Multi-Facility Health System: Cloud Migration & Clinical Data Platform
Client Context
A regional health system operating 12 hospitals and 75+ outpatient facilities across three states. The organization maintained a legacy on-premises data center hosting multiple clinical applications, analytics systems, and patient data repositories.
Aging infrastructure, increasing maintenance costs, limited disaster recovery capabilities, and the need for real-time clinical analytics drove the decision to pursue cloud migration.
Business Challenge
- Legacy infrastructure nearing end-of-life with escalating maintenance costs and limited scalability
- Fragmented clinical data across multiple systems preventing unified patient views and analytics
- HIPAA compliance requirements necessitating rigorous security controls, encryption, and audit trails
- Zero tolerance for downtime during migration—clinical operations could not be interrupted
- Limited cloud expertise within internal IT requiring knowledge transfer and training
Our Approach
Phase 1: Assessment & Strategy (8 weeks)
- Comprehensive application portfolio assessment and dependency mapping
- Cloud platform selection (AWS chosen based on HIPAA compliance, regional presence, and healthcare reference architecture)
- Migration wave planning prioritizing low-risk applications first
- HIPAA compliance architecture design with security controls matrix
- Cost modeling and TCO analysis
Phase 2: Foundation & Pilot (12 weeks)
- AWS landing zone implementation with multi-account structure
- Network architecture (VPC design, Direct Connect, VPN failover)
- Identity and access management (IAM, SSO integration with Active Directory)
- Security baseline (encryption, logging, monitoring, GuardDuty, Security Hub)
- Pilot migration of non-critical application to validate process
Phase 3: Core Application Migration (24 weeks)
- Phased migration of 37 applications across six migration waves
- Rehost strategy for legacy applications (lift-and-shift to EC2)
- Replatform strategy for modernization candidates (containerization, managed services)
- Data migration with validation and reconciliation processes
- Cutover planning with rollback procedures and business continuity
Phase 4: Clinical Data Platform (16 weeks)
- HL7 and FHIR integration layer connecting EHR, lab systems, imaging, and ancillary systems
- Real-time data pipeline ingesting clinical events (Kinesis, Lambda, S3)
- Data lake architecture for longitudinal patient records
- Analytics platform (Redshift, QuickSight) for clinical intelligence and population health
- API layer for third-party application integration
Technical Solution
Architecture Components
- • AWS multi-account structure (12 accounts)
- • Direct Connect (2x 10Gbps) + VPN failover
- • EC2 instances (mix of on-demand and reserved)
- • RDS for relational databases (SQL Server, PostgreSQL)
- • S3 for object storage and data lake
- • Kinesis for real-time data streaming
- • Lambda for serverless data processing
- • Redshift for analytics data warehouse
- • ECS for containerized applications
- • CloudWatch, CloudTrail, GuardDuty for monitoring
Security & Compliance
- • HIPAA Business Associate Agreement (BAA) with AWS
- • Encryption at rest (EBS, S3, RDS with KMS)
- • Encryption in transit (TLS 1.2+)
- • Network segmentation and security groups
- • Multi-factor authentication (MFA) enforced
- • Centralized logging and audit trails
- • Automated compliance scanning (AWS Config, Security Hub)
- • Backup and disaster recovery (cross-region replication)
- • Incident response procedures and runbooks
Outcomes
- Zero security incidents or HIPAA violations during migration and first 18 months of operation
- Unified clinical data platform enabling real-time analytics, population health insights, and regulatory reporting
- Improved disaster recovery posture with RPO < 15 minutes, RTO < 4 hours
- Enhanced scalability supporting 23% patient volume growth without infrastructure expansion
- Knowledge transfer completed with internal IT team managing day-to-day operations