Success Stories / Healthcare

2023
Sírio-Libanês Logo

Sírio-Libanês Hospital Revolutionizes its Cloud Financial Management in 5 Months

Encompassing an expansive area of approximately 1,076,391 square feet in the heart of São Paulo, Brazil, alongside a cutting-edge healthcare facility in Brasília, the Sírio-Libanês Hospital is a hub offering over 60 specialized medical fields and a capacity exceeding 500 hospital beds. Bridging a multidisciplinary clinical team with state-of-the-art technologies, the hospital has consistently achieved pioneering milestones. Notably, it introduced Brazil's first Intensive Care Unit (ICU) back in 1971, and it was a pivotal participant in the southern hemisphere's inaugural robot-guided remote surgical procedure in 2000.

12%

reduction in cloud costs

82%

decrease in vulnerability

53%

drop in security issues

Solutions

launched within 2 weeks

Increase

in process maturity

Overview | Innovating After Migrating to AWS

In 2018 with the help of the AWS Professional Services team, the hospital started to migrate various workloads to Amazon Web Services (AWS) and created a data lake. This process spurred the development of an array of new applications and services, such as the electronic medical record for primary care, a new patient portal, the deployment of the Adma application catering to health insurance users, and the creation of a telemedicine platform, among others.

This series of improvements resulted in an entire suite of digital products created by the hospital's technology division from 2018 onwards being seamlessly developed using AWS. With the changes, the hospital gained agility in development time and solution delivery. However, it also witnessed the growth in environment complexity, and it identified the need to maintain tighter control as cloud costs began to surpass budgetary expectations.

Vitor Bellot, the operational excellence coordinator at Sírio-Libanês, recalls that at the end of November 2022, the hospital established the Alma technology vertical with the purpose of inspiring and propelling the entire suite of digital products, fostering entrepreneurship, accelerating the development and integration of new technologies and products, and promoting connections in support of a fulfilling and dignified life for all. This milestone started a new phase of evolution for the hospital’s Cloud Center of Excellence. At the time, the team’s main challenge was to gain comprehensive insights into the institution's cloud environment.

To address this challenge, the team decided to centralize information about the hospital's digital assets and the associated costs to simplify management.

Female Doctor Wearing Scrubs In Hospital Corridor Using Digital Tablet

Opportunity | An Evolving Solution

In December 2022, the team continued the evolution of the Cloud Center of Excellence by restructuring its foundations, surveying what was in the cloud, and planning how to manage it all. To achieve this, one of the initial steps wasconducting an assessment of the environment, performed by the AWS team.

It resulted in the identification of approximately 65 digital products implemented in the cloud. To enhance control, AWS developed 10 operational dashboards that now oversee the operation of each of these products with a management perspective. These dashboards empower the hospital's IT department with a return on investment (ROI) view of the products residing in the cloud. This initiative led to the identification of 26 cost reduction opportunities, generated by resizing the infrastructure to better accommodate applications.

AWS also suggested that the hospital adopt automatic tagging, which eliminated 622 work hours required to tag around 219,000 resources. This action produced visibility into the projected cost structure for each product, and helped the team determine the right allocation of expenses across user areas, and provided an accurate view of the cost of each product operating in the cloud. Another outcome was the creation of a cost-per-user KPI.

These actions gave rise to an annual budget control strategy, in which AWS Professional Services team establishes a cloud usage strategy based on the budget for the next year and the demands. This allows the hospital to know if their estimates are within the actual range.

“This is a process that has been ongoing for 6 months and continues to evolve. In under 3 months of work, we started to see results,” states Bellot, underscoring that today his team knows exactly what needs to be executed, with a clear view of the roadmap and the confidence to collaborate, accelerate projects, and disseminate information across the institution.

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AWS supported us in translating our metrics to achieve a more mature delivery. It wasn’t merely assistance, but dedication.”

Geison Rodrigues
Product Owner of the CCoE at Sírio-Libanês Hospital

Solution | Enhancing Transparency and Reducing Costs

Geison Rodrigues, the product owner of the Cloud Center of Excellence at Sírio-Libanês Hospital, highlights that the center's establishment has triggered a transformative cultural shift. It is now recognized not solely as an infrastructure provider but as a dynamic business entity capable of assessing risks and implications arising from product and digital asset unavailability. “Our current perspective extends beyond digital assets; it includes the hospital's revenue as well,” he states.

“One of the notable achievements,” says Rodrigues, “is the substantial advancement in governance maturity.” Referring to a scale of one to four for maturity levels aligned with industry benchmarks, he notes that an AWS-led analysis revealed some areas scoring at levels two and three. This evaluation paved the way for objectives, including that by the end of 2023, no domain would score below 3.

He explains that six core pillars are measured: business, people, governance, platform, security, and operation. “Presently, only the platform and security scores are below three. The most significant growth was in governance, soaring to 98 percent. In November 2022, our score was 2.27; now, it's 4.17. The second most notable advancement was in the people realm, with a 30 percent enhancement,” he recalls.

The Cloud Center of Excellence's impact on security measures is also substantial: the integration of 12 automated processes and an 82 percent reduction in vulnerabilities. Critical security issues saw a 53 percent decrease, while other concerns recorded a 50 percent reduction. “Prior to the center's establishment, our security posture lacked transparency. This transformation started with a dashboard providing a CISO-centric viewpoint for informed decision-making; this concept is now implemented. Additionally, the Control Tower, ensuring accurate environment launches, was updated. We went from 60 guardrails to over 300," he reveals.

Currently, Cloud Center of Excellence monitoring dashboards operate according to the diagram below:

Diagram

Click to expand the image

Outcome | Implementing Products in the Cloud

According to Bellot, one of the key achievements brought by the Cloud Center of Excellence is the accurate guidance for cloud product implementation. “Today, we can guide and manage these products, and we are the only department within the hospital capable of evaluating how much that product is yielding,” he says.

This holds significant weight, particularly when dealing with 65 digital products hosted in the cloud and at least two new initiatives per month. This assessment capability has enabled the hospital to form partnerships with healthtech companies, enabling evaluation of where investments should be directed. “We now hold a monthly executive status meeting with our board of directors. This meeting gathers all IT managers and serves to present our results,” he says.

Rodrigues highlights that, without the assistance of AWS, the learning curve for his team would have been much steeper. “We spent hours discussing hospital metrics and goals for the upcoming years, aligning them with the AWS framework, which supported us in translating our metrics to achieve a more mature delivery. It wasn’t merely assistance, but dedication,” he says.  

About Sírio-Libanês Hospital

Sírio-Libanês Hospital stands as an international hub of excellence in healthcare that serves over 120,000 patients annually. With hospitals in São Paulo and Brasília, it covers more than 60 specialties and has over 500 beds.

CCoE Team Members

Vitor Bellot - Coordinator, Geison Rodrigues - Cloud Product Owner, Roberson Santos - Cloud Enterprise Architect, Gabriela Cordeiro - Cloud Engineer Communication, Melqui Santos - Cloud Engineer FinOps, Renato Urbano - Cloud Engineer Security, Vinicius Cruz - DevOps Leader, Valdecir Venancio - Scrum Master.

AWS Services used

Amazon S3

Amazon Simple Storage Service (Amazon S3) is an object storage service offering industry-leading scalability, data availability, security, and performance.

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Amazon QuickSight

Amazon QuickSight allows everyone in your organization to understand your data by asking questions in natural language, exploring through interactive dashboards, or automatically looking for patterns and outliers powered by machine learning.

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AWS Cost and Usage Reports

With AWS Cost and Usage Reports (CUR), you can review, itemize, and organize the most comprehensive cost and usage data for your account.

Learn more »

AWS Security Hub

AWS Security Hub is a cloud security posture management service that performs security best practice checks, aggregates alerts, and enables automated remediation.

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