Accelerating cloud adoption to enhance healthcare

When Rick Stover joined Providence in late 2019 as Senior Vice President (SVP) of IS Infrastructure and Chief Technology Officer (CTO), he was faced with an enormous budget problem that seemed to grow by the day. The COVID-19 pandemic only exacerbated the need to reduce waste and maintain cost efficiency, even as healthcare facilities around the world were faced with the prospect of overwhelming demand for acute care.

Just as the pandemic was beginning, Bryan de Boer joined the Providence team as Executive Director, responsible for the company’s Microsoft Azure migration. This migration was in the early stages—and a massive undertaking. In parallel, there were other initiatives in progress to remediate technical debt and rationalize the company’s application portfolio.

On top of the technical challenges of the Azure migration, there were also cultural and skills challenges. Extensive use of commercial off-the-shelf (COTS) products and lack of in-house software development created an application owner community that primarily comprised “application analysts” with limited infrastructure knowledge. This gave control to the third-party application suppliers and put Providence in the backseat, where it couldn’t establish common engineering practices and standards needed to modernize the application portfolio. As de Boer recalled: “The very ideas of cloud elasticity, flexibility and optimization were completely foreign to this enterprise … Servers were fixed resources that you bought; they were physical resources that just sat there, and it was a one-time upfront purchase. There was a conceptual paradigm shift that needed to occur.”

The COVID-19 pandemic, however, became a catalyst to accelerate Providence’s cloud migration. The Providence team built out a new COVID-19 vaccination tracking and scheduling application that gave the company a use case for the move to Azure. With this rapid test case, the Admin Tech application team proved that they could solve significant problems in a very short period with the agility of the cloud. This became a key proof point in driving the internal cultural change to show the value of cloud infrastructure in driving healthcare innovations that could be quickly and reliably delivered to perform at scale.

Through persistent education of all stakeholders—which de Boer even noted was “fun” — Providence overcame its cultural challenges around cloud and expedited its cloud elasticity journey. In just 10 months, Providence safely migrated more than 1,900 workloads to Azure, with a total infrastructure footprint of about 3,000 workloads. Providence achieved more than USD 2 million in savings through optimization actions while assuring application performance, even during peak demand.

One ingredient to Providence’s success was the adoption of IBM Turbonomic, both as an optimization platform and strategic partner. Using IBM Turbonomic, Providence proved that automation actions were safe—especially for the literally life-saving applications required for patients’ health.

Not only was Providence able to migrate—it was also able to advance beyond a lift-and-shift approach. At the onset of the IBM Turbonomic adoption, Providence began “Project Tetris,” an initiative to optimize the company’s on-premises computing resources and clean up its environment as it moved to Azure. By reducing on-premises costs and waste, Providence freed up financial and human resources—which can now be invested into modernization initiatives that provide better healthcare outcomes for patients.

Since the initial migration to Microsoft Azure, the Providence team has continued to partner with IBM Turbonomic to accelerate their FinOps journey. In 2022, the Turbonomic team began piloting new capabilities to help clients maximize the business value of their Platform-as-a-Service (PaaS) through dynamic scaling of Azure App Service Plans. As an advanced Azure user, Providence was an early leader in adopting these capabilities. Upon implementing the new integration, the team identified right-sizing opportunities that would allow them to reduce their annual Azure App Service costs by 27% without compromising application performance.

Providence’s digital transformation continues apace with its journey to become a modern, industry-leading healthcare services conglomerate. Throughout this journey, IBM Turbonomic will remain an integral part of Providence’s strategy, helping simplify the on-premises ecosystem and optimize deployment of new applications on Azure infrastructure as a service (IaaS) and platform as a service (PaaS) instances.

Providence is a healthcare organization of 120,000 caregivers, 52 hospitals, 1,085 clinics and a range of health and social services present in seven US states: Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Providence also pursues innovations to make its services more convenient and affordable for all, continuing its 100-year tradition of serving the poor and vulnerable.