You can configure your critical healthcare IT solutions for true high availability in the cloud—and gain all the advantages that the cloud affords in terms of ease of access, rapid roll-out, and lower on-site infrastructure costs. But you need to configure for high availability with application access in mind, not just hardware access.

When it comes to high availability application access, one of the key challenges lies in how and where you store the data captured by your healthcare IT systems. You can’t rely on a traditional storage area network (SAN) the way you might have in an on-premises failover configuration because you can’t share storage in the cloud. There are a wide range of storage options that you can deploy—from software-defined storage offerings by third parties to high speed SSD-based storage offerings offered by the cloud service providers themselves. Whatever you choose, you’re going to need to attach storage to both your primary and backup servers, which you’ll configure as a failover cluster, with the primary and secondary systems residing in different data centers (or different Availability Zones if you’re deploying on AWS). You’ll also need a mechanism for actively synchronizing the data from the primary to the secondary storage systems so that, should the primary system fail, your secondary system has an up-to-date copy of all the data that the primary system had been using and can immediately stand in for the primary system that has gone offline.


There are a number of ways to manage replication between storage instances, but you’ll need to test them to be confident that they support your availability targets. The Chris O'Brien Lifehouse hospital in Sydney, Australia, initially configured their AWS-based MEDITECH deployment for high availability using a software-defined storage volumes they selected through the AWS marketplace. The replication and failover features of the storage solution performed well when tested. The team was confident that the backup infrastructure would be online and supporting teams within moments. But the software-defined storage volumes presented an unexpected problem: the EHR system itself delivered sub-par performance when interacting with the software-defined storage. The IT team at Chris O’Brien Lifehouse reconfigured the underlying infrastructure—which they could do rapidly in the cloud—and attached a native AWS storage solution to each failover cluster node, and the EHR solution immediately began to deliver the throughput the team was expecting.

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