Azure vs AWS vs Private Cloud – Which is Right for Your Healthcare Organization

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This is part-six of our Healthcare Moving to Cloud series with True North ITG CEO and CISO Matt Murren.

In part-one, Matt outlined the general challenges healthcare organizations have in moving to the cloud. For part-two, we weighed the advantages of using the cloud for electronic health records (EHR) against the potential pitfalls of such a move.

We followed this in part-three where Matt discussed the specific areas you must consider for your cloud migration strategy. With part-four, we broadened the scope to see the challenges of moving healthcare IT to the cloud.

Finally, for part-five Matt outlined the costs involved in an IT migration to the cloud.

Today, we’ll examine the options available to healthcare organizations for their migration to the cloud (or hybrid-cloud).

The Difference Between Public and Private Cloud Computing in Healthcare IT


Today, I’d like to look into a number of different cloud providers available to those considering to move to the cloud cloud. Certainly, you can have a private cloud, but there are also a number of popular public cloud vendors – Amazon Web Services, Azure and Google stand-out.

Could you speak to the benefits and drawbacks of each option? Are there differences between AWS and Azure? In your opinion, what should someone keep in mind when they’re looking at each of these options after they’ve decided to make that move towards the cloud?

Hybrid vs Community vs Public vs Private Cloud Computing

Matt Murren:

One of the things that we see that folks get surprised about is if you go to Azure, AWS, or even Google to deploy a cloud solution, that core solution does not include a geo-redundant replicated site. You have to manually configure replication to a whole other instance.

When a lot of people compare pricing to private cloud providers, like ourselves, they leave that geo-redundant configuration and replicated system cost out of the equation. Surprisingly, when you add that up in terms of cost, our solution and others are typically less expensive than Azure et. al based on the way they assess workloads and configure cost.

So we’ll encourage them to give us your ‘apples to apples’ and we’ll help you compare. We can help customers go to Azure or AWS if they want, but of course, comparing that to a managed cloud configuration, that’s a big one we see folks leaving out.

Cloud Computing in Healthcare: Public Cloud Solutions aren’t Fully Customizable


What about the other more customized considerations that maybe Azure, AWS, and Google wouldn’t have, such as the customized infrastructure that’s tailored for healthcare software. Is that something as well that isn’t factored into the cost and that is a drawback of these public clouds? Because they’re a catch all service or do Azure et. al also offer that?

Advantages of a Private Cloud Provider

Matt Murren:

That’s a huge advantage. It’s something that we consider to be a differentiator for us in that compute and moving cloud workloads from on-prem to cloud is one thing.

We can consult customers and be very deep in the healthcare vertical while also getting in and actually managing, tuning and optimizing for a healthcare organization. This isn’t something you’ll typically get from Azure or AWS. They will not consult you on the workflow impacts inside of the cloud environment.

There are other vendors like ourselves that will help you do that, but we consider it to be a differentiator in what we do simply because we sit at the support side, the management side and the cloud side to make sure it’s all managed correctly.

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It would seem that the benefits of going with a dedicated cloud provider in the healthcare industry is having that geo-redundant replication. It’s actually a lower cost when comparing apples to apples for that reason. There’s of course that ongoing benefit of the tailored consulting and understanding of workload management.

Would there be any advantages then to going with a popular public cloud provider? Or is it just that branding and familiarity that drives the popularity?

Advantages of Public Cloud Providers

Matt Murren:

Certainly, it’s branding. There’s a fit and function for Azure and AWS and again, I think it also depends on the size of your organization and that scale that you can get. You must consider all options.

Typically, in the space we operate in – which is 50 to 5,000 employees – we feel that we have a competitive offering when we wrap managed services around it, which can make a really good case for the benefits versus Azure and AWS.

That said, we can also replicate data in Azure and AWS for a redundant copy from our environment or vice versa. There’s a lot of different configurations that really just comes down to assessing the comfort level. It’s a business decision, right?

Either way, it can be managed. Our managed services can apply to Azure or AWS set-up as they can when fit in our cloud. The difference is when you’re talking about hosting electronic health records (EHR) for the healthcare space, we feel like we have a really good grasp on how to tune and deliver applications for healthcare. It’s very different than just spinning up virtual servers in a cloud environment.

Still Deciding Whether to Choose a Public or Private Cloud Provider?

Healthcare IT’s Specific Needs Not Always Suitable for Public Cloud


Folks may want more clarity on the comments you had regarding the workflow impact in a cloud environment. You had mentioned that public cloud providers don’t offer workflow analysis or insights into the workloads required for your healthcare systems – what did you mean by that?

Matt Murren:

We look at a system map. The different services as data flows in and out of the healthcare organization. Take, for instance, patient calls: they schedule an appointment, that’s an event. Patient arrives, they check-in and vitals are checked, that’s another point of data and past the engagement with the physician, there’s data flowing all over. There’s parent information, there are orders, prescriptions, lab results and a lot of things occurring in the background that require multiple systems.

Without looking at each of those things and just sticking to a homogenized view of servers it doesn’t necessarily give you the view of how data moves through the healthcare organization and, in turn, how to best optimize those processes to perform.


That’s perfect. I appreciate your time today, Matt. That’s a lot of information for people to think about; especially, once they’re looking at going to the cloud and perhaps they have Azure, AWS or Google systems in mind. Of course, they have a lot more to think about, especially in terms of mapping their processes to the structure of the cloud.

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