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Christian Lindmark – Healthcare Cloud Spend
Christian Lindmark. Chief Technology Officer of Stanford Health Care (Palo Alto, Calif.): We see increased spending in our cloud environments annually and predict it will continue to accelerate in fiscal year 2023 and beyond, for both software as a service (SaaS) and public cloud. Stanford Health Care recently completed a data center consolidation project, moving from five data centers to two co-location facilities and increasing our footprint in the cloud. This is consistent with an overall trend in healthcare, with most organizations determining that owning and operating data centers is not cost-effective or efficient. Furthermore, many vendors in the healthcare space are providing SaaS solutions, eliminating the decision of on-prem versus the cloud.
Historically, when we have looked at our production environments migrating to the cloud, the total cost of ownership has overwhelmingly been more expensive on a five- to seven-year comparison — with capital costs for on-prem hardware and operating costs for management not being reduced enough to offset the increase in operating costs related to cloud spend. However, these comparisons are getting closer each year.
We have found the greatest value in native cloud deployments is with internal software development efforts and disaster recovery environments. The market is still in an early stage, and it will take a few years for some of the greatest benefits for healthcare to emerge, specifically around research data active learning/machine learning.
Additionally, sustainability is a major consideration for us at Stanford Health Care. We are committed to being leaders in improving our IT carbon footprint, and decisions we make related to our infrastructure investments and partners are key considerations moving forward, both in the cloud and on-prem.
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Christian Lindmark – Role of CTO
Christian Lindmark. CTO of Stanford Health Care (Palo Alto, Calif.): The chief technology officer and their team play a key role in helping healthcare organizations achieve their overall strategic goals. Typically reporting to the CIO (as it is at Stanford Health Care), the primary role of a CTO is to ensure reliability, resiliency and security of all information systems, data and devices across the organization. There are hundreds, if not thousands, of applications in use across a health system, and the CTO is responsible for creating an infrastructure stack — both on-premise and in the cloud — that is quick to deploy, secure, fast to access and cost-effective for all these applications. The CTO needs to build strong and collaborative teams in infrastructure, engineering, networking, data center, identity/access management and end-user devices to accomplish this.
Secondly, CTOs are innovators, creating and implementing transformative technology offerings to improve the experience of our clinicians, staff and patients. Clinicians continue to rely more and more on technology in their clinical workflows, yet these technologies can often be cumbersome and frustrating if they’re not easy to use and not always available. The CTO needs to innovate, simplify and secure the technology environment and user experience while working hard to ensure these systems never go offline.
Lastly, but just as important as the other two, CTOs need to develop relationships with clinical leaders, hospital administration and other stakeholders throughout the organization. Having firsthand knowledge of the goals, challenges and vision of these individuals and departments is critical. The CTO role has typically been less clinically focused; however, partnerships with key clinical leaders across the organization are vital, especially as the CTO role in many organizations, such as Stanford Health Care, has expanded to include clinically facing systems such as biomedical engineering and clinical communication technologies.
The CTO role is different from the CIO or chief digital information officer role in that a significant focus for the CTO is on managing and driving technology in support of clinical operations, as opposed to technology that is directly clinical-facing or clinical by nature. The CIO role is the leader of the healthcare IT organization, responsible for ensuring all the IT teams are working closely together and aligned around the organization’s strategic goals. They are not only responsible for the scope under the CTO, but also the clinical/business applications, analytics and security teams, and ensuring the relationships between these teams and key clinical and hospital stakeholders is collaborative and driving toward the organizational strategic goals.
The CIO role has a seat at the executive leadership table within the healthcare organization and directly provides input and feedback into the organization’s strategic goals, while the CTO usually does not. The CIO provides the framework for success and removes obstacles to allow IT teams to succeed. There is no question that CIO and CTO have a mutually dependent relationship, as do the CIO and other IT leaders, but a great CIO makes all teams within IT successful, as well as ensures the organization sees IT not just as a cost center but as a partner in its success.