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Southeast Iowa Regional Medical Center Uses AWS to Improve Recovery Times by 67%

Southeast Iowa Regional Medical Center is committed to providing its largely rural community with the same high-quality healthcare found in larger hospitals. Because reliable IT services are integral to this mission, the hospital decided to upgrade its disaster recovery solution. The hospital set up a secondary site on Amazon Web Services (AWS) using AWS Elastic Disaster Recovery (CloudEndure Disaster Recovery), which minimizes downtime and data loss with fast, reliable recovery of on-premises and cloud-based applications. On AWS, Southeast Iowa Regional Medical Center improved its recovery times by 67 percent and strengthened the reliability of its electronic health records (EHR).

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Using AWS, we were able to offload the entire solution without anyone outside of our team knowing what was going on. There was no impact on database times and no impact on internet connectivity."

Shane Tapper
Systems Executive of Informatics, Southeast Iowa Regional Medical Center

Working to Meet Recovery Objectives

From patient registration software to electronic vital-signs monitors, hospitals depend on the availability of IT systems, particularly EHR applications. Southeast Iowa Regional Medical Center uses an EHR solution that requires at least 50 servers with many interdependencies. The solution provides the hospital with a single electronic record for all patients, so reliable access is critical for delivering quality patient care. 

To prevent downtime, the hospital previously relied on a secondary site in an on-premises data center. However, the hospital found it challenging to meet its requisite recovery time objective (RTO) and recovery point objective (RPO). RTO is the maximum amount of time needed to recover from a disaster after notification of business disruption, and RPO is the maximum amount of time that data loss is tolerable.

Using AWS to Protect Patient Data and Accelerate Recovery

To improve its EHR system’s recovery capabilities, Southeast Iowa Regional Medical Center engaged Healthcare Triangle, which helps hospitals use the cloud for scalable, cost-effective, and secure disaster recovery. The hospital’s IT team shared with Healthcare Triangle its main requirements: the ability to conduct periodic, nondisruptive tests to validate the hospital’s RTO and RPO; improved recovery objectives—an RTO of 12 hours and an RPO of 4 hours; visibility into the health of all servers at any point in time; and support of the EHR solution. 

Healthcare Triangle recommended that the hospital use AWS Elastic Disaster Recovery to set up a secondary site on AWS. AWS Elastic Disaster Recovery is a highly automated service that minimizes downtime and data loss by continually replicating on-premises and cloud-based applications into AWS and quickly launching them in the case of an IT disruption. 

“Because the EHR application is complex, there weren’t a lot of disaster recovery solutions out there that fit the bill,” says Chris Paalman, director of engineering and operations at Healthcare Triangle. “When we dug into the AWS solution, we realized it was a great fit.” The way the EHR application is structured meant that conventional file-level replication would not work. Using AWS Elastic Disaster Recovery provides block-level replication of source servers into AWS, thus meeting this technical requirement. 

Using block-level replication also facilitated near-real-time RPOs. “When a healthcare professional updates a patient’s electronic medical record, only a small amount of data is modified,” says Joe Grinstead, vice president of technology and cloud at Healthcare Triangle. “AWS Elastic Disaster Recovery replicates only the changes within the file, which can be done very quickly, whereas solutions with conventional file-level replication would have to replicate the entire, very large EHR system file.” 

Using AWS Elastic Disaster Recovery also facilitates RTOs that are more robust than what the hospital had been able to achieve previously. It does this by orchestrating and automating much of the recovery process.

Implementing AWS Elastic Disaster Recovery on 61 Servers in 6 Weeks

In cooperation with Healthcare Triangle, the hospital set up and tested AWS Elastic Disaster Recovery on 61 on-premises servers comprising 14 TB of data within just 6 weeks. 

“It was easy to install. The console is very straightforward, and it was able to handle all those terabytes of data, whereas our previous solution didn’t seem to be able to,” says Eric Morehouse, network operations manager at Southeast Iowa Regional Medical Center. “AWS Elastic Disaster Recovery seemed to sync the data to AWS flawlessly.” 

During the implementation, there was no disruption to the EHR application or any hospital services. “Using AWS, we were able to offload the entire solution without anyone outside of our team knowing what was going on,” says Shane Tapper, systems executive of informatics at Southeast Iowa Regional Medical Center. “There was no impact on database times and no impact on internet connectivity.”

Delivering Reliability and 67% Better Recovery Times

Using its new disaster recovery solution, Southeast Iowa Regional Medical Center exceeded its original recovery objectives: it achieved an RTO of 4 hours rather than 12 hours (a 67 percent improvement) and an RPO of 2 hours rather than 4 hours (a 50 percent improvement). 

“In reality, the RPO is near real time,” says Grinstead. “When they did the test, the data in the testing environment was being replicated from the source environment in near real time.” As a result, if an unexpected IT disruption occurs, there will be little to no data loss. Tapper says, “Whereas our prior system was running a backup that was then replicated, the new system is replicating things as they are written.” 

Furthermore, the hospital has benefitted from reliable, nondisruptive testing. It can conduct regular tests to confirm that its disaster recovery plan is effective and fix issues that might arise. The hospital follows the best practice of creating an isolated network within AWS for testing. 

The team also has ongoing visibility into the health of its disaster recovery environment. “I have access to the console, where I can see in near real time where the data is,” says Morehouse. “This is 100 percent different from what we had before.” 

Because ransomware attacks are becoming more widespread, the Southeast Iowa Regional Medical Center team appreciates that it can use AWS Elastic Disaster Recovery to fail over to a version of its source servers from a previous point in time, to before a security event has taken place. “Point-in-time recovery was a nice benefit when we first looked at the product, but it’s starting to become a requirement given how large a target healthcare now is,” says Tapper.

Using Disaster Recovery as a Gateway to the Cloud

Following its implementation of AWS Elastic Disaster Recovery, the team at Southeast Iowa Regional Medical Center is confident that the hospital will quickly recover from any unexpected IT disruptions. The team’s positive experience has led it to begin evaluating how to use AWS moving forward. “The fact that we have gone through the process of setting up a recovery site on AWS and have seen our data accessible in the cloud eliminates some of the questions and hurdles that we might have had a few years ago,” says Tapper. “The long-term plan is to fully embrace the cloud.”

Learn More

To learn more, visit aws.amazon.com/disaster-recovery.


About Southeast Iowa Regional Medical Center

Southeast Iowa Regional Medical Center is a comprehensive healthcare provider in Southeast Iowa serving a predominantly rural area that includes parts of Iowa, Illinois, and Missouri. Its Iowa-based campuses are in Fort Madison and West Burlington.

Benefits:

  • Set up a recovery site on AWS for its EHR solution
  • Replicated 61 on-premises servers comprising 14 TB of data
  • Improved RTO by 67% and RPO by 50%
  • Enhanced disaster recovery testing capabilities
  • Gained near-real-time visibility into the health of servers

AWS Services Used

AWS Elastic Disaster Recovery

AWS Elastic Disaster Recovery (AWS DRS) minimizes downtime and data loss with fast, reliable recovery of on-premises and cloud-based applications using affordable storage, minimal compute, and point-in-time recovery.

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Amazon EC2

Amazon Elastic Compute Cloud (Amazon EC2) offers the broadest and deepest compute platform, with over 500 instances and choice of the latest processor, storage, networking, operating system, and purchase model to help you best match the needs of your workload.

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Amazon Elastic Block Store (EBS)

Amazon Elastic Block Store (Amazon EBS) is an easy-to-use, scalable, high-performance block-storage service designed for Amazon Elastic Compute Cloud (Amazon EC2).

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