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How and why to transition your healthcare business to the cloud

How and why to transition your healthcare business to the cloud
How and Why to Transition Your Healthcare Business to the Cloud - Paubox Dave Ledoux is CIO at Nizhoni Health, the largest home healthcare provider in Massachusetts (and a Paubox customer since 2018).  Ledoux ensures that the most innovative methods and industry-leading tools are leveraged across his company’s clinical and operations teams. SEE ALSO: Nizhoni Health Sends Nearly 200,000 Secure Emails a Year With Paubox Email Suite Plus Ledoux has been instrumental in shifting his company into the cloud.  When he joined two years ago, Nizhoni had “no tracking, no visibility, no reporting, no analytics. We had no insight into anything,” explained Ledoux. “It was a really kind of a blank slate opportunity.”   Ledoux recently spoke about this transition at our virtual healthcare cybersecurity conference, Paubox SECURE @ Home.  You can access a full recording of his presentation here.  Below we will summarize the biggest takeaways.

How a cloud-based system improves security

Ledoux used an analogy of a traditional tumbler key when describing the dangers of an on-prem, legacy system.  With physical keys “you have no audit trail.  Maybe you have a paper sheet stuck on a clipboard in a room somewhere with a string— maybe . How do you control if someone who has exited the company still has a copy or not?” The cloud, on the other hand, provides a central lens, or control center, to view activity.  You “know exactly who pressed that lock, when they pressed it, what lock was unlocked, where, and who entered,” Ledoux pointed out. 


Other benefits of the cloud

With a cloud-based system, “you no longer imagine work as going to a physical place,” explained Ledoux.  “You now have a very dynamic environment that can be centrally managed, from anywhere that you choose." Before Ledoux updated Nizhoni's systems, hundreds of field clinicians needed to come to the office twice a day simply to pick up or deliver paperwork.  “Moving all of their applications onto a tablet device, or laptop of their choosing . . . allows them to work from anywhere and not go to an office if they never want to,” Ledoux said. Another improvement is triggering automatic workflows via interconnected systems.  For example, the HR department can order a new employee's computer and set up his or her accounts before the first day with the touch of a button. However, for Ledoux the biggest benefit is moving towards zero trust.  “The security has to be the user,” Ledoux explained.   “Who are you coming in? Where are you going within our ecosystem? And what should you be allowed to do?” 


Saving time and money

Not only is a cloud-based system more flexible, secure and convenient, it also has saved Nizhoni money.  Ledoux's IT spend dropped by about 50% by removing redundant platforms and applications as well as centralizing management. When he started at Nizhoni, “I can't stress enough how many faxes we used,” Ledoux said.  The team would fax between offices, and even across the same office.   SEE ALSO: Fax Machines Are Terrible for Healthcare – Here’s Why The cost of all the traditional fax and phone lines was six times what Nizhoni now spends on a cohesive VoIP phone system.  “Getting rid of physical server licensing, physical server hardware, the data center footprint—the cost savings was really significant,” Ledoux noted.


How to get started

Ledoux recognizes that transitioning a legacy-based company into the cloud can be a heavy lift.  The more on-prem applications you have, the heavier the initial lift is going to be.   For Ledoux, a good place to start is with your identity provider.  Choose a robust provider that has as many pre-built applications as possible to reduce your workload. Since you are relying on someone else’s infrastructure, it is especially important to put the gateway at the identity level, in line with the zero trust model. Ledoux recommends enforcing two-factor authentication universally with your new system.  “That really leverages your identity to the maximum, explained Ledoux.  With 2FA “no password can be spoofed. You don't necessarily need to start having 18 and 26 and 38 character passwords anymore.”  You also must be certain to make sure that all your vendors follow the same 2FA protocol.  It should be impossible to go around the security gate that you put in place.


Managing the team's reaction

Ledoux’s mission is to provide security but not at the cost of customer service.  Accessing the system “should be a frictionless experience,” Ledoux believes.  “It shouldn't be, ‘Oh, let me just have you put in your 17th password and authenticate with your seventh phone, and turn around and blink at the camera.’” However, no matter how easy the new system is, change is disruptive, especially in a busy environment.  That is why clear communication with staff about upcoming changes and the reasoning behind them, testing behind the scenes, and scheduling upgrades during slow periods is important. Ledoux offered an example of what happened when he transitioned Nizhoni’s phone system from traditional phones to VoIP.  Three weeks later, there was a blizzard in Boston, where Nizhoni is headquartered. “It was the first time in the history of this company founded in 2000, that our company could answer their phones from home,” Ledoux said.   In the past, if there was a snowstorm, Nizhoni would put staff in a hotel to ensure they would not have to drive the next day.  “They would walk across a very cold parking lot in a blizzard and sit in an office space during a blizzard answering phones because that's just what an old digital phone system could offer,” noted Ledoux.  “They just didn't have any flexibility.”



Transitioning your company from legacy systems into the cloud can be a daunting, but worthwhile, task.  Because Nizhoni had already updated its systems, it was in a good position to avoid disruptions this year when the coronavirus pandemic has forced so many people to work remotely full time. SEE ALSO: Cybersecurity Challenges of Remote Working As you start updating and changing your systems, “If you can control interruptions to your colleagues, then there's a very good chance they're going to like what you're doing, especially when in the old days, they used to have to go somewhere to do a specific thing. And now they can do it in their pajamas at their house during a snowstorm,” Ledoux said. SEE ALSO: HIPAA Compliant Email: the Definitive Guide
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