UC San Diego Health has migrated its on-premise Epic electronic health record system to a cloud environment hosted by the EHR vendor as part of a long-term strategy to shift away from a traditional data center model.

In fact, UC San Diego Health is the first academic health system to make the transition from a self-hosted Epic IT infrastructure to the vendor’s cloud hosting environment. Epic offers both on-premise and hosted data solutions for its customers.

So far, UC San Diego Health has moved about 10,000 desktops to this hosted environment, enabling its users to access the EHR through the cloud. In addition, the healthcare organization’s system is supporting UC Riverside Health and community practice affiliates. Further, beginning in November, it also will also share its Epic EHR with UC Irvine Health.

UCSD Health's Jacobs Medical Center“We don’t have a state-of-the-art data center anymore and—as we looked at the need to grow—it was the right time for us to move to a hosted environment,” says Christopher Longhurst, MD, chief information officer at UC San Diego Health, who says cost and scalability were important factors in making the move.

Cybersecurity was also a driver in the decision to move to an Epic-hosted cloud environment, according Longhurst.

“We didn’t have any cybersecurity issues with on-premise hosting, but the level and type of security monitoring that can be offered by Epic through their hosting exceeds what we can do locally,” adds Longhurst, who notes that the cloud provides timely cybersecurity updates and patching as well as heightened security controls. “They’ve got a 24/7 network operations center and—from a technology standpoint—we don’t have the scale to do that ourselves.”

Also See: Why healthcare is continuing its shift to the cloud

Epic maintains a production data center located in Verona, Wis., as well as a disaster recovery data center in Rochester, Minn., which the vendor purchased from the Mayo Clinic to serve as backup infrastructure.

“Our main production environment comes out of Verona, but should that go down or our connection be severed by some natural disaster or something, then we would flip over to the Mayo data center,” Longhurst says. “It’s very stable, and we’ve had zero downtime since conversion. And our performance with the hosted model has actually exceeded our on-premise performance.”

To date, UC San Diego Health has integrated more than 100 third-party applications that work with Epic within the new cloud environment.

“We have an evolving and more modern data center strategy now, which is whenever possible, we move our applications to cloud hosting,” says Longhurst. “The least desirable option is on-premise hosting, which we’ll still have for some security- and latency-dependent applications—but over time, we expect to dramatically shrink our local data center.”

At the same time, according to Longhurst, the UC health system’s five academic centers—Davis, Irvine, Los Angeles, San Diego, and San Francisco—are working together at an “unprecedented” data-sharing approach across the state as California’s fourth largest healthcare system.

“We have a shared data center now between UC San Diego, UC Irvine and UCLA, and UCSF and UC Davis have a shared data center,” he observes. “The goal is to consolidate our 13 on-site data centers to these two shared data centers that then provide backup for each other.”

Within three years, UC San Diego Health plans to fully deploy cloud-based solutions for all its data storage needs.

“Hospitals’ core competencies should be delivering patient care, not running data centers,” contends Longhurst. “The more that we can allow healthcare systems to focus on care delivery, the better our patients will be.”

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