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eBOOK5 phases for migratinghealthcare workloads toAmazon Web ServicesDevelop a strategic andcomprehensive migration plan

Executive summaryHealthcare organizations migrating to the cloud need a strategy that assesses risks and considers all the possibilities.Moving an entire healthcare service to a new IT environment means deciding how to migrate all three subsystems—compute, storage, and networking—and identifying the right components, capabilities, and tools for the job.In this eBook we share information about data migration and protection. You’ll learn how to anticipate, avoid, and managechallenges during your journey to the cloud. You can also use the cloud migration checklist, included on page 5, to trackyour progress.1.The discoveryphase2.The assessmentphase3.The proof ofconcept phase4.The migrationplan phase5.The cloudoperations phaseHealthcare organizations share common drivers for migrating to cloudenvironments: scalability, enhanced data protection and security, cost efficiency,and regulatory compliance.1.ThediscoveryphaseIn the discovery phase, you must consider the following:› Which applications and workloads can be moved and which cannot› Who uses which application, and how often› Network configurations, interdependencies, and integration with external systems› SLA requirements for recovery time objective (RTO) and recovery point objective (RPO)› Healthcare compliance standards and regulations, including: Health Insurance Portability and Accountability Act (HIPAA) Health Information Technology for Economic and Clinical Health Act (HITECH) General Data Protection Regulation (GDPR) Federal Information Security Management Act (FISMA)In the discovery phase, it is recommended that you have a complete and accurateunderstanding of your role in the AWS Shared Responsibility Model. It is important to notethat healthcare users’ responsibilities and liabilities do not vanish in the cloud. In fact,healthcare organizations must retain ownership and an active role guarding electronicprotected health information (PHI), whether it is stored on-premises or on AWS.It is also important to regularly review the latest revisions to HIPAA guidelines and mandatesabout data privacy and security, and consider these when planning your migration to AWS.You can review which Amazon Web Services (AWS) offerings are eligible for applicablecompliance standards that satisfy both U.S. and global regulations (for example, HIPAAand GDPR).The cloud migration discussion is no longer about if it will happen,but rather about what is already happening. Be sure you have theresources, skills, and procedures for transitioning smoothly to bestfit a cloud integration to your needs.2 5 phases for migrating healthcare workloads

In the assessment phase, select your migration method:› Redeploying applications on an infrastructure as a service (IaaS) without making changes› Modifying or extending the existing code to fit the cloud environment2.TheassessmentphaseThis is also the time to build your migration team and identify the appropriateresources, considering:› In-house migration versus outsourcing to a cloud-managed service provider› Communication processes between your on-premises administrators and AWS team› Training and tools that can help you acquire the necessary skillsAWS solutions architects can provide guidance about cloud architecture topology, security,and compliance requirements, and evaluate third-party solutions already in use on-premisesand licensing options.NetApp can also provide valuable cloud migration services, including workshops, which helpyou accurately assess your environment and develop a valuable roadmap that complementsAWS recommendations.The POC phase focuses on testing, including validating workload performance, determiningcapacity requirements including amount and size of Amazon Elastic Compute Cloud (EC2)instances, and projecting costs for running on AWS.3.The proofof concept(POC) phaseBe aware that some healthcare applications are not designed for the cloud, which can leadto performance issues, including latency. The POC phase is your opportunity to identify anddevelop a plan to resolve those issues.During this phase, be sure you understand the benefits of AWS storage solutions anddetermine how or if to:› Replace or fit in your on-premises data repositories.› Leverage Amazon Relational Database Services (RDS) to run your SQL database.› Use Amazon Glacier to keep your archived data.Data protection and securityDuring the POC phase of a migration project, it is important that your healthcareorganization test its physical, cyber, and cloud security procedures and systems. Although itmight not be possible to test every layer of the security model before going live on AWS, it iscritical that both your health organization and AWS take time to review security complianceguidelines and best practices, including the following:› Review current security and privacy audits.› Address any required remediation tasks.› Double-check security controls for on-premises defenses to the AWS equivalents.If the security layers are not revised accurately and completely during the migration phase,your organization could be at greater risk for privacy and security breaches and might alsobe fined for HIPAA compliance violations.Additional considerations:› Necessary network and security controls› How to leverage built-in AWS firewalls for basic-level intrusion protection› Building a layered approach with Security Groups, Amazon Virtual Private Cloud (VPC),and dedicated tunnels such as AWS Direct Connect to protect your AWS network andsecurely move applications and data in and out of your on-premises data center.3 5 phases for migrating healthcare workloads

Once you have decided which applications to migrate, it is time to move forward with acomplete plan. Consider the amount of data involved, as well as its synchronization withyour on-premises data repositories.4.Themigrationplan phaseRecommended plan elements:› Blueprint design› Assignment list with roles and responsibilities clearly identified› Rollback and “what if” procedures› AWS migration tools to help automate the move: AWS Import/Export disk, which accelerates moving large amounts of data into and outof AWS using portable storage devices for transport. AWS Management Portal for vCenter, which facilitates migration of VMWare resources. AWS Database Migration Service (DMS) for relational databases (Microsoft SQL Server,MySQL, PostgreSQL) AWS Schema Conversion Tool for different database platforms AWS Snowball and AWS Snowball Edge for large-volume data› Migration tools for NetApp users: NetApp Cloud Volumes ONTAP: based on NetApp SnapMirror technology, enables youto replicate on-premises data to AWS NetApp Cloud Sync: use to quickly and securely migrate data and workloads to AWSFigure 1: NetApp Cloning reducesfootprint, cost. Create a clonedimage, and deploy all workingenvironments off of clones withoutexpanding your storage footprint.Learning from past AWS migrationsHealthcare and enterprise institutions have successfully achieved AWS migrations and areseeing measurable improvements in performance, outcomes, and efficiency.NetApp customer Healthix, one of the largest public health information exchanges inthe United States, has seen its data grow at the rate of 100 TB per year, necessitatinga migration of its digital archive and disaster recovery to AWS for scalability and costefficiency. Today, Healthix reconciles real-time data from over 70 million provider andpayer patient record numbers to create composite profiles for more than 25 million uniquepatients. Healthix uses NetApp Cloud Volumes ONTAP software and is looking to morefully leverage AWS in the near future. Participating providers use aggregated data tomanage patient populations and measure performance. Healthix projects a significantsavings on digital data backup, and more than half a million dollars of cost avoidance onupfront investment in disaster recovery services on AWS.4 5 phases for migrating healthcare workloads

Make sure your migration plan extends to operations. Consider the following:› 24x7 support for applications using resources equipped with the AWS skills required totroubleshoot infrastructure issues.5.The cloudoperationsphase› Maintenance, including ongoing system maintenance and upgrades.› SLA requirements, including governance, security, compliance, performance, and uptime.› Optimization, leveraging AWS Trusted Advisor to analyze your cloud environment andoptimize deployment cost and security.Review, test, and practice your cloud operations tasks with your internal AWS expertresources who manage daily operations. Specifically, it is important to document which tasksare assigned to which party so everyone knows what to do when a planned or unplannedissue arises.Remember, the cloud brings with it significant and frequent changes. Keeping up with therapid pace of innovation and change is especially important and should be considered anongoing task.Your cloud migration checklistPHASE 1 - DISCOVERYPHASE 3 - PROOF OF CONCEPTPHASE 4 - MIGRATION Itemize your applications. Define your users and usage. Test your workload: Start small andprove value with a phased approach. Create a blueprint of your desiredcloud environment. Identify network interdependencies. Estimate cloud costs. Establish a rollback plan. Consider security and complianceregulations. Determine the amount and sizeof your compute and storagerequirements. Identify tools for automatingmigration and syncing data. Gather a clear definition of yoursystems’ RTO and RPO.PHASE 2 - ASSESSMENT Understand the methods formigrating apps to IaaS. Build your team—consideringinternal resources and/or outsourcing. Understand security requirements,and the need for network andsecurity controls. Understand the implications of theproduction day data move.PHASE 5 - CLOUD OPERATIONS Assess network performance. Keep up with the pace of innovation. Qualify tools and solutions neededfor the migration. Utilize 24x7 support via skilled AWSresources. Utilize Amazon resources forspecific skillsets. Map on-premises third partysolutions to determine howeasily they will migrate.5 5 phases for migrating healthcare workloads Stay on top of system maintenanceand upgrades. Consider SLA requirements and takeinto account governance, security,compliance, performance,and uptime.