But IBM is convinced that the future of health care is in the clouds, and it has been moving steadily, if quietly, in that direction for some years now.
The importance of its deal with the National Marrow Donor Program, which Dave Rosenberg of CNET wrote about yesterday, is that it's a demonstration of what can be done with cloud-sized databases and processing power.
IBM's new deal in Puerto Rico is a beta test of something it can quickly roll out nationwide.
What this means for clinics and hospitals is that most of the gear does not need to be in your office. Collecting EMR data on your patients by hand, and turning a hard drive into your file room, is not the future.
This will be a relief to many doctors who find such systems to be an enormous pain, despite the promise of that sweet, sweet stimulus cash. What they want is actionable advice on what to do for their patients. What they want is an end to the current paper-based runaround.
That's what IBM plans to deliver. The company is working hard on increasing analytics processing speed, because medicine produces great rafts of data that must be tied to other rafts in order to get everyone down to the sea.
In health care, clouds have to be private, they have to be secure, and they have to be managed, or they're no good. Local offices are clients, not servers, so it's interfaces that matter there. An iPad for everyone is fine with IBM --they got out of the client space years ago.
IBM is not wrapping this with a bow and going on TV with it because they want it to work before they sell it to the mass market. But it's clear that they want medical data to live in the cloud, not in the office or hospital, and that they want to be delivering answers, not data.
Which is just what the doctor ordered.