Epic Electronic Health Records (EHR) system is the lifeblood of hospital organizations. Nearly everyone and everything – applications and data – interact with Epic on a day-to-day basis. However, maintaining and optimizing Epic on-premises brings several challenges, which is why organizations are beginning to migrate Epic to public clouds, like Microsoft Azure.
Why Azure? The Challenges of Running Epic On-Premise
Running Epic in an on-premise environment creates challenges with scalability, disaster recovery, and costs. Below we detail four main challenges and how the Azure cloud offers solutions.
Operations Management
Epic is a highly distributed and complex system with four layers of applications, making it challenging for customers to manage in their data center environments. The management and optimization of the Epic environment require rare, knowledgeable, and expensive resources. Finding the right talent can be time-consuming, especially considering that only 22% of IT talent is willing to relocate, limiting the talent pool further. Once you find and hire the talent, you still have to manage and retain them.
The Epic on Azure Solution
In Microsoft Azure public cloud, traditional IT tasks like patching, backups, and provisioning servers can be mostly automated, freeing up resources to focus on more critical activities. Additionally, with Epic on Azure, you can outsource IT management to a managed cloud service provider, reducing your need for in-house talent and resources for cloud infrastructure management.
Capital Investment Costs
Epic’s suite of applications, along with its co-traveler applications, requires significant investments in technology infrastructure. Each new version increases the amount of infrastructure it requires. Healthcare generates enormous amounts of both structured and unstructured data, which inherently takes up more space than structured data. Regulatory requirements often mandate the retention of data for seven to ten years, further complicating storage needs.
The Epic on Azure Solution
With Azure, there's virtually no upfront capital investment required, and you only pay for what you use, allowing organizations to better align operating costs with demand. Inexpensive and scalable cloud storage drastically reduces storage costs, with tiered services like Azure Archive Blog Storage making it even cheaper to store data that doesn’t need to be accessed frequently. For example, you pay around $0.01 per GB per month with Azure Archive Blob Storage.
Lack of Scalability
Due to Epic's highly distributed and complex nature, performance and optimization require hardware upgrades every 3-5 years. Unplanned purchases around year 3 are sometimes inevitable, resulting in unexpected significant capital investments. External events, such as the Meltdown and Spectre vulnerabilities or COVID-19, can trigger unplanned purchases and supply chain disruptions, further complicating the situation.
The Epic on Azure Solution
Deploying on Azure ensures that you always have the right infrastructure at the right time, regardless of whether your network covers a city, a region, or an entire country.
Downtime and Resilience
Disaster recovery for Epic can be as challenging as managing and maintaining Epic production. Most providers need to evaluate all implications to the Epic ecosystem before taking Epic's recommendations for disaster recovery. Epic's ecosystem typically includes 20-35 "co-traveler" applications that need to be available during a disaster. High availability is also critical, as slowdowns or outages can compromise patient care and incur substantial expenses.
The Epic on Azure Solution
With Azure cloud, you can leverage the elasticity of the cloud to ensure high availability and disaster recovery. Microsoft Azure’s global infrastructure allows you to spread your EHR across multiple data centers, minimizing downtime and enhancing resilience.
The Benefits of Epic on Azure
With Epic migration to Azure cloud, you can solve the challenges listed above and improve efficiency. Here are the top benefits.
Stop Guessing Capacity
Using Azure’s OpEx pricing model, you can align capacity with demand. Scale up to accommodate software upgrades without dealing with physical servers. You can also scale up further during unexpected events or vulnerabilities with minimal disruption.
Reduce Your Total Cost of Ownership
Azure allows you to reduce operating costs by auto-scaling infrastructure resources based on demand rather than designing for peak demand at all times. This approach removes the guesswork and costs resulting from over- or under-provisioning infrastructure. Pilot-light disaster recovery infrastructure can reduce DR costs by 40-80% compared to on-premise solutions.
Improve Performance and Uptime
Leveraging Azure’s elasticity, you can adapt to changes in user demands with minimal downtime. Automation and orchestration can manage workloads, reducing unplanned downtime caused by human error. Upgrades can be simplified and easily tested with temporary instances. Additionally, spreading your EHR across multiple data centers can be done in minutes instead of months.
Deploy Epic Releases Faster for End-User Innovation
Epic quarterly releases can be deployed faster, and infrastructure can be right-sized for yearly growth. Traditional IT tasks can be automated by 50%, freeing up resources to focus on differentiating activities.
Modular & Hybrid Designs
Azure supports a modular and hybrid design approach to Epic without disrupting existing investments. Azure can be used for any combination of production, disaster recovery, and development/testing/training environments.
Focus on Healthcare, Not IT
Shifting to Azure allows healthcare providers to focus on optimizing clinical workflows for better patient care and clinician user experience rather than managing IT infrastructure.
Business Continuity and Resilience
Azure's Epic cloud read-only solution enables safe access to Epic production data, even during a ransomware attack or other disaster.
Read Next: Ransomware Resilience with Epic on Azure
Performance and Global Infrastructure
Azure offers powerful compute performance for Epic infrastructure, capable of handling large Epic workloads. With 113 availability zones and over 60 regions worldwide and plans for ongoing expansion, Azure provides extensive global infrastructure.
Compliance and Security
Azure facilitates compliance with healthcare-specific regulations, supporting more security standards and compliance certifications, including HIPAA and HITECH, than any other cloud offering.
Flexibility
Azure services offer flexible pricing structures where users only pay for the services and usage they need, resulting in significant cost savings.
Epic Migration to Azure Challenges: Why You Need a Partner
Complexity and Co-travelers
Epic is arguably the most difficult workload to move from a traditional environment to Azure due to its numerous dependencies. A mid-size medical center can have over 500 interface connections to manage during the migration.
Expertise
There is a cloud skills gap, and cloud resources are expensive and scarce. With only 22% of IT talent willing to relocate, finding qualified talent is further limited by geographical location. Managing and retaining this talent is another challenge.
Cost Management
Early in the migration process, costs can increase due to the need for expert tuning of Azure Deployments and potential data transfer fees. Effective cost management requires financial governance and consultation with a knowledgeable managed service provider (MSP).
Cultural Resistance
Migrating to the cloud is a disruptive event, often encountering resistance from staff. Overcoming this resistance requires educating senior management about the benefits of moving Epic to the cloud and engaging staff through open forums to address concerns and build support.
Get Started with Epic Migration to Azure Today
While the migration process is complex and requires expertise, partnering with an experienced MSP can help navigate these challenges and ensure a successful transition. By moving to Azure, healthcare organizations can optimize their Epic environments, improve resilience, and ultimately enhance patient care.
Ready to migrate Epic to Azure today? Contact us for a free consultation.
