Public Cloud Providers 2022
Delivering Cloud Technology to HIT Vendors

Nearly half of interviewed vendors have migrated all their go-forward solutions to the cloud, and nearly all of the rest are in various phases of implementation or migration. Amazon Web Services (AWS) is the most widely used primary cloud provider. Microsoft Azure is gaining ground with recent wins—75% of interviewed vendors who are in early phases of moving to the cloud are using Microsoft Azure as their primary cloud provider. Approaches to migrating include refactoring applications, cloud-native development, leveraging containers, lift-and-shift of legacy solutions, and back-end enhancements.

Almost half of interviewed vendors have made their go-forward products commercially available in the cloud. Among these, about three-quarters have products running in a multi-tenant SaaS environment; the rest run their products in a single-tenant SaaS environment or have created platform-based offerings that allow clients to use their cloud provider of choice. Many vendors that previously had legacy solutions have either replaced or refactored their products, and they are still transitioning clients to the cloud.

About one-third of interviewed vendors use multiple cloud providers. Reasons for this include the desire to accommodate payer/provider clients’ cloud preferences, the acquisition of products hosted by a different cloud provider, and functionality gaps. Vendors who use Microsoft Azure as their primary cloud provider are twice as likely as AWS clients to use a secondary cloud provider.

Improved Agility Is the Biggest Benefit of the Cloud

Support gaps and cost management are often-mentioned obstacles that interviewed vendors encounter with cloud providers. Vendors primarily using AWS’ cloud solution cite challenges with account turnover, navigating AWS’ organization, and a lack of visibility into technical issues. These vendors also describe billing as complex and say costs quickly get out of control if not watched closely—one AWS client noted it can be confusing to understand the cost of running the entire IT environment, the transition costs, and the discounting programs. Additionally, customers struggle with the rapid pace of change with AWS’ constant innovations. Vendors primarily using Microsoft Azure’s cloud note challenges navigating Microsoft’s organization and accessing resources who can solve complex problems. Understanding and managing costs is also a frequently mentioned obstacle. One Microsoft customer shared that there is sometimes a lack of alignment between what representatives are incentivized to do and what customers would most benefit from. Some Microsoft Azure clients also report learning curve challenges because they don’t have enough people familiar with the Azure environment and struggle to recruit and train people with needed expertise.

HIT vendors still face many challenges that make moving to the cloud difficult. Cost is the most frequently mentioned challenge. Respondents cite storage-retrieval and egress fees, and they would like billing to be simplified and cost-management tools to be improved. Vendors also want to see continual, faster investment from cloud providers in core solutions so they can increase adoption. Desired investments include better tool standardization, a scalable and relational database, more base features and AI capabilities, and better monitoring tools. Additionally, respondents note cloud providers should take on more risk related to security. Vendors want help with ransomware, more security certification coverage, upstream safeguards, better authorization and access, and less traditional IT infrastructure in the cloud.

Telehealth Vendors Are Most Cloud Mature; Core Clinical & Imaging Vendors Have a Ways to Go

Sample Sizes

Unless otherwise noted, sample sizes displayed throughout this report (e.g., n=16) represent the total number of customer organizations interviewed for a given public cloud provider. Some respondents choose not to answer particular questions, meaning the sample size for any given solution can change from question to question. When the number of responses for a particular question is less than 15, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 6, no score is shown. Note that when a public cloud provider has a low number of reporting vendor customers, the possibility exists for KLAS scores to change significantly as new surveys are collected.