Cloud Growing in Popularity for Epic Workloads, KLAS Finds, But Taking it Slow and Getting Expert Help Make the Journey Smoother

As healthcare systems increasingly adopt cloud computing, the transition of Epic workloads to public cloud platforms, such as AWS and Microsoft Azure, is gaining traction. The KLAS report “Epic in the Public Cloud 2024” looks into the experiences of early adopters, particularly large health systems, and weights in on the scalability, performance, and challenges of running Epic in the cloud.

Cloud Scalability and Reliability

For large healthcare organizations, scalability is a top priority when considering the cloud. Although many health systems are still in the exploratory phase, a growing number are achieving full production environments in the cloud. The KLAS report finds that most large health systems using AWS for Epic report high satisfaction with scalability, reliability, and disaster recovery, noting minimal service interruptions.

According to KLAS, “Large health systems in full production environments report positive experiences with cloud reliability and scalability, highlighting smooth service with only minor interruptions.”

Many organizations are also leveraging cloud infrastructure for testing, training, and disaster recovery as a preliminary step before moving their full Epic production workloads to the cloud. This gradual migration, they say, allows testing with lower risk, proving that critical Epic functions can handle real-world demands in a cloud environment.

AWS and Microsoft Azure: Strengths and Challenges

AWS and Microsoft Azure both bring unique strengths to Epic’s public cloud deployments, though customer satisfaction varies significantly. AWS customers consistently rate their cloud experiences highly, especially regarding platform speed, implementation, and support. AWS has garnered praise for its proactive planning, expert team members, and willingness to support customers beyond contractual obligations. Customers are particularly satisfied with AWS’s support, describing its team as “strong partners who have expertise” and as providing “proactive planning and cost projections.”​

Microsoft Azure also performs well in platform quality, but customer satisfaction with support services is inconsistent. Some organizations report that the first-tier Azure support lacks in-depth understanding of Epic-specific requirements, which has led some to pay for higher support levels or seek third-party assistance. This inconsistency in support has impacted Azure’s overall satisfaction score, with some respondents noting challenges in resolving downtime and deploying new features.

Cost and Integration Challenges

Cost is a key factor in the decision to transition Epic to the cloud, with both AWS and Azure customers expressing mixed views on this aspect. Although initial expectations were that cloud infrastructure would reduce operational costs, most customers report that costs are similar to or slightly higher than traditional on-premises environments. The primary value derived from the cloud, however, lies in scalability, flexibility, and the enhanced ability to manage disaster recovery.

Integration remains one of the most significant obstacles for healthcare organizations using public cloud for Epic. AWS and Azure users report challenges around integration, such as lab and security platforms. The report highlights that “the two biggest challenges with being live in the cloud are integration with other vendors’ solutions… and a lack of internal expertise.”​ Addressing these interoperability issues requires substantial internal and external resources, often involving specialized third-party consultants.

Reliance on Third-Party Support

A shortage of in-house cloud expertise has led many organizations to rely heavily on third-party firms for their cloud transitions. According to the report, 75% of surveyed healthcare organizations engaged third-party consultants, especially during the planning and migration stages. These external firms offer support for organizations unfamiliar with the intricacies of managing Epic in a cloud environment. While AWS users appear to rely more heavily on third-party services, Azure customers have increasingly turned to specialized consultants to overcome support challenges and optimize their Epic cloud implementations.

The Future of Epic in the Cloud

Despite these challenges, most healthcare organizations surveyed in the report intend to expand their use of public cloud services. Many plan to transition additional Epic environments to the cloud, including disaster recovery and testing environments, and some even aim to migrate all applications to a cloud-based infrastructure. This trend indicates a strong commitment to cloud adoption as organizations seek enhanced scalability and resilience for their Epic environments.