Good health is imperative to leading a happy, contented life, and is a basic human desire and right. However, from the beginning, mankind has been in a constant battle against disease. That’s why the healthcare field has always focused on supporting innovations that advance our ability to prevent, treat, and cure a variety of conditions. From sheer human brilliance to advanced technology, it makes use of every available resource to further that goal.
Historically, a few key healthcare institutions have pioneered efforts to advance the field of medicine. Michigan Medicine is the academic medical center of the University of Michigan and encompasses a network of hospitals, clinics, and specialized centers; a world-renowned medical school; and a robust research enterprise – making it a global leader in advancing medical knowledge, developing innovative treatments and delivering compassionate patient care.
As the CTO at Michigan Medicine, Dr. Tim Calahan endeavors to uphold and expand his institution’s reputation and leadership in healthcare by executing on an leadership mandate to modernize Michigan Medicine’s IT infrastructure with a strong cloud-first preference.
Lending his Expertise
Calahan started his technical career in the Marine Corps, managing the IT infrastructure for the Judge Advocate General’s (JAG) various legal offices spread throughout Marine Corps Base Camp Pendleton. He left the Marines to pursue his MBA, and his first position after completing it was in a “Big Five” management consulting firm. The majority of his clients were either in financial services or healthcare and over the years, more and more of his clients and customers became concentrated in healthcare and life sciences.
Calahan left management consulting to build cloud products and solutions for EMC[GS1] [CT2] and was responsible for the launch of their EMC Hybrid Cloud product and solution. Shortly after, EMC purchased a cloud company called Virtustream, and Calahan and his colleagues were moved to that subsidiary. His first assignment there was to “Go build a healthcare cloud.” He and his team created the Virtustream Healthcare Cloud, focused on hosting Epic[GS3] [CT4] , a leading Electronic Healthcare Record (EHR) provider, in their private cloud environment. After they had built that into an $80M business, Dell decided to integrate Virtustream back into the parent company.
“I have found the work in healthcare to be deeply rewarding and satisfying, as we have introduced products and solutions that allow organizations to enhance patient care and improve clinical outcomes, says Dr. Calahan[GS5] [CT6]
Having spent the past decade developing effective ways of moving Epic to the cloud, Calahan is excited to bring that expertise to Michigan Medicine. In so doing, he intends to create a roadmap for other healthcare institutions looking to embark on similar paths.
“We are in the early stages of our cloud migration strategy, with a specific set of plans, goals, and initiatives focused on moving Epic, Sectra[GS7] [CT8] (a leading medical imaging solution provider), and 90% of our general-purpose workloads to the cloud, resulting in improvements in operational agility, performance, and overall security,” says Calahan.
Leading Transformation
As a public institution, Michigan Medicine started its cloud transformation journey with a series of Requests For Proposal (RFP) to identify partners to help build key foundations: A WAN RFP to extend their network beyond its own data centers near Ann Arbor, MI to multiple cloud onramps to ensure the redundancy and reliability they need and expect from the cloud; a Colocation RFP to provide cloud-adjacent colocation space, which will allow them to decommission one of their data centers; a Hyperscaler RFP to select a preferred cloud provider; and a Solution Integrator RFP to assist them with their cloud transformation. Finally, they issued a Skills Assessment & Training RFP to establish a baseline and then continuously assess their staff’s cloud knowledge and expertise and provide robust training to fill any gaps.
While this RFP work has been underway, Calahan’s team developed an Epic Cloud Read-Only resource to provide a cloud-hosted instance that now serves as a backup in case their primary (on premises) instance should ever become compromised. They were the first[GS9] [CT10] to deploy Epic Hyperdrive on an Azure Virtual Desktop (AVD) instance. They now plan to expand from these initial proofs of concept to develop solutions that can serve a broader subset of customers.
Calahan points out that maintaining traditional data centers and legacy infrastructure is cumbersome and inefficient. From long procurement lead times to complex vendor management, the overhead is real and substantial. When one adds in the hardware inefficiencies and the tendency to over-provision on-prem hardware in traditional data center environments, the move to the cloud is the logical choice for organizations that seek to elevate their security posture, improve application availability, and increase performance. Plus, with cloud platforms, the ability to deploy infrastructure as code becomes much easier and widespread, resulting in improved flexibility and business agility – basically allowing IT to respond to the business in a much more nimble, structured, and streamlined way.
“As part of our cloud transformation, we plan to embed cloud request items into and within our existing ITSM service catalog, which will significantly improve our ability to respond to the business,” he shares.
Transformation Challenges
When Calahan and his team first developed a model for moving Epic to the cloud a decade ago, it was controversial. Today, moving Epic to the cloud is a fairly standard practice. Both Epic and the public cloud providers have invested tremendous amounts of time, effort, energy, and resources to create standardized reference architecture to properly run and operate Epic in the cloud.
Explaining further, he says a primary challenge is that most existing Epic teams do not know the cloud, and cloud-savvy engineers do not know Epic. So, any institution or team that wants to embark on a cloud transformation involving Epic needs to understand that there will be a bridge or gap that needs to be filled. Fortunately, Calahan brought a team of engineers with deep experience in public cloud migrations when he moved to Michigan Medicine. As such, they confident in moving Epic to the cloud, as they have already been performing that work for the last decade. In fact, they have recently helped and guided some other institutions making similar journeys to assist with their success. As a testament to this collaboration, Charles E. Christian, VP & CTO of Franciscan Health said[GS11] [SG12] , “Leveraging Mitch Duff’s and Charles Knight’s knowledge of migrating and running Epic in the public cloud was critical to our Epic cloud migration project. Their knowledge, experience and partnership regarding public cloud and Epic is unmatched.”
Fostering Innovation in Healthcare Technology
Michigan Medicine has a rich history of fostering innovation in healthcare technology, driven by its commitment to integrating cutting-edge research with clinical practice. It also strongly encourages interdisciplinary collaboration among its faculty, researchers, and clinicians, creating an environment where diverse perspectives come together to solve complex healthcare challenges.
Michigan Medicine supports healthcare startups and entrepreneurial ventures through programs like Fast Forward Medical Innovation. This initiative provides resources, mentorship, and funding to bring new medical technologies to market. It also places a strong emphasis on continuous learning and adaptation, ensuring that staff and students stay at the forefront of medical advancements and technological innovations. This commitment not only enhances patient care but also sets the standard for academic medical centers worldwide.
Balancing Technology and Business Needs
Digital transformation within healthcare is complex, as the landscape of clinical applications is broad, diverse, and in some cases – old[GS13] [CT14] . Because of those challenges, healthcare is just now beginning to adopt cloud transformation, where other industries have already largely embraced cloud and are reaping the benefits. At Michigan Medicine, Calahan and his team are aware of the intricacies of a cloud transformation and that appreciation is apparent in Michigan Medicine’s cloud strategy.
Providing and ensuring seamless continuity of service – especially for patient care and research needs –is critical to Michigan Medicine’s cloud transformation efforts. One of the first questions he received upon arriving was about the potential disruption to the business as applications were migrated to the cloud. Michigan Medicine’s cloud strategy employs strategies to seamlessly mirror and migrate data and applications to the cloud without disrupting customers. Some reference such strategies as a “lift and shift” and while this approach borrows elements of that, it also allows for fine-tuning and optimization of the application landscape to capitalize on the advantages the cloud provides to their application landscape.
“Following our migration to the cloud, we expect to spearhead some degree of application re-design to fully embrace the latest and best tools and technologies that cloud platforms can provide and not available via on-prem data centers. Essentially, we will be elevating the computing platform that the applications operate from, providing a broader range of tools and technologies that did not exist within our legacy data centers,” says Calahan.
Ensuring Safe Transitions
For Calahan, data security and the privacy of sensitive information are top of his mind in Michigan Medicine’s digital transformation journey. It is a core pillar of the cloud strategy, and his team intends to inject security and resiliency into the very fabric of its cloud computing infrastructure to provide the security, reliability, and recovery required to protect patients, research subjects, and the institution’s overall reputation.
By moving to the cloud, Michigan Medicine will be able to segment applications, like Epic and Sectra, and ensure that only relevant networks and ports are allowed access, and those access points will be monitored to baseline traffic patterns to understand if malicious activity is driving network traffic anomalies. Additionally, cloud platforms have the ability to deploy compliance solutions to ensure that cloud configurations meet the compliance requirements set by our information assurance teams.
Assessing Trends in Healthcare IT
A recent McKinsey study commented on the growing adoption of industry cloud platforms that have been modified to meet industry needs. Over the years, the major cloud providers have done a terrific job of making sure their specific cloud platforms meet the compliance, security, and application requirements that are unique to the healthcare vertical. Calahan views that as a critical initial step, but stresses that healthcare organizations still have to undergo the journey to take advantage of these capabilities.
He believes that once healthcare organizations have made the move and migration to the cloud, the next area of evolution will be to take advantage of the many tools and technologies it enables. One area they are starting to explore is the use of generative AI, and Calahan expects their cloud journey will fuel those development efforts.
“As we start to operationalize some of these generative AI solutions, we will benefit from the fact that our data and application environment is adjacent to our generative AI solution. As we look ahead in healthcare, we believe leveraging cloud data products and solutions, coupled with generative AI solutions to augment the use of traditional AI and predictive analytics solutions will yield significant business advantages,” says Calahan.
Thinking Ahead
Calahan and his team have spent the last couple of years at Michigan Medicine preparing for a massive migration to the cloud to fuel innovation and business agility. They are now focused on executing that plan. To do that, they intend to implement a “cloud capability center” to accelerate migration, concentrate cloud skills and capabilities within the organization, and assist institutional stakeholders and partners in maximizing the benefits of using cloud tools and technologies. They will also facilitate the massive cloud migration project that will be underway with their selected system integrator.
“If we fast forward 2-3 years, we will have done an amazing job if we have Epic, Sectra, and all of our general-purpose applications operating in the public cloud. While every IT project comes with its own set of challenges and adversity, we will view those as good and exciting problems to address, as it will mean we are making progress toward our goals and objectives,” concludes Calahan.
Quote: “The secret of change is to focus all of your energy, not on fighting for the old, but on building the new.” – Socrates
[CT14]Yes, but old just puts an exclamation point on it. I’m fine with changing, but “old” in this context and within this context carries with it a negative connotation.