementation of clouds in hospitals. I have assured to use quantitative method to get the overall information regarding the implementation technique of community cloud infrastructure in Pakistani healthcare sector. I have developed a questionnaire for the implementation of community infrastructure in Pakistani Healthcare Organizations with Manager K electric, Key Account Manager UCP Pakistan, CEO Xlent International, IT Consultant Sind Revenue Board & IT Manager Liaquat National Hospital & Medical College. I have designed a likert scale for my questionnaire. I have asked following questions. 36


a. Can we implement community cloud infrastructure I Pakistan? b. Can we mitigate the security risk factors of community cloud? c. Will the community produce the cost effective solution in Hospital d. Will we manage out the data secure in Community Cloud? e. Will we face lot of challenges in the implementation of community cloud? f. Will the community cloud easier to use in Hospital environment?. Moreover I have also designed quantitative approach with diagram regarding the future implementation of community infrastructure in Pakistan major hospitals like Aga Khan, Liaquat National Hospital, Ziauddin, National Medical Center (NMC) and Patel Hospital.

3.2 Data Analysis After the interview questionnaire it is very important to shrink the interview points into descriptive sentence I will use to determine data analysis to examine my data. My research is essentially on community cloud infrastructure beneficial on healthcare organizations. It may save the cost as well as good outcomes from patients.Commnity cloud are not dominant in Pakistan. In the case study of this thesis I displayed the model diagrams and examples of different community clouds in international hospitals. I presented the issues in the precise context of different literature .I investigated and researched with respect to Pakistani healthcare sector. I know it's not easy to implement in Pakistani Healthcare sector. I have a vast experience in hospitals infrastructure and data networks. I think that this idea provides a vision to work and demonstrate. I have discussed with healthcare models in international countries, key factors of community clouds, security issues, benefits of community clouds in Pakistan and storage capacity required in community infrastructure. I presented statements, scenarios and summary of understanding the impact of community cloud in healthcare sector. Most of the scenarios can give the best idea of implementation of community cloud to readers. It’s basically

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the efforts and idea how to build community cloud in Pakistan and other south Asian Countries. We also know that worldwide it is very difficult to share services model but it is useful for cost effective solution. The cost effective solution includes Efficiency, agility, availability and services. Security, cost and storage are the main concerned of this thesis.

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Chapter 4 Empirical Study

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4.1 Quantitative Analysis of Future Community Cloud structure in Pakistani Hospitals. I have workout the idea regarding the implementation of community cloud infrastructure in Pakistani Hospitals. I have worked out the idea of future implementation five major hospitals of Karachi. The Hospitals includes 

Aga Khan Hospital



Liaquat National Hospital & Medical College



Ziauddin Hospital



National Medical Center



Patel Hospital The IT Manager and Project Managers will schedule a meeting of one platform regarding common community cloud center in Karachi. The benefit of community cloud includes



Easily share the infrastructure with lower cost.



Patient transfer facility will be available for EMR software integration



Cloud storage with maximum Storage Facility.



Less infrastructure devices cost



Less manpower



Data easily accessible through website but each hospital administrative limit will be there. Now in Canada especially Hospitals in Toronto have designed common community infrastructure that saves cost Now I will show you 1 year plan (2015) after the implementation of community cloud infrastructure in these Hospitals. It includes Patient OPDs, OT (Operation Theatres) and Emergency plans. Maximum average of patients means revenue will be high. The infrastructure cost of common data includes router cost, switches, server machines, Data storage devices, 40


Firewall for Security, DMZ zones devices, EMR software which supports HIMS plan.

Figure 4.1 Quantitative Analysis For the Future Deployment of Community Cloud in Pakistan in the year 2015

Figure 4.1 Shows the patient admission data related To OPD, OTs (Operation Theatres) and Emergency after the implementation of Community Cloud infrastructure in these Hospitals., More patient in the hospital means productivity of services and revenue will be generate.

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Figure 4.2 Histogram Diagram

700 600

January

500

February

400

March

300

April

200

Aga Khan Liaquat Hospital National Hospital

NMC Ziauddin Hospital

Emerg

OT

OPDs

Emerg

OT

OPDs

Emerg

OT

OPDs

Emerg

OT

OPDs

June Emerg

0 OT

May OPDs

100

Patel Hospital

July August September October

Figure 4.2 Histogram shows that most of the patients will prefer Aga Khan Hospital especially in the OPDs than Liaquat National Hospital and others. Aga Khan Hospital is the biggest Hospital in Karachi where lot of patients admitted in OPDs (General,Nephrology,Neurology,Opthamalogy,Rheumatology).Lot ofOperate in OTs and Enmergency sections.After the implementatio of community Cloud in These hospital Patient admission will be increas also the productivity and revenue will be expand.

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Figure 4.2 Scatter Diagram 700 January

600

February

500

March

400

April May

300

June

200

July

100

August September

0 -100

0

5

10

15

20

October

More patients in the month of January 2015

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Figure Line Diagram 700 600 500 400 300 200 100 0

Ряд1 Ряд2 Ряд3 Ряд4

Aga Khan Hospital

Liaquat National Hospital

NMC Ziauddin Hospital

Emerg

OT

OPDs

Emerg

OT

OPDs

Emerg

OT

OPDs

Emerg

OT

OPDs

Emerg

OT

OPDs

Ряд5

Patel Hospital

Ряд6 Ряд7 Ряд8 Ряд9 Ряд10

44


Chapter 5 Conclusion

45


5.1

Conclusion

I comprehend that Community cloud computing concept is new in Pakistan. I have fundamentally assigns the idea and concept regarding the introduction of new technology in Pakistan especially in Healthcare sector. I have encountered problems to gathered information and technical data for the propose of future implementation in Pakistan. I have showed diagrams, tables in Excel sheets and references from the international IT experts. I have discussed core issues for the implementation of community cloud in Hospitals. Most of the problems are associated with security threats and storage problem. Most of IT Managers scared the data hackers in community cloud. In Canada and Europe, Community clouds are very common in Healthcare sector.. Every organization needs secure environment for its Data Center. But its seems like stupidity that not taking risk for Community Cloud. Community Cloud has to ability to share and collaborate in a way. It saves the cost of expensive Data Center equipments which includes routers, Cabling, Data Storage devices, and Server machines, Firewalls, Cabling, Electric cost and support staffs. It’s the best choice for hospital s and Healthcare sector. I have mentioned the questionnaire regarding Community Cloud with different IT experts. I have received the positive response and strongly recommendation for the implementation of Community Clouds in Hospital sector. Moreover I have given the future idea of patient outcomes after the implementation of community cloud infrastructure in five major hospitals in Pakistan. I have showed one year diagram for the number patient’s visits in OPDs, OTs and Emergency. 46


In the last I will conclude that community cloud in Hospital sector is emerging as beneficial technology for present and future. It’s the cost effective and useful solution for Healthcare organizations especially for South Asian Countries.

5.1.1 

Interviews

The topic of community cloud infrastructure is in new in Pakistan specially in Hospitals,Textiles,corporate,Government and Public Orgnaizations.Most of the peoples of IT know Cloud computing however do not perceive what is community cloud. Its seems to be very hard and not easy task to me. However I have discussed with different IT Managers, programmers, Network Administrators and server Administrators of Hospitals and other industries regarding Community Cloud. The top most persons were IT Manager K electric, Key Account Manager UCP Pakistan, CEO Xlent International, and IT Consultant Sind Revenue Board & IT Manager Liaquat National Hospital & Medical College. I have used the likert scale for this questionnaire related to quantitative measurement. I have developed a questionnaire with likert scale which compiled the choices of Strongly Agree, Disagree, Undecided, Agree, Strongly DisAgree.



Can we implement community cloud infrastructure I Pakistan



Can we mitigate the security risk factors of community cloud



Will the community produce the cost effective solution in Hospital



Will we manage out the data secure in Community Cloud



Will we face lot of challenges in the implementation of community cloud



Will the community cloud more easy to use in Hospital environment.

47


APPENDIX A Interview 1 I have interview with IT Manager of K Electric. I have six questions. He is strongly agreed to implement community cloud infrastructure in Pakistan. But we will face lot of challenges in the implementation of community cloud.

48


APPENDIX B Interview 2 I have interview Key Account Manager of UCP Pakistan.. I have six questions. He is strongly agreed to implement community cloud infrastructure in Pakistan and community cloud more easily to use in Hospital environment.

49


APPENDIX C Interview 3 I have interview CEO Xlent International. I have six questions. He is strongly agreed to implement community cloud infrastructure in Pakistan. However he is strongly disagreed to mitigate the security factors and community cloud is not effective solution in Pakistan.

50


APPENDIX D Interview 4 I have interview Consultant IT of Sind Revenue Board. I have six questions. He is strongly agreed to implement community cloud infrastructure in Pakistan. However he is strongly disagreed to mitigate the security factors and community cloud is not effective solution in Pakistan.

51


APPENDIX E Interview 5 I have interviewed IT Manager of Liaquat National Hospital. I have six questions. He is strongly agreed to implement community cloud infrastructure in Pakistan and community cloud more easily to use in Hospital environment.

Questionnaire Result: Following the questionnaire we have determined that we can implement community Cloud infrastructure in Pakistan. Mitigate the security risk factors in community cloud is not easy in Hospital environment .I have asked the questions to IT peoples Will community Cloud Produce Cost effective solutions in Hospitals? Most of them disagree because expenditure of HIMS and ERP software are high. Most of them are agreed that that there are lot of barriers in the implementation of community Cloud

52


.

Chapter 5 References

53


Accenture.com (2013).Journey to the cloud: Accenture’s roadmap and maturity model for healthcare companies. Ahuja, Sanjay, P., Komathukattil, D., (2012), A Survey of the State of Cloud Security, Journal of Network and Communication Technologies (NCT).

Bokesebeld, R., (2010), the impact of Cloud Computing on Enterprise Architecture and Project Success. Utrecht, Netherland.: Hogescholl Utrecht. Cloud Standard Customer Council (2012), Impact of community cloud on Healthcare English K., (2014), The Cloud Delivers a Better Experience for the Connected Athlete through the Internet of Everything. Gorelik, E., (2013), Cloud Computing Models. Cambridge, Massachusetts, USA.: MIT Hitachi Data Systems (2012), How to improve Healthcare with Cloud Computing Iftikhar, S., Khan, W., Ahmad, F., and Fatima, K. (2011).Semantic Interoperability in E-Health for Improved Healthcare. Technical Report. National University of Computer and Emerging Sciences, Islamabad, Pakistan Jha, A., Doolan D., Grandt, D., Scott, T., Bates, D. (2008), The use of health information technology in seven nations, International Journal of Medical Information

Kermanshahche, K., (2012), Shared services and Healthcare Cloud, Intel Corporation. Kvale, S. (1996) Interviews: an introduction to qualitative research interviewing, SAGE, Thousand Oaks, CA. Lupşe, O., & Vida, M. (2012). Cloud Computing and Interoperability in Healthcare Information systems. Timisoara, Romania.: University of Timisoara

Marinos, A., & Briscoe, G. (2009), Community Cloud Computing. Surrey, UK.: University of Surrey Mell, P., & Grance T., 2009, The NIST definition of Cloud Computing Preece, J., Rogers, Y. & Sharp, H., (2002). “Interaction Design - Beyond HumanComputer Interaction”, John Wiley & Sons.

54


Ren, H.,(2012). Transition to Cloud Computing in Healthcare Information Systems: Cambridge, Massachusetts,USA.: MIT

Ried, S., (2010), Siemens IT Solutions And Services Successfully Positions A Community Cloud, Saleem, R.,(2011),Cloud Computing Effects on Enterprises in terms of cost and security School of Economics and Management. Lund, Sweden.: Lund University Shah, S.,(2012),Importance of cloud computing technology in Pakistan Suo, S.(2013),Cloud Implementation in Organizations: Critical Success Factors, Challenges and Impacts on the IT Function. Arlingtion, Virginia:United States.: UMT. Wang, Q.,(2011),Mobile Cloud Computing,Saskatoon,Canada.:University of Saskatchewan

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ABSTRACT Implementation of Community Cloud ...

ABSTRACT Implementation of Community Cloud ...

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