3.4 Cloud Computing
The term ‘cloud computing’ describes the use of the Internet as a computing platform
for providing services that have traditionally been provided in-house by desktops
workstations and servers [28]. Cloud services are generally partitioned into: 1) ‘software
as a service’, in which third parties provide applications, 2) ‘infrastructure as a
service’, in which third parties make networks and storage space available, and 3)
The Smart Internet as a Catalyst for Health Care Reform 33
‘platform as a service’, where third parties provide frameworks for application development.
Unlike traditional outsourcing relationships, data in a cloud application is
typically distributed across multiple data centres; in the absence of explicit restrictions
on geographical location, data may be stored in multiple legal jurisdictions.
Cloud computing has received significant attention due to popular applications by
Google and other companies. A well-known example is Google Docs, which provides
a cloud-based alternative to locally installed office software programs such as Microsoft
Office. Enterprise computing applications have similarly been offered in the
cloud, such as the customer relationship management services offered by Salesforce.
com. In addition, an increasing number of cloud computing service providers
are offering virtual server infrastructure to their clients. Amazon’s Elastic Computing
Cloud (EC2), IBM’s Blue Cloud and Google’s App Engine are among the most popular
offerings out of a rapidly growing number of cloud computing services. One of the
drivers for organizations switching to cloud computing concerns cost-savings, since
obtaining services from a third party may reduce the need for expertise, infrastructure
and maintenance. In addition, cloud computing offers organizations the ability to
maintain variable levels of capacity, as cloud computing approaches are capable of
dynamically configuring resources to meet a client’s needs.
The development of cloud computing was an important step towards realizing the
vision of the Smart Internet. Not only does cloud computing support automated service
delivery and dynamic configuration, but it also provides a model for the integration
of services based on multiple servers. From an individual user’s perspective, it
extends the use of the Internet beyond the scope of Web pages and data repositories
into the realm of full-featured, process-aware applications providing complex services.
By implementing this shift, the Internet becomes increasingly aware of aspects
of human-computer-interaction (HCI) that had formerly been dealt with only at the
level of the local personal computer (PC). For example, a scientific author using a
cloud-based word processor together with an Internet search engine to retrieve related
work could be provided with more intelligent recommendations of search results
based on an automated analysis of the text authored so far. Analogously, physicians
entering patient data in cloud-based EMR applications could be supported by having
the applications offer the newest practice guidelines and research results on a particular
patient case. The shift to cloud-based services allows service providers to collect
more information about users for the purpose of creating more accurate user profiles,
which can be used to anticipate user needs and individualize Internet offerings.
Clearly, this movement has also generated new questions pertaining to individual
information privacy and trust [29].