Franciscan Health improves care, saves millions with Epic EHR migration to Azure

A mission of uninterrupted care

In modern healthcare, technology is as vital as the stethoscope. It connects the patient care team so they can make informed, life-saving decisions, and it delivers a long-awaited lab result. If healthcare technology falters, physicians can’t deliver optimal care. Faced with rising infrastructure costs and a limited ability to scale, Franciscan Health knew its existing electronic health record (EHR) systems could no longer support long-term growth.

“We run our operations on Epic,” says Charles Wagner, Chief Information Officer at Franciscan Health. “If Epic is down, we don’t have access to clinical data. We don’t have access to pharmacy; we don’t have access to lab results. So, from the minute that’s down, patient care is at risk.”

Downtime is also costly. “It costs us $10 to $12 million a day every day we’re down,” Wagner explains.

To address these challenges, and to ensure a highly performant environment, Franciscan Health made the strategic decision to migrate its systems. The organization moved Epic hosting to Microsoft Azure Virtual Machines, specifically to M-series Azure Virtual Machines, aiming to establish a more scalable, resilient, and cost-effective foundation for delivering uninterrupted care.

From friction to flow

The results were immediate—and the migration was smooth and almost undetected. “Once we did the cutover, I don’t think we got a single call. The clinicians and staff didn’t even know it happened. That’s how we define success,” says Wagner.

After the move to Azure, the system showed a marked improvement in system performance. “Clinicians were noticing how fast it was,” Wagner adds. App response times have improved by 50% since the migration.  

The migration was successful because of close collaboration between Franciscan Health; various teams at Microsoft, including Unified Support; experts at Epic; and a managed services partner.

“Epic builds on Microsoft technology, which creates a single-vendor advantage that simplifies adoption. Everything works together, which makes it easier to bring new solutions online and get more value from our investments,” explains Wagner.

Resilience by design

Security and resiliency were essential. “From a security perspective, the resiliency requirements—our ability to withstand and recover quickly—were really important,” explains Jay Bhat, Chief Information Security Officer at Franciscan Health.

The migration to Azure offered a rare opportunity to rebuild with security at the foundation. “You have an opportunity, from the beginning, to put the right security controls in as part of the requirements,” Bhat explains. This shift from retrofitting longstanding systems to designing secure-by-default infrastructure marked a turning point for Franciscan.

The organization also gained agility in threat detection and response. “We have additional security tools with the Microsoft Defender stack that gives us not only the ability to monitor what’s occurring, but rapidly respond and block threats,” Bhat adds. 

Today, Franciscan’s disaster recovery environment can be live in under an hour, a major improvement over the 8 to 12 hours it once took. That speed is critical in maintaining continuity of care. “With our move to the Azure cloud, we spin up new environments within 30 minutes, and we’re working toward recovering within 72 hours," Bhat notes. The goal is to be up and running within 72 hours in the event of a major incident, minimizing disruption so clinicians can care for patients without delay.

In addition to faster disaster recovery, the team sees major improvement in tests for failover response. “From an operations standpoint, since we migrated to Azure, we can do a failover and be up in 30 minutes. This is something we would never be able to do in our previous environment,” Wagner explains.

For Bhat, these technical gains are inseparable from Franciscan’s mission. “Everything we do from a security perspective is thinking about the patient,” he says. “We want to make sure that our patients always have their data available when they need it and they're always able to get the care when they need it within our organization.”

Smart savings at scale

The migration to Azure didn’t just improve performance—it cut costs. “We’re saving at least a third on infrastructure and support. We are saving hundreds of thousands of dollars a month with migration to Azure,” says Chuck Christian, VP of Technology and CTO at Franciscan Health.

“By moving our infrastructure and support to Azure managed services, we reduced costs significantly, saving $45 million over five years. Using a global support model and eliminating local datacenter dependencies lowered FTE costs and streamlined operations,” Wagner adds.

Strategic hiring added more value. “I created a position called Cloud Cost Analyst, and that one position has saved us millions,” adds Christian. “That analyst uses native cost tools in Azure to monitor usage, identify savings opportunities, and ensure we’re spending wisely.”

It always comes back to care

For Franciscan, success means making technology invisible so clinicians can focus on patients. “I want the technology to be a tool they use to take care of patients,” Christian says. “Every dollar I save on technology is a dollar we can move into patient care.” 

With a modern, scalable infrastructure, Wagner is evaluating Microsoft solutions that make care even more human. “With this foundation, we can now take advantage of Microsoft Dragon Copilot for ambient listening,” he says. “It allows physicians to capture documentation by just having a conversation with the patient.” Dragon Copilot streamlines documentation, surfaces key data, and automates tasks. “We want clinicians focused on the patient, not on the computer,” agrees Bhat.

In addition, the team is building the Franciscan data lakehouse in Azure Data Lake Storage. This consolidates patient data in a solution that supports advanced analytics and AI, so physicians make faster, more informed decisions for patient care.

For Wagner, these decisions were never just about the technology. They were about freeing people up to focus on what matters most. 

“It’s been one of the most successful decisions I’ve made,” Wagner concludes. “Microsoft’s been an outstanding collaborator. I’d make the decision to migrate to Azure again tomorrow.”

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