Health systems are beginning to transition their IT organizations to the cloud, with two of the most common options being AWS and Microsoft Azure.
KLAS surveyed early adopters of the public cloud using Epic's EHR system and found some variability in how each performed. Here are six points.
1. Scalability and reliability
- AWS and Microsoft Azure have proven capable of supporting large health systems in full production environments.
- Scalability, reliability, and disaster preparedness were highlighted as key benefits, with AWS receiving particularly high marks for proactive planning and cost transparency. AWS received a 94.2 / 100 performance score, compared to 84.8 / 100 for Microsoft Azure.
- Most organizations utilize the cloud for disaster recovery as a starting point, with many expanding to testing, training, and full production environments.
2. Vendor performance
- AWS achieved a higher score in relationship and products than MIcrosoft Azure. AWS had 95.2 / 100 relationship score, compared with 73.3 / 100 for Microsoft.
- AWS customers cited speed, strong relationships, and expert support as standout features. AWS also shared cost projections and went beyond the scope of the initial contract to help clients.
- Microsoft Azure was praised for its platform capabilities, though inconsistent first-tier support and reliance on third-party firms for success were noted as challenges. Many decided to purchase higher tier capabilities.
3. Integration and expertise are key challenges
- Both vendors faced challenges with integrating Epic environments into existing infrastructures, especially with third-party solutions like PACS and security systems.
- Lack of internal cloud expertise emerged as a significant barrier, with 75% of organizations relying on third-party consultants during planning and migration phases.
- Customers from both AWS and Microsoft said moving to the cloud helped achieve scalability, flexibility and reliability at the same or slightly higher cost than on-premises resources.
4. Financial impacts and cost considerations
- While cost savings remain a key motivation, most organizations reported cloud solutions to be as expensive — or slightly more expensive — than on-premises systems.
- Executives remain optimistic about long-term savings in areas such as infrastructure and IT staffing.
5. Strategic outlook and adoption
- Nearly all respondents plan to expand their use of public cloud environments, with over one-third aiming to migrate entirely away from on-premises systems.
- Future expansions will likely include advanced testing, disaster recovery capabilities, and innovative uses of AI and analytics.
6. Third party firms
- Organizations increasingly depend on consultants for cloud planning, migration, and management. Firms like Deloitte and Optimum Healthcare IT were frequently mentioned as instrumental in successful transitions.
- Almost all AWS customers said they used third-party firm for planning and assessment, compared to 25% of Microsoft Azure customers.
- New Epic customers often use third-party support for ongoing operations, ensuring smooth adaptation to cloud environments.