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.
