Epic EHR in the Cloud: Increasing System Reliability and Resilience

While the healthcare industry has warmed to the cloud over the past few years, it has yet to tap the full potential of hyperscale computing to transform the digital and analytics capabilities of provider organizations. The latter continue to face numerous challenges around cloud adoption, including too narrow a focus on the near term, and lack of technical expertise necessary to manage a cloud transformation. As a result, physician groups, hospitals, and health systems remain unable to fully leverage cloud technology to deliver personalized, high-value care in an increasingly hybrid healthcare ecosystem.

Over the past decade, Epic EHR technology has become the system of choice for leading healthcare organizations. An Epic implementation represents a significant investment for provider organizations and requires meeting a strict set of specifications and requirements for IT infrastructure necessary for the system to perform optimally.

The challenge for The Cloud to run Epic

The ability to achieve an on-premise view of the Epic EHR in the cloud that supports continuous care means these organizations must ensure their infrastructure can achieve high levels of availability, resiliency, and agility.

“That’s where a huge component of the challenge comes in today. When we think about cloud, all hyperscalers are limited by their compute and storage performance capabilities to successfully deliver this for all organizations,” says Jason Jones, Dell's Global Account Manager for Epic Systems.

“A major challenge is getting the performance needed for the critical EHR database workloads into the cloud using a cloud-first strategy,” he continues. “The solution is putting high-performance, dedicated compute and storage as close as possible to the hyperscaler with the lowest possible latency — otherwise, the application won’t run effectively.”

Given the rigorous demands to support an Epic EHR environment, healthcare organizations stand to benefit from collaborating with a technology partner that has experience with the software itself and the underlying hardware needed to make it work.

“When we truly start to peel back and look at infrastructure and Epic, a majority of all community members in the world run Dell client devices. Nobody understands this environment better than somebody who owns the market,” Jones adds.

Embracing a cloud-adjacent model

To put themselves in a position to benefit from increased cloud adoption without sacrificing performance, physician groups, hospitals, and health systems are turning to cloud-adjacent models that best fit their organization’s setup.

“Database storage and compute infrastructure is going to rely on dedicated hardware,” Jones explains. “There’s a physical limitation of what hyperscalers can provide today because the whole premise of cloud is rinse-and-repeat, which simply doesn’t work for Epic’s well-defined hardware configuration guide at scale

A cloud-adjacent deployment uses hyperscalers for front-end Epic workloads (e.g., the presentation tier, web and service servers) but runs Epic database workloads on dedicated high-performance block storage infrastructure and servers to meet critical response time and IOPS requirements for the database workloads.

The ability to be flexible ensures that each provider organization is able to tailor IT infrastructure to support their unique needs.

“No two hospitals are exactly alike,” says Jones. “The workflows are different. The modules are different. The delivery of care is different. Every organization is unique, so too is every Epic instance. The ability to scale infrastructure to support the biggest of the big or the smallest of the small and guarantee five-nines of storage infrastructure availability is crucial.”

New levels of resilience, flexibility

Enabling efficient and effective disaster recovery is vital to avoiding Epic EHR downtime and data corruption.

A cloud-adjacent model for Epic decreases demands on local IT infrastructure and personnel while improving a provider organization’s ability to refresh the support environment database, increasing database performance, and gaining efficient access to snapshots of database volumes for backups — shortcomings of standard hyperscale cloud environments.

“We can accelerate cloud adoption, but to be risk-averse, we want to be able to fail backward to the data center and continue to deliver care, which the Epic application itself is designed to do,” Jones observes. “If we move to the public cloud, we run the risk of failing “further away.” We want to follow the concept of the application itself and fail closer to the point of patient care, so we’re going to bring that data as close to the patient as we can get it, on every hospital floor.”

By offloading the management of cloud-adjacent infrastructure to a technology partner, healthcare organizations are better able to focus on keeping mission-critical systems running at the point of care.

“It’s technology — it’s going to break,” Jones maintains. “Who’s going to fix it? IT staff actually become more relevant and more important to the organization when they can deliver business value rather than representing a cost center. We’re helping to retool and expand the capabilities of IT teams within the healthcare organizations.”

As the healthcare industry’s appetite for the cloud evolves over the coming years, provider organizations will want to be able to modify their storage and computing needs as needed without incurring high egress/ingress costs. By choosing a technology partner capable of providing infrastructure uniquely suited for each Epic customer, and validated for each Epic instance, these organizations can avoid unnecessary growing pains without sacrificing cloud-based financial models tied to changing consumption.

With healthcare organizations still navigating their way through the uncertainty caused by a pandemic, their ability to quickly adapt their IT infrastructure to new and emerging trends will ensure their ability to deliver care and remain competitive in a changing industry.

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Dell Technologies provides transformative solutions that help healthcare-life sciences organizations prepare for the road ahead - from the point of care to the core to the cloud. From the world’s leading healthcare systems to rural health clinics, we offer essential infrastructure solutions to help you achieve business and clinical agility. Visit us at www.DellTechnologies.com/Healthcare