Cook Children’s Begins Cloud Migration Journey with Disaster Recovery

Cook Children’s Health Care System in Fort Worth, Texas, has grown significantly over the past decade, opening a new hospital in 2023 and acquiring several clinics. The health system now has about 10,000 employees, according to CTO Steve Eckert, and it’s important to build resiliency, scalability and flexibility into its IT ecosystem as it looks to the future.

“We’ve grown so much, and we recognize that we need to make sure we’re able to support that growth through our technology infrastructure,” he says.

Resiliency has been a key focus area for the hospital system as it expands because it wants to ensure that patients get the care they need no matter the circumstances. Cook Children’s has an on-premises data center on its main campus and a fully redundant data center at a secondary location in Texas.

“We invested in technologies to ensure we have full redundancy. However, we know that we can’t provide the same level of support, security and resiliency that a Tier 4 data center can,” says Eckert, adding that maintaining a data center is a tough business due to constant updates and monitoring. “Having a solution in place, whether on-premises or in the cloud, that can support our growth and resiliency was something of paramount importance.”

To improve resiliency amid worsening cybersecurity attacks, rising cyber insurance costs and the increasing severity of weather events, Cook Children’s decided to move its Epic disaster recovery instance onto Microsoft Azure. However, Eckert explains that the health system didn’t want to make the transition alone.

Proven Partnership Aids Cook Children’s Cloud Migration

“We knew that we needed help. We thought it would be important for us to partner with a consulting firm that had proven experience with the journey to the cloud,” Eckert says.

This was particularly the case because the Cook Children’s team was proud of the disaster recovery data center it had built at the new campus and was hesitant to embrace the cloud. Eckert says his team had to communicate the why behind the move from a technical and operational perspective to get everyone on board. CDW helped the team identify cost savings and articulate the shift from capital to operating expenses.

It was also critical to manage expectations around the transition. Eckert says the organization’s systems engineers needed to know that the way they work would be different going forward. Rather than focusing on racking and stacking in a data center, they would have to monitor the amount of compute and storage needed in the cloud.

“You have to explain the why to your team and make them feel comfortable with what their future roles will be. Roles do shift and change as a result of cloud migration, so take the time to understand the human component of that,” says Eckert. “People are important, and the jobs that they do are essential. Change can be scary, but if you know where you’re going and gain access to experience, it becomes a little less scary.”

He also recommends that organizations interested in migrating to the cloud talk to others that have done so. It was helpful to know that his organization wasn’t the only one going through the process, he says.

Cook Children’s was especially interested in partnering with CDW because of its past migration experiences, so the health system could build upon lessons learned. For example, Eckert points out that accessing information in the cloud can be expensive if not monitored. The health system wanted to ensure there would be no surprise costs as the team gets used to the shift from capital to operational expenses.

“Leveraging a partner helped us with the things that, frankly, we didn’t know. They helped educate us and walk that path,” he says.

In partnership with CDW, Cook Children’s developed a multiphase migration path that includes establishing the foundation, optimizing the cloud infrastructure, and preparing for future growth of the organization’s clinical and research infrastructures.

Cook Children’s Cloud Journey Begins with Epic Disaster Recovery

Part of the reason Cook Children’s decided to begin cloud migration was the desire for flexibility and scalability. Another was to align with its business partners, including Epic, Microsoft and Workday.

“All those solutions are being or will soon be delivered via Software as a Service initiatives,” Eckert says. “We wanted to understand where our biggest partners were going and what was important to them so we could kind of mirror that and make sure that we’re prepared to support those technologies as we move forward.”

The first project on the organization’s cloud roadmap was disaster recovery, a common first step in healthcare. Eckert explains that it identified this starting point based on the importance of resiliency and business continuity to Cook Children’s future growth.

“We want to make sure that in the event of a disaster or cyberattack, we can still take care of kids and ensure our clinicians have the data they need to treat patients,” he adds.

The health system began by migrating its Epic disaster recovery instance to the cloud using Microsoft Azure, a public cloud environment. Clinicians rely on the electronic health record to provide care, making it a critical part of the organization.

“If something happened to our primary data center, we want to, at minimum, be able to give our clinicians access to the most recent information we had,” Eckert says. “In this instance, it’s a read-only view of Epic that shows lab results, medications administered and other information in that patient record. When an event occurs, putting that in the hands of our clinicians is imperative.”

We’re going to do what makes sense for us, what’s financially responsible and what we’re confident we can support to have that business continuity.” – Steve Eckert CTO, Cook Children’s Health Care System

Cook Children’s is in the final stages of testing its Epic instance in the Azure public cloud and having it available for disaster recovery, which is part of establishing a foundation in the cloud. Eckert says that although it seems like it’s taken a long time to get here, he feels that the organization is moving rapidly.

“That foundation is key. We’re going to be able to really understand our foundational operating model and establish real-time financial governance,” he says. “We’re establishing our governance structure around enterprise architecture, cloud, cloud steering and portfolio management. All those things are important to us as we continue that journey and start to migrate more systems to the cloud.”

Once the organization has completed testing Epic in the cloud, it will start exploring other solutions to move the disaster recovery function out of its data center and into the cloud. The goal is to be less dependent on the data center by the end of this year. However, the data center will still exist because it handles primary activities for the hospital.

This roadmap is all part of Cook Children’s smart cloud strategy. The health system uses hundreds of applications, but it doesn’t plan to move everything to the cloud. Eckert explains that while many partners and vendors are migrating their systems, it doesn’t mean Cook Children’s will follow them to the cloud.

“We may choose their cloud offering as Software as a Service. We may want to host it ourselves on-premises or host it on our public cloud,” he says. “As our partners move forward, we need to be prepared for which direction we’re going to go with them. That’s why we are leveraging a smart cloud philosophy. We’re going to do what makes sense for us, what’s financially responsible and what we’re confident we can support to have that business continuity.”

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