MKCC Achieves Digital Transformation in Collaboration with E3 to Better Serve Cardiac Patients by Running IQVIA Arcus Air on AWS

In less than three months, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre (MKCC) implemented the IQVIA Arcus Air electronic health records solution on AWS with the help of a local partner, AWS, and AWS Partner E3, enabling caregivers to serve cardiac patients 24/7 and help reduce operational costs. Arcus Air is deployed as a hybrid architecture based on Amazon EC2, Elastic Load Balancing, and AWS Direct Connect.

Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre (MKCC) is a 148-bed cardiac hospital founded in Bahrain in 1992. The state-of-the-art hospital, one of Bahrain’s first medical facilities, aspires to be the leading national and global cardiac center. “At MKCC, we strictly follow a patient-centric care approach in order to provide exemplary services to our patients by utilizing our highly advanced technology, exploiting the outstanding skills and knowledge of our healthcare professionals, and implementing the best practices possible,” says Nawaf Abdulrahman, director of information technology at MKCC.

As part of the Kingdom of Bahrain’s Economic Vision 2030 and in accordance with its digital transformation strategy, MKCC sought to implement IQVIA Arcus Air, a new electronic health records (EHR) system that securely manages patient administration and clinical information. To assist with the implementation of Arcus Air, MKCC chose to work with E3, an AWS Partner based in Dubai that provides IT services and business solutions to healthcare organizations. MKCC and E3 initially planned to deploy Arcus Air in the hospital’s on-premises data centers in late 2020, but that plan changed because of an increasingly shorter timeline. “Given the pandemic there was an increase in the number of patients being admitted to the hospital and increased urgency for care provision was required. Therefore, the hardware had to be procured and deployed in our data centers as soon as possible,” says Abdulrahman.

Additionally, MKCC wanted to implement IQVIA Arcus Air as cost effectively as possible. “We knew the cost of hosting the application environment in data centers would be high, therefore, we needed to find a cost-efficient solution,” says Abdulrahman.
 

Shortly after MKCC shared the high-level design to all the partners, E3 began a solution design workshop with Amazon Web Services (AWS) to consider taking a cloud-first approach and deploying Arcus Air on the cloud. Mahmood Al Balooshi, country manager for E3, says, “We knew AWS would provide a highly available environment, as well as the ability to extend and expand compute resources on demand without the need to buy extra physical hardware.”

MKCC and its local implementation partner created a hybrid architecture that integrates an AWS-based IQVIA Arcus Air deployment with other IT components that reside in the on-premises data centers. A landing zone was implemented using AWS Control Tower, which helped MKCC quickly set up a secure, multi-account AWS environment based on AWS best practices. “By using a multi-account architecture on AWS, we knew we could centrally manage the entire environment,” says Tariq Al Issa, chief of information technology systems infrastructure at MKCC.

Arcus Air was deployed on Amazon Elastic Compute Cloud (Amazon EC2) instances connected to DBaaS highly available MongoDB Atlas Cluster. To increase resilience and availability, the instances are distributed across three Availability Zones in Bahrain. Incoming web traffic is distributed via Elastic Load Balancing. In addition, to enable fast, secure, and highly available communication between the existing MKCC data center and AWS, MKCC deployed two geo-redundant AWS Direct Connect links.

Working closely with MKCC developers, E3 designed and deployed IQVIA Arcus Air in under three months, moving the solution into production in March 2021. “Everything moved very quickly, because of the collaboration, the flexibility and agility enabled by AWS, and the fact that we went live with basic functionality to get caregivers using the solution right away,” says Mahmood. As a result, MKCC went live with IQVIA Arcus Air in time to help serve the growing number of patients being admitted during the height of the pandemic.

By distributing the IQVIA Arcus Air workload across three Availability Zones, MKCC ensures a high level of protection against the failure of individual data centers. “As a cardiac centre, all patients are vulnerable and every second counts,” says Abdulrahman. “All our caregivers rely on Arcus Air to perform their duties and provide patient care daily. Therefore, we cannot afford any slowness or downtime in the Arcus Air system, and AWS ensures that everything is operational 24/7.”

MKCC caregivers are also more productive by using Arcus Air on AWS. “MKCC redesigned all processes and workflows for physicians, nurses, and administrators,” Mahmood says. “Having all the patient data centralized has made it easier for MKCC to transition during a time of digital transformation, and it helps staff work more easily and efficiently.”

Running IQVIA Arcus Air on AWS, MKCC can cost-effectively manage its non-production environments. For example, the hospital has the flexibility to shut down staging, training, and test environments when not in use, which reduces compute costs.

The flexibility of purchasing AWS services as and when required allowed MKCC to realize savings right from the beginning of the project. In an on-premises project, MKCC would have purchased compute, storage, and network equipment at the start of the project. Using AWS, MKCC was able to purchase the resources when needed during the project ramp up. This helped the organization realize cost savings by avoiding idle resources.

MKCC continues to develop additional AWS-based solutions, including a patient costing application and a data management system for radiology images and reports. "By exploiting AWS, we are in line with Bahrain's cloud-first digital transformation initiatives," says Abdulrahman. "We look forward to furthering our transformation and advancement."