Running EPIC on Azure for Production
Episode 3924th February 2022 • This Week Health: Newsroom • This Week Health
00:00:00 00:10:41


Today in health, it we're going to talk a little epic on Azure. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week health. I set a channel dedicated to keeping health it staff current and engaged. We want to thank our show sponsors who are investing in developing our next generation of health leaders.

Gordian dynamics, Quill health tower, site nuance, Canon medical, and current health. Check them out at this week. All right today, Thursday, February 24th at 1:00 PM. We are doing a webinar and the webinar webinar is on cloud and moving epic. Into the cloud specifically moving epic into Azure. We have two health systems St. Luke's university health network.

And cone health who have actually done this. They've moved production out there. They're going to share their journey. They're going to talk about what's working. What's not working. And you can sign up, just hit our website this week. The webinar's right there on that page. And you can, , sign up that way.

All right. So what I thought I'd do today is a little stream of consciousness. I have to prepare for this webinar. I'm going to be hosting it. , today with, , Christine for Shia. B R U. T S C H E a. She's the associate CIO at St. Luke's health network. I talked to Chad Persantine who's the CIO. And he said that Christine is the one you want to talk to. She's a lot closer to the implementation.

, Arthur, , tacit is assistant manager at cone health. He is in the weeds. He knows what's going on. On their cloud and health platform. Dr. McMillan is a CISSO and, , used to work at cone health. He was part of making that migration happen. And now he's the director of healthcare at serious health care. So that's where I'm going to be talking to.

The framework for this is we're going to talk strategy. First of all, then we're going to talk about how they got buy in. We're going to talk about how the, the return that they anticipated in moving to the cloud. , what were some of the things that they were concerned about? What were some of the pitfalls they were trying to avoid?

, we're going to talk about stepping in and how they stepped in to the cloud that itself, what were the results that they achieved and then, , what are the next steps? Are they monitoring it? And those kinds of things, what I thought I'd do today is I'd break down some of the questions that I'm getting.

This will give you an idea of some of the things that we're going to talk about. And some of the things that are top of mine. Again, when you put a webinar out there with a, with a title of moving epic to Azure in really talking to the two health systems that have made it work and done it in production.

, you know, first of all, you get a fair number of signups. Second, while you get a fair number of questions. And I think those are indicative of how people are viewing this. So again, I'm going to give you the questions. I'm not the expert. These people are, the experts you'll have to tune into the,

webinars to hear some of these answers, but, , here's some of the questions. So what was the biggest internal hurdles to overcome as you move to the cloud? I know that when I came in as CIO at St. Joe's, we were going to move to the cloud. And oddly enough, the biggest hurdles. We're in the it organization, not outside the it organization. I made some mistakes in how I did it.

But essentially the rest of the organization says, , , we understand the cloud. We know the cloud, we use the cloud in our everyday lives. We, love the cloud. The it organization, even though we bring change to the rest of the world, I was not as open to that change because they didn't really understand what that meant for them in their career.

, you know, next question historically. It would take months of planning, budgeting, hardware, acquisition, installation, to meet Epic's target platforms, requirements, and yearly growth projections. How quickly are you seeing customers? Deploy epic, quarterly releases into the cloud. All right. So yeah, once you get it up there.

How can you maintain that cloud environment? And what does that look like? , Another question. How has the transition to epic? On Azure impacted the performance and the system availability warranties that may have existed in your organization agreements with epic. Have you seen improvements or challenges with system availability, performance subsequent to the migration was epic, supportive or resistant to the migration, , given choice.

Would you do it again? It's interesting because in our pre-call I talked about some of these things and I think one of the things that's going to surprise you is the performance characteristics that they are attaining for the cloud. I think that's one of the things that people look at and they go, oh, the performance characteristics won't be as good.

And I think they will surprise you with some of the things that they have found. , what were the major hurdles as part of the transition? How did you decide on your cloud provider and how did you sequence the transition? Just to be clear if you're coming to hear how you can move to the cloud in general, , they both moved to epic in Azure.

, there's a reason they both chose Azure. I'm sure they'll share why they chose Azure over other cloud platforms. But if you're wondering, Hey, how am I going to move this to AWS? , we will give you some indication of what it's like to run it in the cloud, but we may not give you an indication as to.

The specifics of how to make it run on that specific cloud environment. So just something to consider as you tune in, , what were the lessons learned when using at virtualization for delivery of epic hyperspace from Azure? That's an interesting question. As you know, there's, there's different ways to, , deliver the desktop in an epic world.

So that's going to be an interesting conversation. And I look forward to hearing what they have to say about that. , recognize the cloud is about more than pure costs is cone or St. Luke's saving money over their on-prem architecture. If it costs more, how has the value proposition packaged?

For senior leaders. And this is one of the more interesting things, because we made mistakes early on saying, Hey, we're going to move to the cloud and we're going to save money. And it turned out, it didn't really save us money, but it gave us all sorts of agility and the ability to, , tap into other systems because the application architecture on internet applications.

As much more flexible and you can plug in and we saw the benefit of that. And the pandemic and how people were able to ramp things up very rapidly. , in the cloud, but with that being said when you look at the different options you have, on-prem. And you have epic hosted, and then you have African Azure. And I think what you're going to find is, you know, if you want to run it on site, you're not going to have as much flexibility, but your cost is probably going to be as low as you could possibly make it. And that's a broad generalization, but that's mostly going to be true

so, , epic hosted though is extremely expensive from people I've talked to who have looked at the pricing. And this falls somewhere in between. So if you're thinking, Hey, I need to get to the cloud. , but I can't afford epic hosted. This is the kind of conversation you're going to want to listen in on.

So, , let's go on a couple more questions. If our organization has a large data center full of on-premise solutions is moving gesture, EMR, really providing any cost savings. And I'll answer that. Probably not. , if you have chosen an on-prem strategy, Then you, you haven't recognized.

, how do you use the cloud? You haven't adopted a cloud strategy then at the end of the day, there's no reason to move one thing into the cloud until you've decided how you're going to handle everything. it's a part of a larger strategy. , Alright, , Is full-stack engineering team required to support the hybrid cloud environment as opposed to formerly siloed teams, DBS networks, software engineer. That's a great question.

You know, even on our on-prem we were moving to, , full stack engineering or dev ops, we were moving that way on prem. Because it offers so many benefits. When you think about your, your infrastructure. As a single application.

And maintaining that single application and wanting the automation that's available and wanting the standardization that's available. , moving to a, full stack engineering team, , made a lot of sense from where we sat and by the way, that was back. Gosh, that's got to be at least.

Six years ago that we were doing it that way. So. , just context. Are you able to implement this without using Citrix? Interesting question. , what's the cost difference between on-prem versus hosting? So a lot of cost questions, some tactical questions. Do you see Azure displacing epic as the platform? , I'll answer that. I don't think so. I don't think Microsoft has any.

, desire. To, , , replace epic. . And at this point, They're a services company. They provide technology and advanced technology to healthcare.

, they are not looking to develop stacks of highly specialized. They're not doing it for banking. They're not going to do it for healthcare. They're not doing it for manufacturing. Yes. They have, , applications that get utilized and those that get customized in those things. But they're our cloud platform. First that gets customized by the people in those industries for use in those industries.

So I just wanted to give you guys a sneak peek into what we're going to be talking about in this cloud. Webinar today. I think you're going to have a great time. , and enjoyed if, if, even if you can't come today, , just go ahead and sign up. And the reason I say that is because if you sign up, you will get the email about the on demand webinar.

And you can come out to our website after the fact log in. And you can watch the webinar at your leisure over the weekend later, next week, it's up to you. All right. That's all for today. If you know someone that might benefit from our channel, please forward them a note. They can subscribe on our website this week or wherever you listen to podcasts, apple, Google, overcast, Spotify, Stitcher.

You get the picture we are everywhere, or at least we're trying to be. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health leaders, Gordian dynamics, Quill health Taos site nuance, Canon medical, and current health. 📍 Check them out at this week. Thanks for listening. That's all for now.



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