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In enterprise IT, it is difficult to find a larger or more pervasive subject than the continuing rise of cloud computing. Most of those narratives focus on the prevalence of hybrid cloud as the solution that many, if not most, businesses prefer.
But what about companies that want to consider, instead, shifting most or all their data center-based assets and processes to the cloud? What drives those decisions, what challenges do they face, what benefits do they hope to capture, and which trusted partners can help them achieve their goals? A recently published customer use case concerning the cloud migration that Virtustream implemented for Franciscan Health offers deep insights into this process.
Franciscan Health: Profile, goals, challenges
Headquartered in Mishawaka, Ind., Franciscan Health’s 18,000 part- and full-time employees serve patients at 12 hospitals and numerous clinics in Indiana, Illinois and Michigan. The company also engages with doctors in hundreds of local medical practices.
Like most large-scale medical organizations, Franciscan Health has shifted from traditional record-keeping practices to EHR (electronic health records) technologies, and has utilized Epic EHR solutions for the past decade. As part of a longer-term strategy to exit the data center business, in 2018 Franciscan Health decided to migrate its Epic system and records to a cloud environment. But due to the inherently sensitive nature of patients’ records and the rigorous compliance regulations they are governed by, the health-care provider decided to look beyond conventional public cloud platforms and services.
Why did Franciscan Health wish to engage a cloud provider with deep managed services capabilities? The company believes the ability to offload portions of its infrastructure operations and application management will enable its IT staff to explore and implement more innovative new technology solutions and projects, that, in turn, help Franciscan Health better support the individuals and communities it serves and more effectively adapt to rapid market changes and unexpected events.
Those were valid and valuable goals, but Franciscan Health’s migration was anything but simple. The IT infrastructure supporting the company’s Epic environment consisted of about 50 physical servers with nearly 3,000 cores that supported 400+ VMs and more than 200TB of patient records and other data. The system served the 24/7/365 needs of some 9,000 concurrent users, including doctors, nurses, managers and other health-care and business staff.
Along with supporting thousands of end users, Franciscan’s IT environment required robust levels of performance. Epic measures its application scalability with Global References per second (GRefs), a metric that represents the number of times per second that the Epic Caché operational database is referenced. In 2018, that translated into 7 million GRefs for Franciscan Health’s 25TB Caché database.
In other words, along with finding a cloud provider that could deliver the levels of performance, security and support required, Franciscan Health also needed help managing what it knew would be a highly challenging migration.
Virtustream Healthcare Cloud
After conducting a diligent search, Franciscan Health chose Virtustream as its cloud partner. Aa a Dell Technologies business, Virtustream is an enterprise-class cloud provider whose services are purpose-built to support complex IT environments and mission-critical applications like those from Epic and SAP.
Of particular interest to Franciscan Health was Virtustream’s Healthcare Cloud, which supports Epic’s EHR Provider and Payer solutions. Those offerings enable health-care organizations and patients to effectively access and review records and data to simplify administrative processes and facilitate care management. Virtustream Healthcare Cloud also offers customers a HIPAA-HITECH and SOC2+HITRUST compliant cloud that secures both protected health information (PHI) and non-PHI data.
Franciscan Health was also impressed by Virtustream’s xStreamCare Managed Services, a comprehensive solution that employs Epic-certified Virtustream experts to manage Epic EHR system maintenance and operations. In addition, the company chose to implement Virtustream’s ITSM Ticketing Integration Services which integrated both companies’ IT incident ticketing and change management processes. As a result, Franciscan was able to automate support workflows and enjoy near real-time response with full ticketing lifecycle visibility.
Franciscan Health and Virtustream: The results
After project planning kicked-off in March 2018, the migration was conducted from September 2018 to February 2019 and went live in March 2019. While Franciscan Health specifically requested that the process proceed over a six-month timeline, Virtustream Healthcare Cloud has managed similarly-sized migrations in less time.
After the success of the initial migration, Franciscan Health migrated its Epic production environment to the Virtustream Healthcare Cloud a few months later. Not only has the move to the cloud satisfied Franciscan’s original goals, partnering with Virtustream has also enabled the company to support additional growth and to address unexpected challenges. In the former case, the number of concurrent users has expanded from the original 9,000 to over 11,000 today. The Epic Cache database has also scaled seamlessly, from 25TB to over 40TB, and the GRefs for Caché have increased by more than 28% to 9M.
Franciscan’s move to Virtustream also helped it to better manage processes and staff during the Covid-19 crisis. During the height of the pandemic, Epic was rolling out updates and releases on a near-weekly basis. Working with Virtustream enabled Franciscan Health to focus on vital initiatives, including supporting remote workers and delivering front-line care to the communities it serves.
Franciscan was also able to continue implementing its long-term cloud strategy despite the stresses inspired by Covid-19. Following the migration to the Virtustream Healthcare Cloud, the health-care provider moved its on-premises Microsoft Office application environment to Microsoft’s Office 365 cloud, deployed a new Cisco VOIP telephony system and introduced a new cloud-enabled health-care imaging solution across its hospital system. The last two of those initiatives occurred during the height of the pandemic.
Final analysis
Along with achieving the goals it originally hoped for, working with Virtustream delivered other substantial benefits to Franciscan Health. The companies’ ticketing integration system enabled Franciscan for the first time ever to achieve Epic Honor Roll status, a set of standards, processes and procedures that Epic benchmarks and recommends for optimum performance. Franciscan’s Response Time Tracking (RTT) exceptions (a value of Epic’s component parts, including database time, network time and system time) dropped to an acceptable rate for the first time ever.
Franciscan Health is continuing to consider ways to expand its path to the cloud. While the company still operates two primary data centers, it hopes to vacate one of those locations and is discussing the most effective cloud platforms to host those applications and workloads with Virtustream. The trusted partnership with Virtustream has allowed Franciscan to achieve and surpass the robust performance requirements it aimed for. More importantly, leveraging Virtustream’s managed services has helped Franciscan Health to effectively re-focus its IT staff on more patient-centric initiatives and innovations.
That shift of attention away from the mundane day-to-day IT management tasks to improving the quality of treatment and the quality of life of Franciscan Health’s patients is a testament to the substantial value of the Virtustream Healthcare Cloud and its related xStreamCare Managed Services.