Rethinking security in hospital informatics
In this guest editorial, Chris Cotreau dives into the shifting landscape of lab informatics, comparing cloud and on-premises systems, and what it means for hospital QC labs
17 Oct 2025
As hospital laboratories continue to modernize their operations, one of the most pressing questions facing IT and quality leaders is: Where should our informatics systems live — on-premises or in the cloud? While traditional wisdom has long favored local server-based deployments for their perceived control and security, the reality is more nuanced — and evolving rapidly.
The evolving role of informatics in hospital labs
Laboratory Information Management Systems (LIMS) and other informatics platforms are foundational to hospital QC labs. They manage everything from sample tracking to data analysis and reporting. Traditionally, these systems were deployed on local servers managed by in-house IT teams. However, the rise of cloud computing has introduced new deployment models — Infrastructure as a Service (IaaS), Platform as a Service (PaaS), and Software as a Service (SaaS) — each with distinct security implications.
The LIMS market is projected to grow from $2.1 billion in 2024 to $3.8 billion by 2029, with a compound annual growth rate of 12.9%, reflecting the increasing reliance on informatics in clinical diagnostics1. As hospitals consider migrating to the cloud, security remains a top concern.
On-premises security: control with complexity
On-premises deployments offer direct control over infrastructure, including physical access, network isolation, and customizable security configurations. This can be advantageous for organizations with robust IT teams and strict internal policies.
However, this control comes with significant challenges:
- Resource demands: Maintaining secure on-premises systems requires specialized staff and continuous oversight2.
- Patch management: Delays in applying updates can leave systems vulnerable to known threats2,3.
- Disaster recovery: Building and maintaining redundant infrastructure is costly and complex2.
- Inconsistent implementation: Security often depends on a patchwork of tools and configurations, increasing the risk of misconfiguration3.
In short, while on-premises systems offer theoretical security advantages, they can become liabilities without the necessary expertise and resources.
Cloud-based security: Scalable, specialized, and sophisticated
Modern cloud providers have invested heavily in security infrastructure, offering capabilities that often exceed what individual hospitals can achieve on their own. Key advantages include:
- Dedicated security teams: Cloud vendors employ experts who monitor systems 24/7 and respond to threats in real time2.
- Automated updates: Security patches are applied automatically, reducing the risk of human error or delay2,3.
- Advanced threat detection: Cloud platforms use AI and machine learning to detect anomalies and prevent breaches4.
- Built-in compliance tools: Many cloud services are designed to meet HIPAA, SOC 2, ISO 27001, and other regulatory standards4.
- Geographic redundancy: Distributed architectures enhance resilience against outages and cyber attacks4.
Cloud providers also offer sovereign cloud options to address data residency requirements, ensuring that sensitive data remains within specific geographic boundaries.
Addressing common cloud concerns
Despite these benefits, some organizations remain hesitant to adopt cloud solutions due to concerns about control, multi-tenancy, and internet dependency:
- Loss of control: While cloud systems shift some responsibilities to the provider, they also reduce the burden on internal teams and improve consistency4.
- Multi-tenant risks: Leading providers use strict isolation mechanisms to prevent data leakage between customers4.
- Internet dependency: While cloud systems require connectivity, they also offer robust failover and recovery options that often surpass on-premises capabilities2.
Security evaluation criteria for cloud adoption
Compliance certifications: Ensure the provider meets healthcare-specific standards such as SOC 2 Type II and ISO 27001.3,4.
Data protection: Look for encryption at rest and in transit, strong key management, and data isolation4.
Access controls: Role-based access, multi-factor authentication, and audit logging are essential2,3.
Contractual protections: Review SLAs for breach notification, data handling, and compliance support4.
Vendor transparency: Ask about vulnerability management, penetration testing, and incident response protocols2,3.
Exit strategy: Ensure data can be securely exported if you change providers2.
Making the right choice for your lab
Cloud-based informatics solutions can offer security equal to or greater than on-premises systems, provided they are properly implemented and configured. For many hospital QC labs, especially those with limited IT resources, the cloud represents a more secure, scalable, and sustainable path forward.
That said, the decision should be based on your lab’s specific needs, including regulatory requirements, integration complexity, and internal capabilities. A hybrid approach may also be appropriate in some cases.
References:
1. Build vs. Buy: What’s the Right Approach for Your LIMS System?
2. On-Premises or Cloud-Based: Which LIMS Model Is Right for Your Lab?
3. Is SaaS LIMS Right for Your Lab?
4. The Key Differences Between On-Premises and Cloud Security