February 17, 2021

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February 17, 2021: For Epic customers, 2021 presents a unique opportunity to reevaluate current EHR and clinical application infrastructures. Is it time to take advantage of interSystems IRIS? Here to run you through the switch to this latest data management software platform is Marty Momdjian and Josh Peacock from Sirius. We know that moving from an SMP to an ECP architecture can be overwhelming. Why should health systems have this on top of mind right now? How can healthcare leaders select a platform that fits their data center and technology management methodology? What is the biggest benefit of upgrading to IRIS? What is the most challenging part? What is the best way to migrate existing applications in order to take advantage of the performance and efficiency of InterSystems IRIS?

Key Points:

  • Epic are giving customers the opportunity to change their platform licensing without an upfront capital investment. This will essentially future-proof their upgrade and consolidate their future platform roadmap. [00:01:49] 
  • Ansible is a great open-source tool that you can use to manage an environment and keep everything very concise [00:06:22] 
  • Sirius experts can help you build out a modern infrastructure that will include a flexible upgrade cycle along with a predictable cost model to ensure that you’re aware of and prepared for any future upgrade costs [00:08:10] 
  • What is your technical team’s skill set? What is the platform? Could they manage it better? What is your current data center hardware? [00:10:54] 
  • InterSystems IRIS: The Next Generation Data Platform
  • Sirius

Modernization is now – What to consider before upgrading to IRIS

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Modernization is now – What to consider before upgrading to IRIS

Episode 366: Transcript – February 17, 2021

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

[00:00:00] Bill Russell: [00:00:00] Thanks for joining us on This Week in health IT. This is a solution showcase. My name is Bill Russell, former healthcare CIO for a 16 hospital system and the creator of This Week in health IT. A channel dedicated to keeping health IT staff current and engaged. All right, today, we are joined by Marty Momdjian and we are returning guests, Josh Peacock.

[00:00:26] And I’m looking forward to this conversation. We’re going to talk we’re going to [00:00:30] talk the Epic IRIS migration what opportunities exist for health systems as they look at this. Welcome. Welcome to the show guys. 

[00:00:40] Marty Momdjian: [00:00:40] Hey, thanks for having us. 

[00:00:42] Bill Russell: [00:00:42] Yeah.  So this should be good. I want you guys to feel free to, you know, really go at it and talk about this and explore this topic. Marty and I actually just did a a webinar on this. We got a lot of questions, so people are very interested in this topic.

[00:00:57] There’s a lot of back and forth going on. So I’m [00:01:00] looking forward to hearing what you guys have to say. Let’s start with just a broad question, which is, what is this? What’s Epic doing? What’s the opportunity. What are health systems? Why, why should the health systems have this be top of mind right now? Marty, do you want to start with this and then, and then we’ll kick the next one to Josh. 

[00:01:22] Marty Momdjian: [00:01:22] Yeah. Yeah. So historically Epic’s core database was always running on cache. That’s been [00:01:30] the core database engine for a very long time. Intersystems released the next generation database platform. Which is InterSystems IRIS. What Epic is doing, essentially helping customers migrate to the new platform because cache is going to get deprecated sooner or later.

[00:01:49] They’re also giving customers the opportunity to change their platform licensing without a upfront capital investment. So [00:02:00] historically if I was running on power or if I was running on Linux and I need to change platforms, there was always a license reissuing cost associated with it. For the next few years, they are actually removing that costs to give healthcare systems the opportunity to move to platform independent or platform specific licensing to essentially future-proof their upgrade and, you know, future platform roadmap.

[00:02:28] For if they want to run on [00:02:30] power or if they want to run on IBM and sorry. If they wanna run IBM power or if they want run on Linux and switch platforms there won’t be costs associated with it if they go platform independent placements. 

[00:02:42] Bill Russell: [00:02:42] Wow. All right. So platform independence is, is one of the, one of the biggest things. Then there’s licensing benefits as well. So let’s. Let’s go down this, it really does represent, when you talk about platform independence for the first time, I’m not boxed in, right? So I’m not [00:03:00] boxed in by a financial weird financial model that doesn’t allow me to go to a platform. And I’m also not boxed in because now I can literally look at my data center and say what makes the most sense for me?

[00:03:13] So Josh, as you, as you are working with clients on this and talking through it what, what do you see as the biggest benefits and opportunities? We have platform independence. We have licensing. What are, how our health systems approaching this? 

[00:03:27] Josh Peacock: [00:03:27] Well, I think because of the platform [00:03:30] independence option and the ability to kind of take that, that switch about the penalty.

[00:03:35] I mean, we’ve been recommending that that’s the direction people go just for flexibility now and, or indoor in the future. The other thing I think, based on what we’re seeing too ECP used to almost be kind of a nasty thing to say enterprise cachet protocols, multi-tier kind of spread users out and I’ll save utility servers for kind of spreading the load as these environments get so large.

[00:03:59] What’s been kind of [00:04:00] recognized that that’s going to be a regular thing for most organizations that of any size going forward. And the other thing is they moved to IRIS. That’s an inherently multi-server license, which allows ECP to be deployed without another additional charging curve. So I think be able to switch to a different platform and that native ability to run multi-server without an additional cost has, has really opened up the doors for really any size organization to go that direction without [00:04:30] incurring additional costs associated with it licensing wise. 

[00:04:33] Bill Russell: [00:04:33] You know, one of the questions we got in the webinar, which I think you know, it’s interesting because it speaks to what you just talked about is, you know. How does this scale better than ECP? Does it you know, does it still require us to manually sync the CPS files with the remote scripts?

[00:04:51] We got a lot of very technical questions in the webinars. I was really fascinated, but you know, how does this scale better than ECP? 

[00:05:00] [00:05:00] Josh Peacock: [00:05:00] Well, I, I think the unfortunate and part of that is it’s probably going to be very similar in the way that we’ve traditionally managed ECP and dealt with it. Some of the techniques and technologies that InterSystems has in from asn IRIS perspective where, you know, whether or not that’s being able to scale in a different way across more servers those really aren’t available to us when we’re talking about an operational database for Epic.

[00:05:25] If you were developing your own thing or some other technologies that, you know, like an ensemble [00:05:30] or something like that, they might be able to take advantage of that, but really the way the data structure sits in Epic, I think we’ll see things being, you know, more of the same, at least for the near future.

[00:05:42] Marty Momdjian: [00:05:42] I think the biggest advantages, essentially, what is Epic going to do with IRIS? Because it’s still very new. With the upgrades and with a virtualized data center, when you, if you move to an x86 platform, it’s additional virtual [00:06:00] servers, right? You’re treating it as a virtual server, just like everything else.

[00:06:04] And it’s throwing more memory and CPU, depending on how much you need to scale. And when you can scale for your center database server and your ECP surface. 

[00:06:14] Josh Peacock: [00:06:14] The other thing I think that it opens up to, and this kind of goes to the, multi-platform not that on AIX. We can’t use some of the tools that are out there, but there’s some really mainstream tools.

[00:06:22] One for example, is Ansible that you can use to manage an environment, keep everything very concise and the same. And that is [00:06:30] one thing we’ve deployed for a couple of clients where we’ve been able to essentially throw down a base image of red hat in the environment. And then from there, Ansible will take care of rolling out all the operating system changes to support Epic’s requirements, along with the organizations, you know, active directory, integration user, you know, the way that the users access menus and all those sorts of things.

[00:06:53] And you can make that super consistent across all of your servers. And then whenever you just need to add some ECP servers into the mix, it [00:07:00] just becomes another one of the pool that you’re managing the same, same manner. 

[00:07:05] Bill Russell: [00:07:05] All right. We’ll get back to our show in just a minute. We have a lot of good stuff after the break. Just wanted to share with you a message from our sponsors Sirius Healthcare, VMware and Intel. 

[00:07:17] Sirius commercial: [00:07:17] The new year. is a great time to reflect on the past and look ahead to the future to figure out what was done well and what can be improved as we move forward. For Epic customers, 2021 presents a unique [00:07:30] opportunity to reevaluate their current EHR and clinical application infrastructures and determine if now is the time to take advantage of the latest data management software platform interSystems IRIS. As the next generation data platform, IRIS excels at delivering a modern, consistent, and reliable experience to clinicians and patients. However, at Sirius, we know that migrating our upgrading to a new platform presents its own set of challenges, such as managing current and future costs, switching [00:08:00] from SMP to ECP, when migrating platforms or determining the best services or manufacturer for your future platform. When it comes to managing costs, Sirius Healthcare experts can help you build out a modern infrastructure that will include a flexible upgrade cycle along with a predictable cost model to ensure that you’re aware of and prepared for any future upgrade costs.

[00:08:23] We also know that switching from an SMP to an ECP architecture can be overwhelming. The Sirus [00:08:30] Healthcare team is fully capable of offering guidance and support while building out your new architecture, minimizing the impact on your it team and clinical users. When exploring disaster recovery options for a new platform, we know you want the best technology available while controlling costs.

[00:08:46] By utilizing a hybrid cloud model, our experts can help you discover the perfect mix of services and technologies to do just that. A significant benefit of the IRIS platform is its compatibility with many Intel [00:09:00] manufacturers, such as Cisco, Dell, HP, and Lenovo. So if you’re switching from power to Linux, the Sirius Healthcare team can help plan a migration with a manufacturer you’re most familiar with while developing a roadmap to manage your new platform for the long haul.

[00:09:14] Deciding to upgrade and selecting a platform license type by the end of 2021, doesn’t have to be a daunting task. If you’d like assistance, choosing the best available options, technologies, and architecture to fit your organization, contact Sirius Halth care today. 

[00:09:30] [00:09:30] Bill Russell: [00:09:30] When I get smart people like yourself on the show, I like to role play a little bit, and I want to go back into the CIO role. You guys are going to be CTOs. And what we’re going to first talk about is how I should be thinking about this, right? What are some aspects I should be looking at? So I’ve got ,I have too much variability in my data center. I still have too many systems, too much software. I have some challenges I need to deal with. I need to deal with 21st century cures, API management. Those kinds of things. I’ve got to think [00:10:00] through architecture. Am I going to be usually utilizing cloud or not utilizing the cloud? I’ve got capital expenses operating expenses. If I’m making you dizzy yet, I’ve gotta be able to leverage all these new technologies.

[00:10:12] I got to, you know, NLP AI, machine learning I’ve, I’ve gotta make better connections to my consumers and be able to build platforms and those kinds of things. All right. So those are all the things from a CIO perspective. But I’m thinking about next like that. That’s only half of what I’m thinking about during a pandemic, but but those are the things I’m [00:10:30] thinking about.

[00:10:30] This is an opportunity, right? You’re giving me platform independence. You’re giving me flexibility. I can. Now what consolidate am I going to be able to consolidate around certain platforms? Am I going to be able to reduce costs? What. What am I going to be able to do? I’m the CIO asking you to my CTO?

[00:10:47] So you can both formulate the answer to that. How should I be doing this? And what, what is the opportunity for us?

[00:10:54]Marty Momdjian: [00:10:54] Honestly, I think it’s looking at what is your technical key skillset? Right? What is [00:11:00] my technical teams skill set? What’s the platform. Could they manage it better? And what is my current data center hardware? 

[00:11:06] Bill Russell: [00:11:06] So you’re going to, you’re probably going to assume it’s VMware, since you know, 98% of my systems are going to be running on VMware at this poiso I want that to be a platform. But the hardware itself, I can really go in any direction at this pointt can’t I?

[00:11:23] Marty Momdjian: [00:11:23] You can, you can. I think it also part of the hardware is what’s my compute? What’s my storage. What’s my network. You know, have I [00:11:30] standardized on Cisco UCS? Am I running fabric interconnects?

[00:11:33] And can I go buy a Cisco, you know, four socket solution. That’s going to suffice for the operational database that I can manage the same exact way. Besides minor specifics there on locking down the system for access. From an operational database that I can for the rest of my Epic and clinical application infrastructure.

[00:11:54] I think the biggest part of all of that is, is coming up with a cost model. So [00:12:00] most organizations, if you were to ask me to come back to you and say, Hey, you know, Bll, my CIO asked me to price this out for three years. The first thing I ‘m going do is not just look at the hardware pricing, but figure out what the soft costs are.

[00:12:13] Find out what the licensing prices are, depending on what platform I’m running, how you got VMware licensing, right? And figure out what hit licensing, figure out support for three years, and then extend that off to five years and figure out based off what you are. The CIO is telling me [00:12:30] if we’re going to onboard any additional users, go live with clinics or acquire any hospitals to come back to you with a TCO and say, Hey, here is the actual, if we were to onboard 1000 users or 5,000 users, after going through a migration based off whichever platform we’re selecting, I can give you a cost for the next three to five years, including a refresh and adding an initial capacity based off number of users.

[00:12:56] And hopefully you project that out to 10 years. Another part of it is [00:13:00] skillset. This is a very good opportunity for me to come to you and say, Hey look, we’re short-staffed right. We’re doing a lot with very little people and we need to sharpen our skill set a little bit, but send some of the Epic support staff to training, not just for VMware, but go to Epic training, go to VMware training. 

[00:13:17] You know figure out if you’re changing platforms like Josh mentioned, is this a good time to implement Ansible? Is that a skill set that we should learn to expand out beyond just the operational database, our other red hat servers. [00:13:30] Consolidation rights, platform consolidation, right. When am I refreshing my hardware for my operational database?

[00:13:37] When am I refreshing, my hardware for hyperspace and Citrix and VMware horizon? When am I refreshing my hardware for everything else application server wise. Can I get into a predictable refresh model where I can come to you and say, here’s the costs for updating 33% of my clinical application infrastructure hardware, including Epic every year [00:14:00] to make that a palatable cost?

[00:14:02] Or are we going to get stuck in this format where I knock on your door every three years and say, Hey, we’ve got to do a hardware refresh. We have two months we’re out of capacity. I need X amount of dollars and we need to do in the next three months. 

[00:14:15] Bill Russell: [00:14:15] Josh. I want you to give me an answer to that as well. Next, we’re going to go into the actual migration by the way. So this is where we’re really going to nerd out. And I’m going to ask you what it’s going to take for me to do this migration to a new platform in [00:14:30] cycle? I’ll hit some of these questions we got in the webinar because they’re very specific.

[00:14:34] And I think that’s really interesting, but, but Josh, what am I going to, am I going to the CEO and saying, look, we just have to do this. Applicant’s told us to do it. Or is there, you know, we heard a couple of things there. We heard consolidation skills. We heard consolidation of equipment. We heard opportunity for you know, improve training and those kinds of things.

[00:14:58] You know, am I going to be able to, one of [00:15:00] IRIS’s things is it’s it’s cloud deployable. So AWS, Google Cloud Platform, Azure. I mean, am I going to be able to do some, some interesting things there from an availability and other standpoint? 

[00:15:12] Josh Peacock: [00:15:12] Well, I guess I get to be the negative Nancy I’m going to use, but for a couple of things, the, the cloud piece is really all dictated on what the public clouds are able to give us for performance 

[00:15:23] Bill Russell: [00:15:23] Right. So I can’t, I can’t move that transactional data store to you know, to a cloud [00:15:30] too far away. Cause I have too much latency. 

[00:15:33] Josh Peacock: [00:15:33] Well even just the number of storage IOPS that they can pull off for the operational database of Epic. We’re, we’re looking at somewhere probably eight to 10,000 concurrent users as your max size client that can fit in a public cloud today.

[00:15:45] Today that’s, you know, that’s increasing every day, but so there’s limitations there and we have to be careful of the consolidation of our platforms within the organization that you’re supporting the vendors that you’re working with, the support locations that you know, that you’re contacting, those are all things that are good [00:16:00] benefits of moving to that consolidated compute platform and VMware and those pieces all make a lot of sense to be that I think.

[00:16:09] I don’t know that it gets us away from, you know, the way we manage some of these is special systems and they’re still hiring the board and the central, you know, system for all of Epic, for example, runs on that core database. Right. So you can still pretty much point to the server that, you know, is Epic production and the data center type of thing.

[00:16:28] So it’s not, it’s not [00:16:30] abstracting that so far away that it’s not quote unquote, a special server that we take a lot of extra care and. So there’s, and there’s a lot of things that we have to do that are particular to those environments versus just standard windows compute or Linux normal compute servers that are sitting in a data center.

[00:16:49] But I really think that consolidation of red hat skills and getting back into VMware and just kind of reducing the number of different things that people have to keep track of and understand, and support contracts have [00:17:00] to be out there. And all that stuff is some massive savings and streamlines the operations.

[00:17:06] Bill Russell: [00:17:06] Well, well, thanks Josh. Thanks for pulling me back down to the earth. I was really hopeful here that, you know, we were going to see a public cloud version of Epic sometime in the very near future. Actually, we’ll get to futures, you know, a little bit. I’m going to come back to that. Let’s talk about the migration.

[00:17:23] So You know there’s a lot of things to to take into account, but a lot of it has to do [00:17:30] with the data. And we got a bunch of questions on, you know. Will an IRIS database mirror with a cache database allowing us no shortened downtime? That was one of the questions. We had questions on migrating, you know, what is the data conversion from power AIX to Linux red hat look like? Give us an idea of what the process is or moving one to the other. And some of the considerations. 

[00:17:58] Josh Peacock: [00:17:58] I can kick that one off. [00:18:00] So the way I look at it for the most part is it’s almost like a standup of a new applique environment. So we basically stand up as much as we can, all the red hat environments ready to go. Just as if we were going into a net new, Epic go live.

[00:18:16] And that allows us to make sure that we have all the user access and all those things defined as necessary. And then the real piece that comes is building your first mirror and IRIS and cache can mirror together. [00:18:30] So that’s a good thing. But that’ll allow us to mirror across to a Linux-based version of our database.

[00:18:37] And then from there, we’d be able to start taking snapshots or clones or whatever you have for storage technology on the backend. And we can use those to create our sub tab, other environments that are needed that are full size in the environment. And there is a conversion. So there is a process of us copying that data over initially running through a conversion of from big Indian, the little Indian.

[00:18:59] And [00:19:00] that gets us to the point where we can start nearing. And then from that point, it really becomes a bit of a, a strategy game with your environment teams to kind of schedule when you can move environments to the new servers and make those final cut overs. And then. Finally, you know, essentially your prod cut over is almost kind of try to tell people to treat it like a DR fail over. It’s basically you’re going through the same steps. You’re promoting your mirror to a production and demoting your current production [00:19:30] mirror down to a DR mir member. And if things were to go completely south too, the good news is you’re able to revert back in a similar fashion just by switching out, which one’s the primary mirror member.

[00:19:42] So it really, for me, it’s not really any different in lot of cases that how we’ve used strategies to migrate from physical server to physical server in the power world for the last number of years as well for the operational database. And timing has really driven. [00:20:00] I feel like we can, you can set up that core Linux environment in a pretty short amount of time.

[00:20:04] It’s really driven by the environment team and getting those downtimes scheduled to cut environments, not a lot of other technical effort in that mix. 

[00:20:12] Bill Russell: [00:20:12] So again, questioning from the CIO perspective give me an idea on, so how much testing are we going to do how? Much of that testing can be automated? You know, that’d be, what does that, I mean, you’re talking about, I mean the most sizeable system we have [00:20:30] in here, there’s a lot of, a lot of data elements moving from one to another. Are we gonna have to test every aspect of beaker and every aspect of every module out there? 

[00:20:41] Josh Peacock: [00:20:41] The big things to really hit on are things printing making sure that those things are able to to work, but a full beaker, probably not. Cause as long as again some work goes in ahead of time to make sure that just like in a Dr switch or if we were switching from one server to the other, like most organizations have had to do in the last five years. [00:21:00] We’ve had to kind of abstract away, right? Epic production is known by DNS alias typically it’s one of the things that Epic likes to do too. So we can re point it users and other end points to that, that alias, which allows them to communicate without having to go directly to a known IP address. And that allows a lot of flexibility to make that migration with a lot of effort.

[00:21:26] Most of the time, I don’t see organizations [00:21:30] probably having to do a lot more testing than what we would do during a switch out from server to server, just because Epic has done so much work with Linux. And then the past few years performance testing and everything we’ve seen, a lot of switch has happened without significant issue performance wise or new things crop up because we’re on Linux versus another alas.

[00:21:56] Bill Russell: [00:21:56] That’s fantastic.  

[00:21:57] Marty Momdjian: [00:21:57] Bill the biggest key part is [00:22:00] for the end users, the clinicians. and even to an extent, the application folks that are supporting the applications like beaker right or ADT, they’re going to have the same exact experience. Where there’s any major differences there’s going to be for that actually managing the infrastructure and the operational database. Their experience is going to change and their, the way that they manage, you know, downtime, standard maintenance is going to be a little different than what it was before, but it [00:22:30] should be, you know, if you. Take your time planning and do a good enough job to run through the migration for your POC test dev environments, document everything, you know, sometimes build things up, fail back, make sure you really understand how it works. It should be just like a regular downtime for your end users when you do that the actal full production cut over. 

[00:22:52] Bill Russell: [00:22:52] Is this just is this any harder than the normal updates we’re doing on Epic on a quarterly or [00:23:00] now? It seems to be more common to be semi-annual basis? Is this any more complicated than that?

[00:23:08] I mean, I see from a CIO perspective. I see the opportunity. I mean, I can replatform you know, we were using their, HIE products and whatnot. It was all built. It’s now all built on top of IRIS. The inner systems platform is all built on top of IRIS.

[00:23:23] And that was our, that was our integration engine. And it was our platform where you’re using for the [00:23:30] ensemble. Yeah. We were using it for APIs and all sorts of stuff. So there’s, there’s a lot of benefits and opportunities there, I would assume. And so I see the opportunity, but it’s, it’s the migration is the upgrade any more than just the quarterly, normal, quarterly that we were used to doing.

[00:23:48] Josh Peacock: [00:23:48] I mean, I think that there’s risk associated with anything you do. Right. But I don’t see that this is, I mean, most of these people are taking this on, in between an application upgrade or, you know, in [00:24:00] parallel to doing their normal quarterly upgrades. I don’t see anybody that I’ve been working with yet like clausing Epic upgrades or anything to be able to take on this migration. That’s just been happening in parallel for the most part. Some of the biggest things from an end user perspective that we see is likely those changes as. A lot of people on other technologies had like local users and passwords and maybe synchronized between all the servers, but, you know, as they go to Linux, it’s all, you know, single username and password backed by active directory [00:24:30] type of thing.

[00:24:31] Maybe you curb those passing directly in there, logging in. So there’s just some changes like that. And depending on how they’ve structured their old environments, they might break out into more servers. But at the end of the day, that’s really just a mapping for their analysts and those people, not like an clinicians, they don’t, they’re not going to notice any difference.

[00:24:52] Maybe faster just because they are a newer tech, but that would be the only thing they experience. 

[00:24:57] Bill Russell: [00:24:57] Well that’s a number of question I hear is this really going to be [00:25:00] faster? Is there going to be any performance improvement? The cost reduction, that kind of stuff. Well, let’s talk about what’s next. I guess the question from my perspective, again, I’ll just go back to, this is what this is essentially what IRIS is saying about their own platform.

[00:25:16] And this was back in 2018. I mean, the reason they came out with this thing was to really take their capabilities to the next level. So it’s cloud provision. It’s an interoperable platform, API management [00:25:30] analytics, and it plugs into a lot of different analytics, backend business and tone intelligence and LP AI and machine learning.

[00:25:39] I mean, these, these were not a word you’re going to you, you do these things in this platform. It’s we are going to connect to the most common systems that are out there. What is the potential where’s Epic going with this potentially again, and all this stuff’s going can be forward-leaning. This is just your opinion based on your experience expertise.

[00:25:58] And as you look [00:26:00] out and look at the capabilities that IRISh now gives Epic, what is possible? Where could this potentially go over the next three, five, seven years. 

[00:26:14] Marty Momdjian: [00:26:14] Right now, what Epic essentially doing is taking what they have for cache for the data selector and the datasets. They’re essentially migrating that over to IRIS without any major updates, right.

[00:26:24] They’re treating it as the core database or any access. It will [00:26:30] be interesting now that ensemble has transitioned away from being ensemble. And now it’s a part of IRIS and it’s part of my risk for health, where. Hmm, from the research that I’ve done and looking into what InterSystems is. If you take Epic out of the picture, they have built a database platform and database management engine and a true.

[00:26:54] They’re trying to push for a truly integrated data system and data platform for healthcare [00:27:00] we’re pushing to the HIE and data exchange are built-in, you know, you have advanced analytics that are running on the system, and if that takes that and develops against it I think it’s gonna create some great innovations.

[00:27:14] It’s also going to take some time because it might involve significant changes to the database in themselves. And Epic does have their clarity, Cobra reporting environment anyway. Right. It’s what portions of that might move over to the IRIS platform over time and is going to be [00:27:30] more efficient to run that on IRIS to actually extract additional value out of the data that’s sitting there.

[00:27:35] It’ll also be interesting to see what happens on tumble data. So it’s still fairly widely adopted it. It’s out there, you know, not everybody. Moved over to core point or another system. What are they going to do when they go to upgrade? What’s going to be different for them. And how is that going to integrate into Epic?

[00:27:51] And then what type of guy do with the platform itself and the next couple of years down the road, the next 10 years, because Tasha wasn’t on for a very long time. [00:28:00] They had significant improvement improvements on how they would be cash rate. And now they’re going to be the same fryers. I think it’s going to be up to the health care systems to get their hands on some of the development capabilities to see what they can do out of the box, besides using as a base database engine for Epic itself.

[00:28:20] And if there’s going to be other vendors, other healthcare, innovative vendors that take our and start developing it out. 

[00:28:26] Bill Russell: [00:28:26] Yeah. Josh, where do you think Epic’s going? 

[00:28:30] [00:28:30] Josh Peacock: [00:28:30] Well, I think the most near term things that we’ll probably see as the benefits is this epic’s been doing a lot of work to try to make things easier on the administrators, particularly trying to use copper to do more and more effort, even on the operational database side.

[00:28:45] So I think some of those API driven benefits might be first exploited in Kuyper. It’s to help manage the database through that tool more. And then I think, you know, real-time access to the data because of the [00:29:00] fact that we’re ETL and out to. The other Colorado environments some more real-time interaction and activity in the database to get insights. You know, F point of care or in a quicker, less retro selected way I think is probably where I would see the next couple of things happening. More so than anything else in my point of view. 

[00:29:24] Bill Russell: [00:29:24] Interesting. Any, any  changes out DR? Think there’s  going [00:29:30] to beDR  new options  available? 

[00:29:35] Josh Peacock: [00:29:35] I don’t know. I would like to believe that at some point from an HR perspective, instead of having single operating system and single storage subsystems, and all those sorts of things only being available. In cache mirroring first, brought it in to where you could do a synchronous Miriam with a V between two servers and two sub separate storage subsystems underneath. Those things we [00:30:00] do have clients that are using that for the ensemble environments. However, Epic has never, ever been able to make that jump yet.

[00:30:05] Maybe IRIS will have enough performance gains to allow us to run something like that in a synchronous mirror where they could always take over for each other. and have more resiliency built into the environment. I think that would be one of the first things I would see other than I think VR today will stay fairly similar.

[00:30:23] Some of the clients that are really drilling it and doing good can fail that environment in 15 minutes or less. [00:30:30] So I think that’s fairly Fairly good target to shoot for. 

[00:30:36] Bill Russell: [00:30:36] Well, fantastic. I appreciate Josh, Marty. I appreciate you guys coming on. If people are interested in you know, talking to you guys more about this, they can reach out to their serious rep or a hit Sirius Healthcare’s website as well. You can track these guys down. And they can help you with this migration. It’s not for the faint of heart. It’s a, I know if I were a [00:31:00] CEO, I’d be making phone calls to find people who have done this before and have the experience. It’s too too critical, a move. And quite frankly, I think the opportunity is pretty significant to replatform.

[00:31:14] We were constantly looking a the fact that we had 900 applications and we had to support multiple operating systems, all that stuff was a cost to me. And it was, it was hard to manage those things, you had to keep special skillsets around, and this is an opportunity to [00:31:30] really reduce those and get much more efficient around that. So Marty, Josh, thanks for coming on the show. As always I learned a ton. 

[00:31:39] Marty Momdjian: [00:31:39] Thanks Bill. 

[00:31:40] Bill Russell: [00:31:40] What a great discussion. If you know someone that might benefit from our channel from these kinds of discussions, please forward them a note. They can subscribe on our website this week health.com or you can go to wherever you listen to podcasts, Apple, Google, overcast.

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