Legacy HealthFirst Microsoft Azure Hybrid Epic DR Configuration

The Problem: Rising Costs of Infrastructure

Portland, Oregon-based Legacy Health was looking for a way to reduce costs, improve resiliency and accelerate growth across the organization. The healthcare system wanted to focus on the business of healthcare and helping patients and not on the business of managing physical hardware and data centers. Legacy Health consists of seven hospitals, 80 clinics, 13,500 employees and 22,000 system users.

At the time, Legacy Health was operating an active-active Epic data center environment. With millions invested in identical infrastructures at two data centers, Legacy Health determined that migrating their Epic disaster recovery environment to Azure would allow them to modernize their infrastructure platforms.

Legacy Health Good Samaritan Hospital

Evaluating On-Prem, Hybrid, and Cloud Solutions

In order to begin the move, it was important to have base Azure infrastructure in place: directory services, networking and security. To provide technical expertise and facilitate the Linux conversion, Red Hat connected Legacy Health to their Epic go-to partner, OST. OST’s experience with the Cache database infrastructure helped Legacy ensure that their Epic database would perform and scale properly in Azure. Legacy Health optimized their Azure costs by implementing an on-demand database infrastructure that uses minimal resources during normal operations but can be scaled up to support production operations in the event that a disaster is declared.

Statistical Outcome


Savings Over On-Prem Infrastructure

To achieve success Legacy required the partnership of Epic, Red Hat, OST and Microsoft. According to Michael Carr, VP IS Technology and CISO at Legacy Health, “Every (partner) organization had a vested interest in making this a success.”

In December 2018, Legacy Health went live with Epic production running Red Hat Linux on Hyper-V on-premise and Epic Disaster Recovery in Azure.

Moving Forward with a Cloud-Appropriate Approach to Infrastructure

Not everything belongs in the cloud. Many organizations get caught up in asking, “can we move this to the cloud?” But they don’t first ask the more fundamental question: “should we move this to the cloud?”

Epic has very specific requirements for performance and availability of the systems which drive the technology architecture. In addition, there is an ecosystem of application dependencies and integrations that must be carefully considered in the overall system design. When looking at multimillion-dollar expenditures to maintain the resiliency level that Legacy had built, being able to leverage Azure for the DR environment had the potential to strip out costs without compromising the availability. Shifting their DR environment was less risky than trying to start with production workloads. Early in the planning process the teams estimated Azure DR would result in reduced costs over their current solution with the ability to provide the same level of resiliency. In the end, the benefits to using this approach for DR not only minimized Epic recovery times, but also allowed for scalability based on user needs, and reduced wasted investments in hardware. Plus, it was the perfect first step toward building their broader cloud strategy.

Many organizations realize there are benefits to extending their on-premise technologies into the cloud. However, balancing existing investments, resource and skill constraints and other concerns may be delaying their progress. Starting with DR allows organizations the ability to align costs and value by paying for what they need as it is used without compromising performance. The benefits of a hybrid-cloud approach include reduced risk, flexibility, speed and alignment.

Legacy Health Emmanuel Medical Center

The Results: 65% Savings Over On-Prem Infrastructure

Legacy Health realized a 65% savings in running their Epic Disaster Recovery database in Azure over its on-prem infrastructure for the same environment.

Now, their costs are in line with the actual usage of their DR environment. And with these savings, healthcare organizations can direct more dollars to patient care.

Legacy has also built on this foundational cloud work and migrated hundreds of servers to the cloud to continue optimizing their operations. With automation, consumption-based billing, and a wide variety of other benefits, healthcare organizations can experience reduced costs and increased efficiency through their hybrid cloud strategy. Because of a partnership with Epic and Microsoft, Azure is now a core part of the data center fabric and Legacy Health has moved to a cloud first approach.

DRaaS Makes Sense for Healthcare Organizations

Healthcare organizations have unique requirements for their IT systems because an outage can literally create a life or death situation.

The difference between on-premise environments and hybrid cloud is that the capability of the cloud is flexible, so it doesn’t need to be active 100% of the time. Instead, healthcare organizations can turn on their cloud-based DR solutions only when they need them. This reduces costs without sacrificing performance. In fact, hybrid cloud solutions can often reduce a healthcare organization’s recovery time objective (RTO) to mere minutes and reduce recovery point objective (RPO) down to seconds.

OST Can Help Your Healthcare Organization Leverage Hybrid Cloud Solutions

At OST, we understand the gap between traditional systems and the future of IT, and we know that digital transformation is the only way for healthcare organizations to compete. 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 contact form. We look forward to hearing from you!