Moving Epic in the Cloud: Strategies from Early Adopters

Healthcare organizations and HIT vendors alike have noted the benefits of moving to a public cloud provider—see previous KLAS research for insights into the experiences of organizations that have used Amazon Web Services (AWS) or Microsoft. Given the potential benefits, health systems are reporting increasing interest in utilizing a public hyperscale cloud provider (such as AWS, Google Cloud Platform, or Microsoft Azure) to support their EHR environment. Interest is especially high among Epic customers.

To learn more about their strategies, KLAS conducted in-depth interviews with 10 organizations that are planning to move all or some of their Epic environment to the cloud. Our recently published report Approaches to Moving Epic in the Cloud 2023 highlights insights from these organizations regarding which public cloud providers are up for consideration, which Epic environments they are considering moving, what their goals and concerns are for this approach, and how they will utilize third-party firms in the transition.

Cloud Gaining Traction across Variety of Organization Types

Interviewed respondents represent a variety of organization types and sizes, demonstrating that interest in the cloud is not limited to a specific customer type. Though the majority of respondents have Epic live on premises, some will be going live with Epic directly in the cloud. Additionally, some respondents who are current Epic customers have a few sites that are contracted with other EMR vendors. Almost all participants—regardless of which EMR vendor(s) they use—have an on-premises IT environment; one organization is using hosting services from Epic and another is leveraging a third-party cloud offering.

Cost Is the Top Motivator to Move to the Cloud—as Well as the Top Concern

Reported by 80% of respondents, the top benefit Epic organizations hope to achieve in moving their environment to the cloud is to reduce hardware expenditure and therefore reduce capital cost. Other commonly mentioned drivers include better system reliability, improved security, increased agility, and reduced need for FTEs. However, on the flip side, cost uncertainty is also the number-one reported concern (noted by 60% of respondents). Respondents say that since many factors influence the true cost of hosting in the cloud, it is difficult to confidently predict what their ongoing costs might be. Other top concerns (reported by half of respondents) include hesitations about (1) whether the public cloud providers can adequately scale to host Epic, and (2) whether health systems’ own staff have the expertise necessary to support the transition.

Microsoft Azure Frequently Top of Mind Due to Preexisting Use of Azure or Other Microsoft Tools

Nine of the ten interviewed Epic organizations are considering Microsoft Azure for their public cloud provider, and Azure is the likely choice for five of them. The majority of organizations considering Azure already use the solution in other areas or use the Microsoft Office 365 suite and feel that leveraging this existing relationship and experience would ease the transition.

AWS is also being considered by almost all interviewed Epic organizations and is the likely choice for two. The vendor was an early developer of broad cloud capabilities, and thus many prospective healthcare clients view them as being able to offer more of the capabilities needed by healthcare organizations than Microsoft. Organizations that are considering AWS cite that the vendor has proven success with other Epic customers, offers technical expertise specific to Epic, and has quality staff.

Google Cloud Platform (GCP) receives few considerations. Respondents note concerns about poor relationships, a lack of Epic experience, a weak healthcare strategy, and Google’s security and patient privacy management.

Considering the Cloud? Here’s What Early Adopters Advise

Health systems that are exploring the idea of moving their EMR environment to the cloud have the benefit of learning from others that are further along in the decision-making process. The respondents in this report are at various stages of the selection process, but most have taken or plan to take certain actions before selecting their cloud provider. Here are their high-level recommendations to peers:

• Analyze your organization’s readiness and need to move to the cloud
• Identify cloud providers that will best meet your organization’s needs
• Meet with the cloud providers and evaluate their solutions

For additional details on this peer guidance and Epic customers’ strategies for moving to the cloud, be sure to check out the full report.

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