Cloud Computing

2014 - 6 December - Disaster Management
Christine C. Toevs, MD, FCCM; Brian Toevs, PhD
This article explores the intricacies of cloud computing.

This article is part of a series that highlights the challenges and benefits of emerging technologies in the intensive care unit.

Last night, my neighbor called me at 10:30 p.m. in a panic: “My computer stopped working, and the external drive that I use for my backup won't let me restore! Help!” It turns out that his home office was in the basement, and the dust had clogged the vents to the point that the drive overheated and failed. All of his family photographs and digital files that were important to him were gone in an instant.

Another friend was using the outdoor grill too close to his house, and the resulting fire destroyed his home and his computer. Even the file backups in the safe were destroyed by the heat. Everyone was fine, and the insurance replaced the house and all their possessions—but again, every thing digital was gone forever.

These are only two of the hundreds of stories I could relate on personal and business disasters I have responded to as a cybersecurity professional.

You are in your hotel room the night before your presentation or that big meeting. You're going over the notes one last time before turning in, and you notice that one of your files is missing. You know that you have a copy on your desktop at home or at the office, but that's not helpful. If you had a copy stored in the cloud, you would be able to access it from anywhere you could establish an Internet connection.

This article will examine the viability of storing your data in the cloud. Two very good reasons have been provided for why you should do so. There are also some very compelling concerns that you should be aware of before you start moving your data to the cloud. You don't want to place personal identifying information and electronic health records in your personal storage, regardless of the location: office, home, cloud, or portable storage device. Storing electronic health records on your personal device is likely against your hospital’s security policy, but you may want to store your own data in a location that is safe from physical threats.

What is cloud storage? The National Institute of Standards and Technology has defined cloud computing as “a model for enabling convenient, on-demand network access to a shared pool of configurable computing resources (e.g., networks, servers, storage, applications, and services) that can be rapidly provisioned and released with minimal management effort or service provider interaction.”(1) That means that your application or data— such as your photos, documents, spreadsheets, and portable document format files—are stored on the Internet instead of your local computer or a convenient external universal serial bus (USB) drive. This can be terrifically convenient for our newfound mobility facilitated by smartphones and tablets.

However, cloud storage is not simply some huge disk drive on the Internet where files are stored just like on your C: drive. There are two very distinct types of cloud storage:  you can select the files you want to store in the cloud and move them there, or you can set up an automatic backup of your files to the cloud. Whatever route you choose, there are trade-offs.

First, let’s discuss the backup option. You should always back up your files and store them away from your computer. They can be placed on a removable drive and taken offsite for storage, but that can be difficult to maintain. Cloud backup systems like Carbonite ( perform this arduous task automatically. Once set up, the system runs in the off-hours of your computer use and keeps a current copy of all documents, photos and other files without any further interaction on your part. If you lose your local copy for any reason, a couple of hours later your data are restored to the last  backup point (usually in the previous 24 hours). The downside is that these services often require you to restore the entire drive, not just individual files.

Google Cloud, Microsoft OneDrive, DropBox, and other providers offer cloud storage solutions that operate more like your C: drive or USB. You place the files into folders and access them when you want them from anywhere you have an Internet connection. The disadvantage to this process is that you have to do all the work, so the latest data may not be available for recovery after a disaster. The advantage is that if you want a single file, it's easy to access.

A review of the specific cloud storage providers is outside the scope of this article, but a good comparison of the available systems can be found at Making the best choice for your budget and necessary security requires answers to a few questions. The most important thing to remember is that you aren't restricted to selecting only one. You can have both cloud storage and cloud backup. 

When selecting a cloud storage provider, consider security. Several of the major providers are now certifying their products as compliant with the Health Insurance Portability and Accountability Act. This does not necessarily indicate a service is secure, but it does offer a reasonable yardstick. Look for options like encryption and two-factor authentication, which confirms identity via an additional step beyond user ID and password.  Texting a personal identification number to your phone every time you try to log in would be an example of this. Also, be sure to use the purchase versions of these products; free versions are routinely mined for user marketing data. Convenience is also important, so verify that you will be able to access the service from your various mobile devices. Another aspect of convenience is the ability to share content with others. These systems can be configured to share the entire storage space, a collection of folders or only individual files.

Computers are fragile machines that have a tendency to fail at the most inopportune time. When this occurs, it is often catastrophic and sudden. The Internet has brought many wonders into our homes and offices, but one of the greatest benefits it offers is the opportunity to store the huge troves of data in a place that is more secure than your home. These cloud storage solutions are accessible, inexpensive, easy to use, and relatively safe. They facilitate sharing and, most importantly, encourage us to make backups of our digital memories.  Please take 10 minutes and sign up for a backup service. Put an end to the data recovery aspect of my business.


1.  National Institute of Standards and Technology (NIST). NIST cloud computing program. Available at:  Accessed December 15, 2014.