First, do no harm – is the prime directive for doctors and other medical professionals. IT professionals follow a similar, if less elegant, cautionary principle: If it’s not broken, don’t fix it.
That’s why when healthcare enterprises ask me if they should move their Epic software – or any large software system – to public clouds like Amazon Web Services (AWS), my first response is “What’s broken? What is your existing on-premises deployment preventing you from doing?” My intent is not to dissuade them from migrating to the cloud but to help them focus clearly on their own goals and to determine whether those goals are realistic. In other words, how do you expect to benefit from this move?
The answer to that question often depends on where you sit in the organization. The eyes of your chief medical officer (CMO) may glaze over at discussions of capex versus opex, but talk about faster time to market for productivity enhancements and less application downtime and they’ll sit up and listen. Every seat at the executive boardroom table has a stake in the decision to migrate and needs to be clear on what to expect.
With Epic on the cloud, there's something in it for everyone. But the benefits differ across departments. Let’s look at the benefits of Epic on the cloud for healthcare C-levels.
The on-going movement from on-premises infrastructure to the public cloud changes the funding model from one based on capital investment (capex) to ongoing fees based on usage (opex). This shift benefits organizations financially in several ways. First, every company has a finite amount of investment capital so organizations must make choices about where to invest. Eliminating the need to purchase data center hardware and software frees up investment capital for other uses more directly related to growing the business. Retail companies and professional services enterprises can open more branches and hospitals can upgrade imaging equipment and medical information systems. Industrial enterprises can modernize production lines, while transportation companies can acquire more rolling stock.
In addition, cloud-based infrastructure allows cost accountants to more closely tie expenditures to revenues, especially helpful in internet-based retail businesses where spikes in resource usage usually correspond to increased revenues. Charging computing and storage costs back to the users of those resources motivates business unit leaders to monitor and manage their departments’ public cloud spending.
Chronic understaffing is a fact of life for most CIOs. A study by IT recruiting firm Robert Half Technology reports that 43% of CIOs queried believe their departments are either deeply or somewhat understaffed for handling their current workloads. More and more of the operational burden falls on fewer and fewer people, leading to increased human errors and job burnout.
Moving to the cloud won’t cause skilled IT professionals to materialize in your security department a la Star Trek, but it will allow you to reassign some of your existing staff to projects that reduce costs, increase services, and accelerate innovation. WIth the day-to-day workload becoming more manageable, you can invest in training existing staff to grow your internal skills and avoid the need to hire additional personnel.
Clinical users – physicians, nurses, and other healthcare delivery staff – depend on Epic to do their jobs, so the last thing they need is an unreliable system. The severity of reliability issues ranges from performance slowdowns that impact productivity to shutdowns that force hospital staff to go back to writing on paper patient charts – a ponderous and error-prone process that can compromise the ability to deliver first-rate care.
Public clouds are among the most reliable business services available. Cloud providers invest heavily in top-of-the-line technologies to ensure redundancy, rapid failover, and geographic dispersion. Of course, you can in principle implement similar measures in an on-premises environment and expect to realize similar levels of reliability, albeit at a very high level of capital investment. The big difference is that reliability is fundamental to the cloud provider’s business model, and therefore is integrated into the architecture, not bolted on.
It’s ironic that what was initially perceived as the most concerning weakness of the cloud – security – has become one of its biggest strengths. All public cloud providers have adopted a shared responsibility model for security in which the provider secures the platform – hardware and software – while you, the customer, secure your applications and data.
To a healthcare organization, a data breach is a nightmare. To a cloud service provider, a data breach is an existential threat. Public cloud is a highly competitive marketplace, so if a provider got the reputation of being vulnerable to cyberattacks, their business could literally dry up in weeks or months. Therefore, it is no surprise that providers are highly motivated to implement the best security possible and keep up with new and more virulent threats.
Healthcare IT systems need to roll out new services to help the organization remain competitive, and time to market is crucial for success. In particular, hospital CIOs are driving integration and automation to both cut costs and improve the user experience for patients, clinicians, and staff. The Epic EHR and its ecosystem are usually at the center of these initiatives.
Running Epic in the cloud speeds development in two ways. First, software engineers can spin up their own development and test environments themselves using self-service portals, without IT involvement. This approach cuts the time to bring up an environment from days or weeks to minutes. As a result, engineers save time and also can afford to try out more alternatives than would be possible with an on-premises data center.
In addition, all the major cloud providers have service catalogs showing hundreds of functions such as text-to-speech engines, image recognition for diagnostic support, customer contact centers, and enterprise search. By using these off-the-shelf, pretested modules, developers can shorten development cycles and improve the overall quality of the applications.
As you evaluate Epic in the cloud, your staff will undoubtedly generate a blizzard of spreadsheets, presentations, and reports laying out the quantifiable pros and cons. But there’s more to the decision than numbers. When you host your own Epic software on premises, you’re effectively in the infrastructure business – and that has profound implications for healthcare executives whose expertise is in, well, healthcare, not IT. Imagine that you’re the CEO of a large healthcare enterprise – do you really want to spend valuable management time evaluating capital investments in servers and storage systems?
Moving to the public cloud gets you out of the infrastructure business, once and for all. That change frees up substantial management time that can be refocused on the core mission of the organization: delivering superior healthcare, enhancing regulatory compliance, and growing the business. Healthcare organizations that embrace the cloud can better focus scarce resources, from executive staff to systems administrator, on initiatives that more directly improve patient care, employee safety, business growth, and profitability.
Moving a core component of your organization, like Epic, to the cloud is undoubtedly a big change that's not to be taken lightly. However, if you analyze it, the benefits of migrating Epic to the cloud are so compelling that you really can’t afford to wait.
Contact us today to learn more about how Cloudticity and our partner Sapphire Health can help you make the transition into the public cloud and unlock the full potential of your investment in Epic software. Or download These Five Things Are Slowing Your Epic to AWS Migration to learn about common roadblocks to get in front of before you start.