eClinicalWorks thrives in the cloud with Azure Virtual Machines and Azure Disk Storage

Moving forward with Microsoft Azure

Under its traditional colocation hosting model, eClinicalWorks needed to buy more servers, hardware, and data storage as it introduced new customers. In addition to driving up costs, this process slowed growth and required IT teams to increasingly dedicate time to managing new hardware installations and customer migrations. “We took a step back and asked, ‘Is this the model that we want to live in?’ We decided we wanted to reduce the overall management of our hardware and monitoring of our services by moving to the public cloud,” says Bharat Satyanarayan, Vice President of Technology and Quality Assurance at eClinicalWorks.

The company sought a cloud solution that’s compliant with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and could meet the company’s requirements for scalability, security, and storage. Its search led it to Microsoft Azure. The healthcare IT leader has since moved its EHR platform to Azure in a seamless migration to Azure Virtual Machines and Azure Disk Storage.

Tapping into enhanced reliability and Microsoft support

Aligned with its mission of “improving healthcare together,” eClinicalWorks dedicates its resources to developing platforms that link multiple aspects of patient care, creating unmatched visibility and improved efficiency for both clinicians and patients. Customers use the company’s robust EHR platform with its suite of integrated products as an all-encompassing healthcare ecosystem. eClinicalWorks’ electronic medical record and practice management system serves as an end-to-end technology platform for providers and is the industry-leading patient relationship management software. Using the Patient Portal and healow Patient Engagement tools, patients can review their personal health records, communicate virtually with their providers, schedule and confirm appointments, access prescriptions, and take advantage of other hands-on services online. Providers can also manage patient scheduling, charting, insurance payments, billing, communicate with patients, and conduct virtual consultations using a single, integrated solution.

“Our EHR system runs the customer’s entire day-to-day operations,” says Satyanarayan. “So, if our system goes down or becomes inaccessible, everything comes to a standstill. These are critical applications for our customers, and our responsibility is to ensure that we’re able to run them reliably with acceptable performance.”

After evaluating Azure and competing cloud platform providers, eClinicalWorks was drawn to Azure for the straightforward setup, ease of use, and dedicated support from Microsoft experts. The company worked closely with an Azure development team to migrate massive amounts of eClinicalWorks-hosted data to the cloud, including millions of small but unstructured data files, such as faxed or scanned medical documents.

Reaching its full potential using Microsoft solutions

eClinicalWorks manages more than 2,200 Azure virtual machines (VMs) spread over multiple regions, and primarily depends on compute and memory optimization for running its Java applications and SQL Server databases. In a typical SQL cluster, the company has two VMs deployed in zone redundancy and one for disaster recovery in a different region, which enhances the availability and reliability of the application in the cloud. 

In addition to the on-demand scalability, flexibility, and speed and performance enhancements it gets from Azure VMs, eClinicalWorks particularly values the ability to give customers the same high-quality service without interruptions or data leakage. “Every customer gets their own back-end database and is logically separated on the shared infrastructure,” explains Satyanarayana. “This is how we’re able to deploy customers running independently without any commingling of data.”

eClinicalWorks also builds security into its business processes using Microsoft Defender for Cloud. “Defender for Cloud provides security recommendations based on our workloads, and we can easily go in and deploy policies to be compliant with different regulatory requirements,” says Satyanarayan.

Completing its cloud migration and supporting customer growth 

Moving customer clusters from its legacy hosting environment to Azure every weekend, the migration of eClinicalWorks’ EHR platform to Azure is now almost 99 percent complete. The company is also in the process of moving over the rest of its EHR components, including up to 70 component services, with several already moved and running smoothly.

Customers can now take advantage of new and continually emerging capabilities including contactless patient check-ins and electronic payments using Azure Event Hubs, while also enjoying more stable and predictable performance with their eClinicalWorks’ solutions. And with the flexibility of Azure and its ability to support rapid innovation, eClinicalWorks is deploying these innovative features into its customer offerings faster than it was able to deliver new capabilities in the past—often in weeks versus months or years. “Because we’re able to easily scale horizontally or vertically, customers can gain efficiency using new eClinicalWorks software that’s not constrained by hardware limitations,” says Satyanarayan.

Improving agility and accelerating time to market 

eClinicalWorks attributes a number of major benefits to its use of Azure but notes that the greatest impact has been its reduced time to market. “As we get out of the infrastructure management business, Azure has given us platform agility, resilience, and uptime,” explains Satyanarayan. “We’re able to build those benefits into our deployments and ensure that we have high availability so we can handle potential failures without issue.”

In addition to optimizing its operating speed, eClinicalWorks has accelerated time to market for new physical hardware from three months in its previous colocation model to a maximum of two weeks with Azure, including security and compliance checks. This has already helped the company add new customers and deploy new applications faster than previously possible. Many of our self-hosting customers, says Satyanarayan, are also exploring a move to the cloud.

eClinicalWorks is continuing its cloud transformation as it explores deploying more native Azure services for added ease of management, in addition to new applications for technologies like AI and machine learning. “We’re extremely happy that we moved to Azure as the heart of our applications,” concludes Satyanarayan. “Azure has been a big step for us, and we foresee a great future with it.”

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