We Bring the Cloud to Healthcare

Cloud Readiness – What does it mean to you?

April 16, 2019

Cloud Readiness – What does it mean to you?

So, you have made the decision to move towards a cloud-based solution. As I’m sure you learned during the process, cloud doesn’t always mean all workloads running outside of your datacenter. It can mean using the cloud for specific functions: Disaster Recovery, Archive storage for MEDITECH Scanning and Archiving and PACS, Backup replication and storage, or for hosting specific applications (i.e. MEDITECH, Email, Time Keeping, Physician Dictation, etc.).

As you shift to a cloud model there are several important aspects to consider up front. This is when the “5Ps of Success” come to mind – Proper Planning Prevents Poor Performance. When looking at the cloud as a viable option for certain facets of your IT environment, the key areas to focus on after the Return On Investment and Total Cost of Ownership analysis is completed are:

Active Directory
The Network
Application Integration
End Point Devices
End User Workflows
Internet Connectivity

When evaluating these key areas, here’s what to look for:


Security used to be defined by most healthcare organizations as a group of polices and firewalls designed with the hope of keeping the bad guys out. Today, with ransomware and other cybersecurity threats, it goes much deeper than that. Having solid, established plans and policies for physical security, user access, patching, and devices play a significant role in the success of going to a cloud environment for both your organization and the cloud provider.

Active Directory:

Active Directory (AD) is something that almost every organization in the world is using today. Deployments can be either simple or complex, depending on the size and scale of your organization. Most cloud solutions require some level of integration with your local AD environment and that means the current health of that environment is crucial of the overall project success. The majority of the issues CloudWave has observed around this aspect of cloud transformation involve logon scripts, group polices, drive mappings, and replication. Understanding the current health of AD goes a long way in problem prevention once you are “LIVE” within the solution.


Ahh the network. It’s always the first thing to blame whenever there’s a problem. When I used to work in hospital IT I would always push back on the assumption that the network was the problem, but now that I’ve worked with hundreds of different hospitals as a consultant, (I hate to admit it) I’ve frequently seen the network be the root cause of problems. Just don’t tell the Physicians I used to support!

The network is the foundation for everything in your environment and will be the one thing that will never fully go into the cloud. That means that as you adopt cloud solutions in your organization, the importance of your network will continue to increase. Having a core understanding of the performance, redundancy and configuration of your network, and its ability to support cloud services is a key factor is a truly successful move to the cloud.

In my opinion, the network is the most important element for a successful migration to the MEDITECH Expanse platform. I’ll elaborate in an upcoming blog article.

Internet Connectivity:

The Internet is becoming a major area of focus as organizations adopt cloud. It is the connection method for a number of solutions. Understanding the current state of your Internet connectivity deployment can be a deciding factor in whether or not a project is perceived by users as a success or a failure. If you learned today that you were dropping 2% of packets that were going out over the internet, you probably wouldn’t be concerned if it hasn’t impacted your users. However, since cloud is so reliant on the Internet as the connection medium, 2% packet loss can be the difference between a response time of milliseconds vs. seconds. CloudWave recommends, and in many cases, works with customers to complete benchmark testing of their Internet connections that include speed testing, redundancy, bandwidths, and latency.


Endpoints are and have always been a challenge in a lot of healthcare organizations. The question is: if they work, why replace them? They are one of the few IT assets that can be depreciated over a 10-year term. Moving to a cloud solution, especially hosting, may require a change to access methodology depending on what versions of applications you are running. This change traditionally moves your organization to a Virtual Desktop Infrastructure (VDI), leveraging technologies from either VMware, Citrix, or Microsoft. Each has requirements and best practices for configuring the endpoints.

End User Workflow and Training

As I mentioned above with endpoints, cloud solutions can create a major change for how you access your systems. This change is easy for IT folks, because they understand how it all works, but that doesn’t always translate to quick adoption by users. It’s important to remember that not all end users have a good understanding or comfort level with technology. An example is the Registration Department. Registration sees every patient that comes into your hospital. They have been working with “that box under the desk”, and when it doesn’t work, they hit the power button to solve the issue – which could range from a traditional windows PC issue to a scanner/printer/credit card machine issue. To the user, it’s all the same and the first line of defense is to reset the PC. When implementing a solution that’s going to change how users access their technology, it’s extremely important to understand their workflows today and proactively educate them on upcoming changes to ensure a successful transition.

Proper Planning & Preparation Pay Off

Understanding the requirements and potential challenges of your unique cloud implementation will be a huge time saver and go a long way toward resulting in a win for the organization.

Remember, it doesn’t matter if a problem existed prior to moving to the cloud environment, if it’s discovered in the process of migrating, users will be left with a negative impression. Unhappy users mean the morning management huddle puts the IT Department in reactive mode, scrambling to correct problems that may have been there for years but were never exposed. Performing a full assessment of the key areas defined above will help avoid unforeseen issues.
Healthcare IT executives have a daunting job because they have 2 groups of customers they are accountable to: users within the organization, and patients of the hospital. Providing IT solutions that improve the patient and clinician experience in a competitive healthcare market is more important today than ever before. And with proper preparation, the cloud can help you do just that.

Want to learn more? Email customersfirst@gocloudwave.com for a detailed outline of key technology areas to review as you plan your move to the cloud.

Mike Donahue

Managing Director, Technical Services