Technology Trends for Modernizing your Epic Infrastructure

During the pandemic, Hospital IT departments put many basic activities on hold to support the urgent needs of clinicians and patients.  With focus shifting to supporting a remote workforce and telehealth for providing patient care, datacenter infrastructure upgrades and refreshes took a back seat.

Throughout all of that, however, patient data in the EHR continued to grow as planned and for some, their data growth was well beyond what was planned due to M & A activities and Epic Community Connect.  Many Hospital IT teams have found that their Epic Operational Database servers can no longer support future growth.  Below are several trends to consider as you evaluate your Modernizing Your Epic Infrastructure.

Epic Infrastructure Modernization – Moving Away from IBM Power Systems

For years Epic Operational Databases have been housed on IBM Power Systems running AIX, to have the performance necessary for Cache/IRIS.   Now that Cache/IRIS is certified to run on Red Hat Enterprise Linux (RHEL), hospitals can modernize their Epic infrastructure on x86 based servers for their Epic Operational Databases.  Unix Engineering resources are scarce in general, so moving to a more widely known OS like RHEL allows for better support and more automation in support of Epic.  It eliminates that one-off instance of AIX, which helps to simplify the overall IT ecosystem within Hospital IT departments.

Another big concern with Power Systems is security. Newer servers with x86 based processor architecture have many built-in security features, such as Secure Boot. This newer x86 technology allows you to detect tampering with boot loaders and operating system files. What this means is that platform managers can ensure that only authorized firmware images can be installed and run on their platforms, something lacking in IBM Power Systems.

High Performance Compute: The Epic Platform of Choice

The healthcare industry is undergoing a data monsoon with no signs of a slowdown.  In 2020, RBC reported that healthcare data comprised an astounding 30% of the world’s data volume. They projected that number would grow to 36% by 2025, overtaking all other industries for data growth. In an important sense, this is great news for healthcare as more data means the ability to enhance patient care. However, without the proper datacenter infrastructure, this data growth will be difficult to plan and manage. That’s where High-Performance Compute comes in, when it comes to modernizing your epic infrastructure, HPC is winning the race.

What does the HPC Mean for the Healthcare Industry?

Today’s modern business, including healthcare, can only work at peak performance when technology, data and advanced computing solutions are working together in harmony. The task of keeping up requires a solid strategy.

Artificial Intelligence and Machine Learning alone process huge amounts of data, requiring heavy duty compute power. The ability of HPC to help manage exponential data growth and process that data quickly with AI and ML puts those with an HPC architecture strategy ahead in the nearly impossible race to keep up.

HPC Benefits for EPIC Infrastructure 

With EHR’s maintaining critical patient data, clinicians must have access to this information when and where they need it for quality patient care. With patient data increasing at such a high rate year over year, IT needs to somehow compensate for this growth. Legacy infrastructure can no longer keep pace with data growth because it lacks the ability to expand seamlessly with today’s increased demands. Replacing Epic ODB hardware, by necessity, causes migrations which can lead to negative impacts on availability.

HPC helps organizations create a more stable Epic environment by creating a modern, open infrastructure that supports the realities of rapid data growth. In addition, HPC provides a highly available, secure environment. Simply put, an HPC platform can be built upon as needed, allowing IT to keep up with the increased demands for Epic while minimizing disruptions to all Epic users.  Learn more about the benefits of HPC for Epic in this whitepaper.

HPE Superdome Flex – The Best Performance for Epic

HPE Superdome Flex (SDX) is a very strong recommendation for modernizing your Epic infrastructure. Why?

  • The SDX platform was purpose-built to provide rapid, consistent and cost-effective high-performance compute for today’s mission critical applications.
  • SDX is an Epic validated architecture.
  • HPE Superdome Flex provides the fastest server (by far) available in the market for the Epic database tier, with superior performance even in the largest Epic environments.
  • SDX architecture enables adding additional compute in building block chunks, a highly cost-effective approach that avoids duplicating entire server systems.
  • Long and productive relationship between Epic, HPE and Comport.

Take a look at the benefits of HPE Superdome Flex in this blog post.

Epic Platform Modern Payments:  The Shift to “Pay as You Go” Consumption

Hospital procurements have always been a mix of capital and operational expenditures, but IT “hardware” was typically a huge capital expense budgeted every 3-5 years.  Today we are seeing hospital CIO’s and CFO’s increasingly interested in proposals that include IT as an Operational transaction.  There are strong reasons why “pay as you go” consumption is accounting for more IT purchases these days.

First of all, with Capex there is an inherent mismatch between the expenditure and the actual usage of the computer equipment.  A capital purchase of computer infrastructure means paying multi-millions of dollars upfront, years before that capacity is really needed and used. It also means estimating and purchasing multiple more years of capacity than you need right then.  Additionally, no CIO wants the painful experience of going back to their CFO for additional capital funds, but if their growth estimates are off that’s exactly what must happen – running out of compute or storage isn’t an option.  So there is great budget inefficiency with a capital purchase, both in paying upfront for excessive capacity and not being able to use those funds for other worthy projects.

Unlike Capex, Opex has low or no upfront costs.  The expense is spread out over a long period of time.  With so many hospitals under financial pressure from the pandemic, freeing up large chunks of funds is huge game-changer.

A second factor is the tax treatment of Capex and Opex.  This is complex and something that the hospital financial team is best equipped to handle. There may be tax benefits when moving to more of an OpEx model, so it is important to work closely with your finance department when considering this method. In some cases of infrastructure acquisition, for example HPE GreenLake, a purchase with “pay as you go consumption” can be structured as either Opex or Capex, whichever best meets the hospital’s financial requirements.

Hospital CIO’s are looking for IT that is always on, scalable, secure and delivered in a consumption-based pay as you go offering. With HPE GreenLake, additional capacity is always structured in, to accommodate peak workloads.  When more capacity is needed, a simple change order does the job.

HPE GreenLake delivers the cloud experience on-premises, plus the ability to manage multi-cloud and hybrid cloud environments, whether that is on-premises, private cloud, colocation, public or any combination of that.  In some cases hospitals are pulling workloads back from hosted environments, like public cloud, reducing ingress and egress fees.

In summary, there are multiple ways to structure infrastructure modernizations, boost Epic performance and structure the procurement financially in ways that positively impact budget realities.  It’s no longer a matter of comparing speeds and feeds, it’s a much more holistic approach that benefits your core mission of patient care.

Comport’s deep expertise and hands-on experience in healthcare will help you navigate Epic Infrastructure’s changing requirements – as well as other Healthcare IT solutions and services.  Our Field CTO for Healthcare, Bill Flatley, is available (no charge of course) for remote or in-person meetings to discuss your objectives, projects, or an Overview of Comport’s capabilities and track record with Hospital Systems. With years of experience in healthcare and a team that has walked the walk, Comport is an ideal partner.  Reach out to our Healthcare Field CTO Bill Flatley to discuss your organization’s IT needs and solutions or contact us here.

“Epic, “Cogito”, and “Hyperspace” are registered trademarks of Epic Systems Corporation.
“IRIS” is a registered trademark of InterSystems Corporation.

Author:Bill Flatley, Field CTO for Healthcare

Bill is responsible for technical strategies and recommendations for Comport’s Healthcare clients. His extensive experience includes four healthcare systems in leadership roles supporting Clinical Applications, Digital Health, and Office of the CIO as the primary liaison between IT and the business.

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