SRE: critical to the future of healthcare?

Cloud-based technology is fast becoming critical to how healthcare professionals serve patients. SRE could prove the key to helping health-tech achieve maximum uptake.

In a moment, I will share how I see Site Reliability Engineering (SRE) of cloud systems becoming critical to healthcare. But first, a little about why I care so much about this specific domain of technology work.

I am a technologist at heart with 4 years of experience working in tech startups as a cloud administrator and technical support. I've also had a lengthy career in the healthcare space as a pharmacist, operations director and health programs manager.

A large part of my healthcare industry work has been with digital systems. I spearheaded initiatives like eCommerce and paperless administration to name a few.

Now that you have some context, let’s move on...

Cloud-based technology gained true acceptance in healthcare around 2015. Overnight, I began to see seminars advertising how to make our workforce "digital-first". All the while we continued to deal with antique systems, paper-based workflows and faxed orders.

Now, technology is urging (in some practitioners' view, threatening) healthcare to really update how it does things. From eRx to decision support tools like AI, it's all happening. But the most difficult part of this for people like me is that a lot of it isn't as effective as the marketing label says.

And ultimately, people like me are accountable when these tools fail to help us serve patients in the frontline. It's a gut-wrenching experience to tell someone you can't help them because the eRx prescription system is not working.

The eRx support ticket emails I get cc'd into every time someone on our health network has an issue tells me that it happens a lot more than it should.

I've experienced it first-hand as a fill-in pharmacist as the third-party cloud-based eRx system stopped retrieving tokens. It was a busy Tuesday morning when I had a line-up of people — many of whom suffered from mental health issues — and had to tell them our systems were down for who-knows-how-long.

Some stayed grudgingly while we rang physicians for oral orders. Others couldn't handle this and walked out. Some likely didn't get their much-needed prescriptions filled at all as a result.

LEVELS OF DISASTER CAUSED BY CLOUD-BASED SOFTWARE
**Annoying** - decision support systems don't work e.g. drug interaction tool or AI radiology support don't load. Clinician relies on their experience and print handbooks (slow, but not detrimental)

**Detrimental** - eRx system doesn't load for serving a high-needs customer who relies on in-person prescription filling and advice. They might not get the medication filled due to sheer annoyance or logistics issues.

**Disastrous** - vital IoT diagnostics system stops working suddenly and randomly without providing a warning of malfunction - like those display billboard screens that show Windows errors (luckily redunancies are in place to prevent such issues)

It's all well and good to create innovative technology products. But healthcare demands strong foundations supporting the veneer of innovation. It demands reasonably fast and proper use of data being generated for improving data reliability and reliable uptime of critical systems (SRE).

What is a desirable "learning from failure" moment for software people in other spaces is a "failure by a thousand cuts" for professionals like me who have to disappoint our customers through no real fault of our own. All for the lack of the right SRE teams within the engineering group.

Do you develop technology products for healthcare professionals? You should invest in SRE teams. No ifs and buts around it.

We need decision-support tools that use the best possible dataset.

We need cloud software that's as reliable as the Windows (and some DOS) software we previously depended on (and secretly want to go back to).