Cloud

Reaping the Rewards of Migrating EHRs to the Cloud

By successfully migrating electronic health care workflows to the cloud, healthcare organizations can leverage cutting-edge services and technologies.

Novid Parsi

Novid Parsi is a freelance writer based in St. Louis who covers a wide range of fields, including healthcare and technology.

Leaders at Sentara Health, a healthcare system serving Virginia, North Carolina and Florida, knew that keeping their electronic health records stuck in an on-premises data center wasn’t ideal — for the organization or its customers.

“Our customers should not have to come to my data center and sit in the hospital to be able to access their data,” says Jeffrey Thomas, senior vice president and CTO at Sentara Health.

Moreover, he adds, an on-premises EHR meant that Sentara could not fully leverage new technologies, such as a data factory, in a cost-effective manner. Starting in 2018, Sentara began migrating its EHR workloads and processes to the cloud. But the organization did not simply lift-and-shift its EHR, Thomas says.

“A lift-and-shift is the worst way to get to the cloud because you repeat the mistakes and costs you created in your data center,” he says. With a like-for-like migration, costs that have been hidden in the on-premises data center are perpetuated in the cloud, he adds.

Instead, Sentara’s EHR cloud migration involved a reengineering and redesigning process to “reduce, simplify and transform,” Thomas says. Of the roughly 1,300 applications that Sentara had prior to the migration, the organization moved only about 550 to the cloud.

“The cloud enabled us to do new things but also helped us clean house and implement new practices that are good for business,” Thomas says.

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Managing the Culture Change: Beyond Day One

Sentara’s EHR migration did not come without challenges, Thomas says. “The biggest challenge is the cultural change within the IT organization.”

To ensure a successful migration, Sentara broke down internal silos by embracing agile, DevOps and DevSecOps approaches to work, helping the operations and security teams to collaborate closely. “It changed how we work in IT,” Thomas says.

Migration also requires careful planning and a phased implementation to minimize disruption to clinical operations, says Kees Hertogh, vice president of public sector and healthcare marketing at Microsoft: “Treat the migration as a major program with proper project management and risk mitigation plans.”

Healthcare organizations considering migrating their EHR to the cloud might be tempted to see the first day of migration as the most important milestone. “The hardest thing is day two and beyond,” Thomas notes.

To achieve ongoing, long-term success with a cloud-based EHR system, leaders should prepare the organization to embrace the change. “Organizations that don’t commit to the change try to run like they did when they weren’t in the cloud,” Thomas says. As a result, they end up with a secondary, cloud-based IT team that operates differently from the on-premises team. “So, they create another silo,” he says.

That’s why an effective EHR cloud migration must involve a transformation of culture and process — not just moving records from one location to another. “It’s not about going to the cloud,” Thomas says. “It’s about moving to the right business operating model that allows the migration to be successful.”

Change management is key, Hertogh says: “Explain to stakeholders — from clinicians to the board — the ‘why’ of the cloud move. Share a roadmap and celebrate quick wins, like improved performance in test environments, to build buy-in.”

It’s about moving to the right business operating model that allows the migration to be successful.”

Jeffrey Thomas Senior Vice President and CTO, Sentara Health

Reaping the Benefits of a Cloud-Based EHR

Now, with an enterprise data platform in the cloud, Sentara can more effectively manage its EHR, integrate with cloud-based services such as data reporting and analytics to gain better insights, and leverage new artificial intelligence capabilities such as hyperautomation and agentic AI.

Users benefit too: It’s not only patients who can access the cloud-based EHR from their devices. So can providers, who are now able to work remotely and communicate via tablets and mobile devices.

Scalability and agility are top benefits of using cloud-based EHR systems, Hertogh says. With a cloud-based EHR platform such as Epic on Microsoft Azure, “IT can support growth with a few clicks instead of lengthy hardware procurements.”

“I can scale out capacity in the cloud that I can’t scale out easily on-premises,” Thomas says.

Notably, cloud-based EHR technology ensures stronger data security, Thomas finds. With EHRs on cloud platforms, like Epic on Azure, healthcare organizations benefit from continuously updated security defenses, a team of security experts and 24/7 monitoring. “This often means stronger security than most hospitals could achieve on their own,” Hertogh says.

Sentara’s migration also improved its financial management, Thomas says. Now, with a cloud-based data platform, he can easily see and manage cost drivers on a granular level.

“Cloud economics shift expenses from capital expenditure to a more predictable, pay-as-you-go model, often reducing total cost of ownership,” Hertogh says.

UP NEXT: Use data to improve clinical workflows in the electronic health record.

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