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What to do when a new storage system requires an EHR migration

Executing an EHR migration to a new storage platform can be a daunting task. Health IT experts from North York General Hospital share their experience and lessons learned.

When North York General Hospital in Toronto moved from its legacy storage platform, the hospital also faced an EHR migration. The hospital uses Cerner's EHR. Sumon Acharjee, CIO at North York General Hospital, and Alshad Damji, IT manager for information services at the hospital, describe the process of migrating their Cerner EHR to Pure Storage.

Acharjee and Damji also provide advice for other healthcare CIOs who may be considering an EHR migration to a new storage platform.

What was the process of migrating Cerner to your new storage platform?

Alshad Damji: We were able to take the copies off our database and the Cerner database and put it on Pure and kept it replicated and synced. We did have a one-hour downtime to cut over the final bit, but that was the only down time we had to take to complete the final migration over from our legacy storage to Pure. It was fairly straightforward.

Why did you need only one hour of downtime during your EHR migration?

Damji: Our legacy storage also had a replication feature so keeping the data alive or synced up between the database ... on the legacy storage, as well as on Pure -- having that replication feature and keeping it in sync just to have it point over to Pure made the length of the downtime very short. A lot of it could be done in uptime and then the last little bit pointing to the Pure Storage database was the only cut over that was needed.

What lessons did you learn from your EHR migration to a new storage platform? What advice do you have for healthcare CIOs?

Sumon Acharjee, CIO, North York General HospitalSumon Acharjee

Sumon Acharjee: First and foremost is you need to manage risk ... leveraging what you have in your legacy to help enable the new technology to come to bear. So there needs to be some review of what is your legacy versus what's to be, [and] doing that in an effective test environment or an offline mode so you don't create any catastrophic issue. How can you de-risk that migration? In the actual selection of the product, that is one factor. The other factor is your growth and adoption rates and history might not necessarily be a good indicator of what your future details are as technology improves or as more and more richer data that needs larger files and the types of files that are being created and what's being stored in your database -- getting a good handle on that [and] getting a good understanding of the total cost of ownership over the total period of ownership.

Damji: Our Cerner system, or Cerner's system in general, it's got a back-end platform which is the apps that are in the database, but it's also the front end. We set up Cerner through Citrix and so we approached the whole migration very cautiously. We just did the back-end first, mainly the database, and we saw incremental gains and then once we gained confidence in the storage itself, you know, this technology is standing up and it's not crashing on us or anything like that, we moved our front-end Citrix ... to Pure and that's where we gained the most benefit as well. So one lesson learned is we approached it very cautiously but, having seen our results, if CIOs are interested in moving their Cerner platform to Pure, it might be good to bundle the migration together because that's where you see the biggest benefit. So that's one point. The other is the support from Pure through the whole exercise, the hand holding. Their support was excellent, it was second to none. Still today they are very proactive. So to examine the vendor support that you're going to get during the migration is key as well because they have visibility on thousands of clients; we are just one client, we only know ours and so things like Oracle databases and things like that if they have seen any issues or heard of any bugs, they would be the first ones to know and they could advise us on software updates and everything. They kept monitoring and seeing our migration throughout the night and also a week after as well.

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