Deploying Cloud Computing to Implement Electronic Health Record in Indian Healthcare Settings

Background: In April 2013, Ministry of Health and Family Welfare (MoHFA) India released Electronic Health Record (EHR) standard to encourage electronic health information exchange among healthcare stakeholders. In addition, MoHFA expressed a need to find a suitable technology for EHR. Many technology solution providers have advocated cloud computing as a solution for realizing the EHR in India. Therefore, the aim of this study is to obtain insights into the desirability, feasibility, and concern to deploy cloud computing as a technology solution for EHR. Methods: A focus group discussion involving sixteen medical informatics experts was facilitated. The experts exchanged 76 emails using a group email address. The texts generated through emails were analyzed using grounded theory method. NVivo 10 was used for the coding of texts. Results: The textual analysis revealed three broad themes: (1) desirability to have superior attributes in cloud computing technology compared to the existing technologies; (2) concerns towards cloud computing to implement EHR; (3) solutions suggested in the current healthcare and ICT infrastructure of India. Conclusions: The results of this study suggest that the use of cloud computing for the EHR is likely to emerge in the future. However, given the current ICT infrastructure and healthcare system of India, several concerns were raised. Therefore, the superiority of cloud computing over other technologies needs to be assured, and stakeholder’s concerns should be satisfactorily answered.