Data centers' impact on American health care

When we listen to the news, we are inundated with stories about the impact of data centers on the economy, the environment and the potential vulnerability of losing patients' health care data. Data centers are becoming a critical, but often overlooked, part of American health care. They are the infrastructure behind electronic health records, medical imaging, telemedicine, patient portals, billing systems, genomic databases and increasingly, artificial intelligence. The issue is not whether health care needs data centers, because we currently depend on them. The key issue physicians must address is how to gain the benefits while managing the considerable costs and risks of data centers popping up in rural America. In this article, I will explore the benefits and risks of data centers and their impact on American health care.

Benefits of data centers for health care

1. Greater access to data. Data centers allow physicians to quickly view a patient's medical records, imaging studies, medications, laboratory results and other important information from any location. This immediate access can help physicians make faster and better-informed decisions.

2. Better continuity of care. Data centers allow important medical information to follow patients as they move between hospitals, specialists, emergency departments, primary care practices and other health care settings. When information is readily available, clinicians are less likely to make decisions based on incomplete or outdated information.

3. AI becomes possible at scale. Modern artificial intelligence requires enormous amounts of computing power and data storage. Data centers provide the infrastructure needed for generative AI, ambient AI scribes, predictive analytics, radiology AI and clinical decision-support systems to operate at scale.

4. Telemedicine. Data centers provide the infrastructure that supports virtual visits, remote patient monitoring and the transmission of medical images, laboratory results and physiologic data available from wearables. As health care moves beyond traditional brick-and-mortar exam rooms, reliable data infrastructure becomes essential.

5. Population health. Large health care datasets allow physicians, hospitals, academic institutions or medical organizations to identify trends and patterns that may not be apparent when looking at individual patients. Health care organizations can use these data to identify high-risk patients, predict readmissions, recognize medication-related problems, monitor outcomes, monitor epidemics in real time and identify disparities in care.

6. Research. Data centers allow researchers to analyze enormous datasets, including millions of medical records and large genomic databases. This computing capacity can dramatically accelerate research that once required years of analysis using traditional computing methods.

7. Disaster recovery. I have experienced firsthand the impact of Hurricane Katrina, which destroyed patient records and made follow-up care difficult. Properly designed, redundant data centers help preserve medical records and essential health care services when a practice or hospital's local computer systems fail. Whether the cause is a hardware failure, cyberattack, natural disaster or other disruption, redundant systems can provide an important safety net.

8. Scalability. Hospitals and health care organizations will not need to purchase ample computing capacity to manage their peak demand. Cloud-based data center infrastructure can expand or contract as demand changes, allowing organizations to increase computing capacity when needed without maintaining all the infrastructure themselves.

9. Lower administrative burden. Data centers provide the computing power necessary to automate many time-consuming administrative tasks, including scheduling, billing, documentation, coding and claims processing. Although technology will not eliminate health care's administrative burden, it can reduce the time physicians and staff spend on nonclinical, administrative work.

10. The foundation for continuous care. One of the most important benefits is the ability to move health care from episodic to continuous care. Wearable devices, home monitoring systems and other connected technologies can continuously transmit information about a patient's health rather than waiting for the patient to develop symptoms and appear in the physician's office or require a visit to the emergency department or admission to the hospital. Data centers provide the infrastructure needed to collect, store, analyze and act on this continuous stream of information.

The risks and disadvantages of data centers

1. Enormous energy consumption. Data centers consume large amounts of electricity. AI growth is accelerating that demand. For health care, this creates a paradox: we may use technology to make health care more efficient while simultaneously increasing the energy required to run it.

2. Water consumption. Many large data centers use substantial quantities of water for cooling and preventing the computers from overheating. In regions experiencing water shortages, this can create a negative environmental impact.

3. Cybersecurity. A centralized digital health care infrastructure creates an enormous target for cybercriminals seeking access to patients' health care data. A cyberattack could disrupt an entire hospital system. Recent ransomware attacks show this is not theoretical.

4. Privacy. Health care data is among the most sensitive forms of personal information. Putting millions of medical records into centralized digital environments creates enormous responsibility for protecting patients' confidentiality.

5. Concentration of power. If a relatively small number of technology companies operate the data centers on which American health care depends, health care organizations may become dependent on those companies.

6. Cost. Building and operating sophisticated data centers requires billions of dollars. Those costs ultimately must be paid by someone: technology companies, hospitals, insurers, taxpayers or patients.

7. Infrastructure vulnerability. Data centers depend on electricity, telecommunications, cooling systems and physical security. A natural disaster, prolonged power outage, cyberattack or other infrastructure failure can interrupt access to critical information.

8. The digital disparity. A sophisticated digital health care infrastructure doesn't automatically produce equal access to health care. Patients without reliable broadband, smartphones, digital literacy or the ability to navigate the internet may be left with less health care.

Bottom line: Data centers are becoming the invisible infrastructure of modern medicine. We may never see them, but they increasingly determine how we practice medicine, access information, use artificial intelligence, protect patient privacy and ultimately care for our patients. We need to recognize the enormous benefits data centers provide but also understand the risks of becoming increasingly dependent on them. In medicine, the infrastructure we cannot see may have the greatest impact on the care we provide.

Neil Baum, M.D., a professor of clinical urology at Tulane University in New Orleans, Louisiana. Dr. Baum is the author of several books, including the best-selling book Marketing Your Medical Practice: Ethically, Effectively, and Economically, which has sold over 225,000 copies and has been translated into Spanish.