WellSpan recently completed one of healthcare’s most comprehensive cloud migrations, moving nearly its entire technology portfolio to Amazon Web Services in just over three months. While unusually ambitious, the project reflects a broader shift occurring across the healthcare industry.
As health systems modernize their technology environments, many are rethinking the role that the cloud should play in their infrastructure strategies.
Some are embracing cloud-first strategies, moving most applications to a single cloud provider. Others are moving toward hybrid or multi-cloud environments using a combination of on-premise, or health system-run, data centers, and one or more cloud providers.
Rather than converging on a single model, healthcare leaders say the right decision depends on organizational priorities, application requirements and long-term strategy.
Why are health systems making the move now?
No single factor is driving cloud adoption. According to Anshul Pande, interim chief technology officer at Seattle Children’s, the economics of on-premises infrastructure versus cloud computing have shifted significantly, and software-as-a-service platforms and cloud providers with enormous scale have matured. At the same time, the growing demand for AI capabilities is increasing the need for scalable computing resources, while the cost of GPU hardware continues to rise.
“It wasn’t one specific catalyst,” Pande said. “Rather, a combination of factors over time led us to rethink our approach to the cloud and view it through a different lens.”
Cloud migrations are also driven, in part, by financial urgency when hardware needs expensive updates, but that’s not the only factor.
“We did have a financial driver, but we really had more of a strategic driver,” said Darin Prill, vice president and chief technology officer at WellSpan.
Rather than simply replacing aging infrastructure, WellSpan viewed the migration as a way to build a stronger foundation for AI and future innovation, he added.
Children’s Hospital of Philadelphia reached a similar conclusion. Wes Barnes, interim chief digital and information officer, said the organization realized its vast clinical and research data remained “locked up in on-premise data centers,” limiting its ability to advance precision medicine, analytics and AI.
“It was evident to us that if we did not reposition our core technology stack and data estate, we would quickly fall short of our desired pace of innovation,” he said.
Cloud, hybrid or on-prem? How leaders are deciding
Although the organizations shared many of the same motivations for moving to the cloud, they reached different conclusions about how much of the IT infrastructure needs to move and where.
WellSpan opted for a comprehensive cloud migration, including its Epic EHR. Prill said moving nearly the entire enterprise allowed the organization to approach the migration holistically rather than through a series of disconnected projects.
“If [there were] no latency issues and the vendor could support the move, we moved it,” Prill said. “Just from a simplicity perspective, it made the most sense to get as much up there as we could.”
Seattle Children’s took a different approach, adopting a multi-cloud strategy that aligns workloads with the environments best suited to support them. Rather than standardizing with a single cloud provider, the organization kept its most specialized patient care systems on-premises in its own data centers while moving other, more standardized technology workloads to multiple cloud providers.
According to Pande, the objective was to make the IT infrastructure complexity invisible to caregivers and staff.
“Our users shouldn’t have to think about where the data resides or how the underlying infrastructure is managed,” Pande said. “Their focus should be on delivering care, while technology works seamlessly in the background.
Children’s Mercy Kansas City adopted what CIO Brian Lancaster described as a ‘cloud-smart approach,’ evaluating each of their software programs to determine which cloud option would be best. They evaluated the programs individually based on business value, technical readiness, security, disaster recovery requirements, operational needs and cost before determining where it should run.
Meanwhile, CHOP pursued a cloud-first strategy but established clear exceptions.
“Our philosophy was straightforward: it moves unless there is a technical or financial justification for it not to move,” said Barnes.
Systems that remained on-premises in CHOP-run data centers included those directly connected to specialized instrumentation, certain building infrastructure and high-performance computing workloads where cloud costs outweigh the benefits.Â
Best practices for making the move
Although each organization took a different approach to cloud adoption, leaders described several common practices that helped make their migrations successful.
One of Children’s Mercy’s most significant discoveries was that cloud migration was ultimately more of an organizational challenge than a technical one. Early in the migration, IT leaders realized that successfully moving applications to the cloud required deeper engagement from the clinicians, business leaders and application owners who rely on those systems every day. Rather than pushing forward, the organization slowed portions of the project to strengthen planning and stakeholder engagement.
“Technology is often the easier part of the migration,” said Lancaster. “Building organizational alignment, establishing shared ownership and ensuring that stakeholders are actively engaged in shaping the future-state architecture are what ultimately determine the success of a cloud transformation.”
At WellSpan, leaders emphasized the importance of standardizing the migration process. The organization developed what Prill called an “application migration factory” — a repeatable framework for documenting application requirements, identifying dependencies, coordinating with vendors, planning cutovers and validating each migration. Applying the same process across hundreds of applications helped keep one of healthcare’s largest cloud migrations organized and consistent.
“If you want to move to the cloud, you have to move to the cloud,” Prill said. “You have to put that much focus into it and really make it a goal.”
However, looking back on WellSpan’s accelerated migration, Prill said his biggest recommendation is simple: “I’d get more time.”
More time, he said, would have allowed teams greater flexibility to prepare each migration while reducing the pressure of an aggressive timeline — a reminder that moving to the cloud is as much about preparing the organization as it is about moving the technology.
As cloud adoption expanded, CHOP also focused on establishing strong governance and preparing its workforce. The organization created a Cloud Center of Excellence to centralize cloud governance, cybersecurity and financial oversight.
“What used to be hundreds of disparate accounts owned and governed by individual groups across the enterprise are now controlled by the CCoE,” said Barnes.
Barnes also emphasized that technology investments alone are not enough. Organizations must prepare IT teams to operate in a cloud environment before production migrations begin. At CHOP, more than 85% of technology architects, engineers and operators completed Azure training, with many earning certifications before production migrations started.
For organizations still weighing their cloud strategies, health system leaders offered one key message: there is no single blueprint for success. The right destination and timeline depend on each organization’s priorities. Still, they emphasized that successful migrations require careful planning, organizational commitment and realistic expectations about the work ahead.
Elizabeth Stricker, BSN, RN, comes from a nursing and healthcare leadership background, and covers health technology and leadership trends for B2B audiences.
