## 2 e-Health Cloud Opportunities
The other method to collect indicators is for the Cloud owner to provide an on-line tool for health care operators to report incidents such as sentinel events or adverse drug reactions. Such data is important and sometimes it may not be available in the operational data that the operators send to the Cloud, hence creating the need to setup specialized tools to gather it and make it available. * **Support research:** the e-Health Cloud can offer an integrated platform to host a huge information repository about millions of patients' cases which can be uniformly and globally accessed. This integrated platform can be easily utilized to develop data mining models to discover new medical facts and to conduct medical research to enhance medications, treatments and healthcare services. * **Support national security:** the e-Health Cloud can increase the ability to monitor the spread of infectious diseases and/or other disease outbreaks. The Cloud can be serviced as an alert system for monitoring the diffusion of any dangerous infectious diseases as well as it can be used to determine the infection areas, the spreading patterns and hopefully the reasons of the outbreaks. * **Support strategic planning:** decision makers can use the e-Health Cloud data for planning and budgeting for healthcare services. It can also be integrated with other Cloud services to help in forecasting future healthcare services needs. This will help for example in planning the needs for doctors, medical labs and equipments, operating rooms, patient beds, and other medical facilities. * **Support financial operations:** the ability to streamline financial operations as the Cloud can act as a broker between healthcare providers and healthcare payers. The billing, settlements, and approval processes can be automated and integrated among both parties. * **Facilitate clinical trials:** the data stored allow the Cloud owner to partner with pharmaceutical companies and medical research institutions for clinical trials for new medicines. As data is collected in an integrated fashion, it is easy to detect the availability of special patients' cases and provide appropriate pools of trial cases. * **Facilitate forming registries:** the data shared will allow for the formation of specialized registries targeted for specific types of patients such as cancer and diabetes registries. On the other hand, centralization of health care data on the Cloud may result in a number of risks; though we view these risks as technical and ones that exist with any central store of data scheme. Some of the risks include:  
* **Data security risks:** as in accessing patient data by unauthorized users. Many Cloud services offer some security measures. For example, Today's systems in particular HIPAA compliant health care systems--have the ability to record every access attempt by user names and to include date, time as well as relationship to the patient. However, more work is to be done to enhance security and more importantly increase the users' trust levels of these security measures. * **The risk of loss of data:** Although it is a significant issue, advancements in database management systems such as Oracle, Cache' and SQL have created concepts of hot and cold backups, mirroring and data base restores to provide efficient solutions that minimizes this risk. Not to mention, off site backups and disaster recovery sites. * **The risk of systems unavailability:** losing an e-Health service could be a major issue especially in an emergency situation. However, advancements in the science of business continuity have increased systems reliability and availability. e-Health Cloud as presented in Figure 1 is a special-focus Cloud that provides \(\Pi\Gamma\) services to improve patient care while increasing operational efficiency. Typically, the Cloud consists of an array of layered elements, starting at the most basic physical layer of storage and server infrastructure and working up through the application and communication layers.