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David VandeWaa

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October 3, 2019

Why Migrate On-Prem and Legacy Healthcare Systems to the Cloud?

Hybrid Cloud for Healthcare Image

Modernizing and optimizing IT systems can bring a wide variety of benefits, but many healthcare organizations are hesitant to move forward with hybrid cloud solutions. Why? Here are just a few reasons:

  • Healthcare organizations understand there are benefits with migrating to the cloud, but they struggle with understanding how to achieve them.
  • Security and compliance are still some of the biggest concerns for moving to the cloud.
  • Teams’ lack of experience and knowledge of cloud architectures create concerns about potential implementation issues that could result in significant problems for clinicians, staff, or even patients.
  • IT sees cloud solutions as added complexity that must be managed along with multiple other priorities and day-to-day activities.
  • Moving to the cloud requires shifting governance processes that may not exist. For example, traditional models center on planned capital investments (CAPEX) in technology. Cloud-based solutions, on the other hand, rely on consumptive expenditures (OPEX) associated with cloud usage. Healthcare organizations are fearful of unplanned or unchecked costs associated with this shift.

In this article, we’ll discuss each of these issues along with the changing role of healthcare IT teams, new opportunities the cloud brings to healthcare organizations, and some of the important reasons why healthcare organizations need to move on-premises IT infrastructure (especially legacy applications and systems) to the cloud.

The Demands on Healthcare IT Teams Are Changing

Today, IT teams are working more closely with the business and are expected to be increasingly proactive and even innovative. This is especially true in the healthcare industry. Several key factors are driving these new demands:

  1. Operational efficiency, clinical productivity, connected teams, and other optimization strategies as part of the quadruple aim have become top-of-mind for administrators and other healthcare leaders, including those in IT.
  2. To remain competitive, healthcare organizations need to shift their focus to drive increased patient engagement and improved experiences that foster retention.
  3. Improving population health while lowering the costs of care requires access to systems that provide insights driven by internet-scale data, real-time quality metrics, integrations, and artificial intelligence. And many of these tools are only available through modern cloud platforms.
  4. Healthcare organizations are being driven to make large investments in new technologies to support the quadruple aim while continuing to maintain proprietary and legacy systems.

These demands are requiring teams to be more flexible and agile. In turn, healthcare organizations are evaluating platform options that will remove the limitations created by physical systems and accelerate digital transformation. They are fundamentally trying to seize new opportunities that will improve patient experiences and outcomes. And hybrid cloud solutions are going to play an integral role.

What Is Hybrid IT?

Broadly, hybrid IT is an environment comprised of on-premise IT infrastructure, private cloud, and public cloud resources working together to deliver both internal and external services for your organization. It’s essentially a partnership between what you have on-premises and the cloud.

The goal of hybrid cloud solutions is to lift the limitations associated with on-premises data centers, both physical and conceptual. By adopting cloud solutions, healthcare organizations can stop wondering, “is that going to fit in our data center?” With unlimited resource capacity, they can instead ask, “what’s possible?”

With a hybrid cloud solution, investments in your on-prem data center don’t go away. You open up new opportunities that extend into the cloud so you can fully utilize all of your resources to optimize your platforms, products, and services for the results your organization values most.

The Benefits of Hybrid Cloud Solutions for Healthcare Organizations

Most organizations know they need to expand their on-premise and cloud technologies. They know that the right IT infrastructure approach is essential for realizing their goals and vision. And they know there are tangible benefits for growing their data analytics and other technology capabilities.

For example, leveraging hybrid cloud architectures can lead to quantifiable improvements in revenue, margins, and reduced costs:

  • $34,000 higher average revenue per employee
  • 65% higher gross margin
  • 14% higher net income

These astonishing numbers from an in-depth analysis don’t happen overnight. Instead, gains like these are made as a result of conscientious, deliberate modernization efforts that focus on cost optimizations, increasing agility, streamlining processes, automation, and facilitating innovation.

The benefits of a hybrid cloud approach also go beyond dollars and cents, especially for healthcare organizations. Broadly, those benefits can be broken down into four main categories:

Reduced Risk

Moving to the cloud comes with a wide array of inherent security and compliance features enabled. For example, Azure (Microsoft’s cloud platform) is completely HIPAA compliant, and it’s compliant with other global, national, and industry-specific standards, like ISO, SOC, and more. Plus, Microsoft will sign a business associate agreement (BAA) with healthcare organizations that utilize the Azure platform.

Security risks are particularly high with legacy systems. When a major vendor, like Microsoft, sunsets a platform or application, they stop writing security updates. This is a fresh issue for many healthcare organizations’ IT teams who faced (or are still facing) the end of support (EOS) deadline of July 9, 2019 for SQL Server 2008 and 2008 R2 as well as Windows Server 2008 and 2008 R2 on July 14, 2020. And similar EOS issues will certainly arise in the future.

But security risks like this can be mitigated with cloud adoption. In the case of SQL Server 2008/2008 R2 and Windows Server 2008/2008 R2, for example, Microsoft is offering up to three years of extended security updates by utilizing Azure, which effectively gives you several more years to manage your transition to new platforms.

Flexibility

Flexibility is one of the biggest advantages of a hybrid cloud solution for healthcare organizations. IT teams can slowly ramp up their cloud usage and gain experience while simultaneously developing new strategies for larger and more complex workloads. Some of the other unique benefits of hybrid IT include:

    • Healthcare organizations can spin up small workloads in a matter of minutes.
    • Sandboxing is incredibly easy in the cloud. Using a sandbox in the cloud, IT teams can bring up test environments to try new versions of operating systems, database technologies, etc.
    • Web apps, and even websites, can load and operate very fast on the cloud.

Fast provisioning, always-on compute, and processing available through the cloud mean you can scale up whenever you need additional resources. And when resources may no longer be needed, they can also be spun down to conserve costs. This flexibility makes the cloud a compelling choice for test, quality assurance, and disaster recovery workloads that are not needed at full capacity like production.

Speed

Moving infrastructure to the cloud means instant access to new features and capabilities that can accelerate digital health initiatives. Most developers now write applications, updates, and enhancements for the cloud natively. This means instant integration with your cloud environment and reduced technical debt for your IT teams. Similarly, new products, updates, and features are released to the cloud first. Microsoft, for example, provides the Azure community with access to their products before they’re available anywhere else. And with faster, earlier updates, your organization will remain compliant with the latest security updates and patches.

Alignment

In many cases, healthcare cloud solutions can also increase alignment among IT, business, and clinical teams. Connected and intelligent clinical platforms encourage collaboration across the organization. Empowering clinical teams through digital health capabilities means IT plays a key role in helping your organization leverage the cloud’s flexibility, performance, and capacity to support digital initiatives. The cloud repositions IT as an agile business partner rather than a cog in the wheel or cost center.

At other times, the urgency of a situation (like end-of-life for a product) creates alignment as everyone works together to overcome the challenge they’re facing.

With these key cloud benefits, your organization can pursue new digital health initiatives and care enablement—on a shorter timeframe.

How Do You Start Moving On-Prem and Legacy Systems to the Cloud?

Every healthcare organization will have unique needs when it comes to cloud adoption. At OST, we have an approach that focuses on five pillars of hybrid IT.

1. Attaining Capacity

This is often the easiest part of your healthcare organization’s cloud journey. It simply involves setting up your subscriptions and instances in the cloud. Many healthcare organizations are already using platforms such as Microsoft Office 365, which means they have the initial framework in place to quickly make progress migrating on-premises and legacy systems to the cloud.

2. Connect

The next step is to begin extending your existing network, storage, applications, etc. into the cloud. An important part of securing this connection is extending your Active Directory environment into Azure, which allows authentication on the cloud along with identity and access capabilities like multi-factor authentication and single sign-on. You will also want to evaluate secure VPN options for connecting to the cloud.

Another crucial aspect of connecting to the cloud is making sure you can maintain acceptable latency levels and ensure that bandwidth is sufficient to move your data back and forth.

3. Avoid Risk

Reducing risk is often the primary concern of healthcare organizations transitioning on-premises systems like backups, disaster recovery, and legacy applications to the cloud. As we mentioned above, the cloud offers increased security and compliance via embedded platform features. Cloud providers like Microsoft also routinely work with healthcare organizations to establish and enforce any agreements necessary to facilitate operations. The cloud also offers additional risk-mitigation features to improve email hygiene, prevent data loss, manage mobile devices, replicate instances, and much more.

One important fact to remember about cloud migration is that you still need solutions for data protection, backup, and recovery. These need to be set up separately, whether on-prem, in the cloud, or via a hybrid approach.

4. Avoid Mistakes and Manage Costs

With multiple teams utilizing cloud resources, healthcare organizations need to carefully monitor and manage their cloud usage to effectively keep costs under control. Cloud management needs to go beyond traditional infrastructure monitoring by carefully tracking consumption and spend. The cloud offers a variety of tools that can help healthcare organizations determine who is using what (and how much) to facilitate chargebacks and accurately determine budgets at a granular level.

5. Achieve Velocity

With all your necessary infrastructure in place, your organization will be able to start leveraging the flexibility and capacity of the cloud to further the quadruple aim. For example, the cloud allows you to temporarily utilize extremely high compute capacity for single events (like analyzing large data sets) and then scale back down. The cloud can help your teams capture data, use that data to inform decisions about care, and make it available to the right people at the right time. And the cloud allows your healthcare organization to quickly adopt and utilize innovative technologies related to IoT, machine learning and artificial intelligence, data analytics, and more—without massive investments in additional on-premises resources.

With these five pillars of hybrid cloud squarely in place, you can achieve the future with innovations to improve patient care, improve population health, reduce the cost of care, and increase staff engagement and retention.

RELATED EBOOK: The Five Pillars of a Successful Hybrid IT Strategy

Ready to Start Leveraging the Cloud for Your Healthcare Organization?

At OST, we understand the gap between legacy systems and the future of IT, and we know that digital transformation is the only way for healthcare organizations to compete. We have had a national healthcare practice since 2004, we have specialists in Epic and other healthcare software, and we have handled hundreds of projects in the U.S. related to digital transformation in healthcare. We have national partnerships with leading technology companies to provide healthcare IT consulting services centered around infrastructure, design, architecture, high-availability re-platforming, disaster recovery, cloud implementations, and other areas.

To connect with one of our experts, simply call (616) 574-3500 or complete a quick contact form. We look forward to hearing from you!

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About the Author

With a master’s in English, certifications in search engine optimization (SEO) and marketing automation, and nearly a decade of experience in digital marketing, Dave brings a deeply nuanced understanding to everything from high-level digital strategy to the nitty-gritty details of implementation.