AWS, Azure Shine as Front Runners for Epic Orgs During Cloud Migration

The adoption of public cloud migration within the healthcare industry is on the rise, with some organizations already implementing the strategy and others on their way. Among early movers in the Epic community, Amazon Web Services (AWS) and Microsoft Azure are top picks, according to a recent KLAS report sent to journalists.

The report, "Approaches to Moving Epic in the Cloud 2023" by KLAS, spoke to 10 healthcare organizations actively considering migrating part or all of their Epic environment to the cloud, gaining insights into their decision-making process around this move.

Out of the ten Epic organizations, five are leaning toward Microsoft Azure as its cloud migration provider, four are considering it, two are leaning toward AWS, and seven are considering it (respondents were able to say they were considering multiple different providers).

Organizations considering Microsoft Azure for their cloud migration needs have often already utilized its technology in other areas, such as Azure Workloads or Microsoft 365. Using Microsoft as their cloud migration provider is seen as an extension of their existing relationship with the vendor, which they hope to leverage to their advantage.

In a separate KLAS study, it was found that healthcare organizations that use Microsoft Cloud technologies have experienced a range of benefits. Specifically, this study found that many healthcare organizations have realized cost savings, shorter project timelines, and improved care coordination.

However, scalability remains a concern among those still considering Microsoft Azure, with some respondents stating that AWS better supports larger organizations. The Epic organizations would like Microsoft to prove effective at helping customers of a larger size, KLAS officials wrote.

AWS established its reputation as being more suitable for the needs of larger organizations than Microsoft Azure by introducing its broad cloud capabilities early on. Among Epic organizations, AWS is also appreciated for its existing proof points with other Epic customers, technical expertise, and robust resources supporting functions such as onboarding and long-term cloud strategies.

However, one Epic organization is concerned about the immature healthcare focus of AWS, and another said AWS has a higher overall cost when factoring in partner costs, compared to other options. Additionally, some organizations already use Microsoft products, including Microsoft Azure, and instead are contemplating moving forward with Azure to consolidate contracts and vendor relationships.

Given that most early movers' top goal is cutting capital costs by eliminating hardware investments, high costs are definitely an area to watch. Additionally, 50 percent of the respondents identified system reliability as the second most crucial reason for migration.

Migration to the public cloud was also driven by various other objectives, such as enhancing security measures, increasing operational flexibility, and lowering staffing requirements.

“Though capital cost reduction is the main driver for moving to the cloud, cost uncertainty is the top concern,” KLAS researchers wrote. “There are many variables that make the true cost of cloud hosting difficult to nail down, and respondents worry their costs could increase in the long run if their cloud environment isn’t architected properly, if utilization isn’t effectively monitored, or if their cloud provider increases the price when the contract renews.”

“Additionally, several respondents (particularly those at larger organizations) are concerned about scalability, as public hyperscale cloud providers are still relatively new to hosting Epic in a production environment. Respondents are also concerned their staff doesn’t have the needed skills to support a move to the cloud,” they continued.

Most respondents are eager to quickly leverage disaster recovery capabilities as they move their production environment to the cloud over the next year or two, the report showed. While their reasons for transitioning varied, respondents said they wanted to avoid significant capital investments in hardware, improve data security, and find hosting alternatives that better meet their needs.

Most respondents aim to use the cloud for disaster recovery within the first three months of contracting with their public cloud provider, allowing them to test the migration process and avoid relying on paper during outages.

Epic organizations also plan to move other applications (both Epic and non-Epic) to the cloud, including production environment and testing. Respondents anticipating the longest time to move to the cloud cite constraints such as finding skilled resources, developing a deep understanding of cloud architecture, and consolidating their health system onto one EHR.