Geisinger's epic journey: Scaling EHR operations on AWS (HLS207)

Key Takeaways from the Geisinger Epic Journey on AWS

Geisinger's Approach to Cloud Migration

  • Extensive planning and preparation was key to ensuring a successful migration
  • Geisinger first moved other clinical applications to the cloud before migrating Epic
  • They set up a full training instance in the cloud to test and validate the environment
  • Geisinger's original plan was to move production to the cloud for a week and then move back on-premises, but they ended up staying in the cloud permanently due to positive user feedback

Benefits Experienced

Reliability

  • Geisinger has been able to provide continuous access to patient records by leveraging the high service resiliency of AWS

Performance

  • Geisinger saw at least a 20% improvement in average response time and a 50% reduction in workflows missing the response time target

Cost Optimization

  • By right-sizing their instance types and leveraging newer AWS technologies, Geisinger was able to reduce their costs despite increasing the number of servers

Importance of FinOps

  • Geisinger emphasized the need for a dedicated FinOps team and program to continuously optimize costs and identify opportunities
  • Strategies include leveraging compute savings plans, optimizing backup and data retention, and validating new instance types before scaling

Lessons Learned

  • Educate and prepare all stakeholders (executives, IT teams, application teams) for the cloud migration
  • Adopt a "watch one, do one, teach one" approach when working with partners
  • Thoroughly understand all the integration points and dependencies of the Epic system
  • Enhance security and resilience measures, such as using separate accounts and firewalls
  • Invest in FinOps early to proactively identify and act on cost optimization opportunities

Advice for Other Organizations

  1. Conduct a capacity assessment and review your instance types
  2. Establish a dedicated FinOps team and program
  3. If not already in the cloud, explore the benefits and work with AWS to understand the options
  4. Leverage AWS services and partners to set up an isolated Epic recovery environment to improve resilience

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