The company has also been using an external cloud service from a major vendor, which Rawlings did not want to identify, for about a year and a half. That service supports several applications, including processing for websites Rawlings runs for some of its non-healthcare clients. The vendor enables Rawlings to easily scale capacity up or down depending on its needs, Landgrave says.

When considering the external cloud, look at the volume of data, Landgrave says. "That drives most of the cost and processing-speed issues," he says. "Security obviously is always at the top of the list, but if in the future that is determined not to be an issue, the size of the data set...is one of the primary factors," he says.

Rawlings is currently evaluating cloud services from vendors such as Microsoft, Rackspace and IBM to help handle its fast-growing data-processing demands. But the company's processing needs--it has several hundred terabytes of data in-house--render those services too costly under their current monthly pricing structure, Landgrave says.

"So far it's much more expensive to use the cloud for the size of data sets we're talking about," he says. "It quickly becomes cost-prohibitive."

Cloud Security, Compliance and Integration