Florida’s Agency for Health Care Administration (AHCA) is the chief health policy and planning entity for the State. AHCA is responsible for the State’s $21.2 billion Medicaid program, which serves some 3 million residents. Additionally, the agency is in charge of the licensing process for Florida’s 41,000 health care facilities. AHCA’s mission is to: reduce the number of uninsured, target fraudulent providers, cut unnecessary regulation, and reduce administrative costs. The Florida Center for Health Information and Policy Analysis (Florida Center) recently migrated its back-end operations to the Microsoft Azure platform to streamline this complex process, while reducing costs. It is accomplishing this with Microsoft Gold Technology Partner, ISC Consulting.Situation
The Agency utilizes the Florida Center’s staff of researchers, analysts and writers to collect and disseminate patient data and to provide technical assistance to interested parties. The Agency maintains statistics on the disposition of hospitals, in-patient care, emergency department performance, and ambulatory out-patient care as well as short-term psychiatric, comprehensive rehabilitation, and long-term psychiatric hospital performance. The Florida Center then uses that data to develop detailed reports that analyze health care trends and outcomes.
“We collect patient-level data on hospitals, ambulatory surgery centers, and emergency departments,” explains Beth Eastman, Administrator for the Office of Data Dissemination within the Florida Center.
That data is then leveraged into a website – www.Floridahealthfinder.gov – by the Agency’s Microsoft Gold Technology Partner, Tallahassee, FL-based ISC Consulting. ISC is a technology development and consulting company that provides high-end, software development consulting services to public sector agencies and private companies. The company’s particular areas of expertise are as a provider of hosted enterprise applications and solutions built on Microsoft’s .NET platform.
“Our job is to aggregate all of the data to create this website and present it to citizens in a useful manner,” says Eastman.
“Florida statute 408.05 requires us to plan, develop and implement a transparent consumer-centered healthcare delivery system with public reporting performance measures,” Eastman explains.
“We were tasked with creating a website for consumers to compare quality and charges of various providers including, but not limited to, hospitals, physicians, health plans, and pharmacies.”
At a time when public sector budgets have been stretched to the breaking point, Platform-as-a-Service (PaaS) technologies are yielding particular value in cost, efficiency and ease of management in the application development process.
The Agency authorized ISC Consulting to leverage Microsoft’s Windows Azure and SQL Azure cloud services platform to meet Florida’s statutory requirements. The move builds on an established relationship that ISC has with the State.
“The agency outsourced this website and all the applications to us before we migrated to Azure,” explains Mark Alexander, managing partner at ISC. “So in a very important way, our task was to make the move to Windows Azure and SQL Azure completely transparent to the agency.”
The driving factor for moving to a cloud-based application development platform revolved around managing the extreme complexity associated with coordinating a broad array of legacy-based systems.Solution
ISC, which had also developed a public-facing, constituent services application on Windows Azure for the City of Miami, had been running the Agency’s website and databases using “fixed” infrastructure and application development resources. The Agency required eight different ASP.Net applications and three leased SQL Server databases. To further complicate the challenge, several of those applications needed to interface with a State web hosting service that has secure, HIPAA-protected information which must remain on-premise.
With this in mind, ISC and the Agency, through the Florida Center, embarked on the mission of migrating those databases and applications to the cloud, with Windows Azure and SQL Azure. These solutions enable organizations to build, host and scale applications in Microsoft datacenters. They require no up-front expenses, no long term commitment, and enable agencies to pay only for the resources that are used at the time that they are consumed.
According to Eastman, the Agency’s selection of ISC was based on a couple of factors:
ISC’s expertise in web design and website applications; and
The firm subcontracts with Treo Solutions, the State’s data analysis contractor.
“That was the real key. We needed to have that expertise into how data should be treated and interpreted,” she says. Benefits
Before the Azure migration, ISC was supporting eight different applications and six different databases. Moreover, several different versions of SQL Server were supported, including 2000, 2005 and 2008.
“It was a big smorgasbord of environments,” Alexander says.
Because ISC is a Microsoft Partner, they were extremely familiar with Azure platform. “We have been working with clients in a number of cloud projects on Microsoft technology. One of the things we expected to get out of moving to Azure was to make that whole process easier to manage.”
The migration process began in March 2009 and was completed in September 2010. The move has allowed the Agency to streamline and better integrate the critical stages of managing the ongoing data-base driven website,” he says. These include the:
Staging phase; and
The Azure platform has allowed the entire process to be enormously simplified,” Alexander says. “That’s probably the greatest benefit.”
Another significant benefit was cost savings. The Agency had been leasing servers from a prominent off-site server leasing company.
“It is very true that, today, anyone can go online and just lease server capacity,” Alexander says. “That part is pretty easy. But then what you get is a raw server that you have to manage.”
Also, if the Agency wanted to install SQL Server on one of the leased remote servers, it had to be uploaded using internet-based installers because staff did not have physical access to the servers.
“You are left managing the server remotely and making sure the Windows updates get applied in an organized way and things of that nature. This is cumbersome and time consuming,” Alexander explains.
Moving to Azure changed all that.
“Today, we don’t have to fool with servers,” Alexander says. “We just publish the application and we manage the database.”
Moreover, the cost of managing the physical servers has been removed from the budget.
“Right now, we’ve got two 10 GB databases up there in the cloud. Whenever necessary, we can provision a new database and use it for temporary storage to handle any contingencies. There have been times when we’ve had to roll back entire data sets on the live website. With Azure, we utilize resources liberally and our costs are still under control. What we have today gives us a lot more freedom and ease of testing. It allows us to move from staging to production easily,” he says.
Another big benefit of the Azure migration was the extra server capacity they can spin up during significant upticks in demand.
“We’ve had situations where there’s been some kind of media coverage and traffic to the website has spiked significantly,” Alexander says.
“The last time we had a big press release we went in and scaled from two instances of our environment up to four for a couple of days to make sure we could handle the spike.”
From Eastman’s perspective, the entire migration experience has been transparent and has not affected her operations.
“We have not seen any disruption to our operations. And if it makes it easier for ISC to manage our site better, then we are all for it.” For More Information
For more information about Microsoft products and services, call the Microsoft Sales Information Center at (800) 426-9400. In Canada, call the Microsoft Canada Information Centre at (877) 568-2495. Customers who are deaf or hard-of-hearing can reach Microsoft text telephone (TTY/TDD) services at (800) 892-5234 in the United States or (905) 568-9641 in Canada. Outside the 50 United States and Canada, please contact your local Microsoft subsidiary. To access information using the World Wide Web, go to: www.microsoft.com
For more information about ISC Consulting products and services, call (850) 893-6741 or visit the Web site at: www.goisc.com
For more information about Florida’s Agency for Health Care Administration, call (888) 419-3456 or visit the Web site at: www.FloridaHealthFinder.govThis case study is for informational purposes only. MICROSOFT MAKES NO WARRANTIES, EXPRESS OR IMPLIED, IN THIS SUMMARY.