Gelre ziekenhuizen first hospital to move Electronic Medical Record (EMR) to the cloud
Azure Cloud
for platform uniformity and cost control benefits

Case Study - First published on June 13 2022, updated on May 24 2023

Gelre ziekenhuizen is ready for the future of healthcare. A cloud workplace, a data platform and an electronic patient file on Microsoft Azure help Gelre to become a data-driven hospital that is ready for more collaboration with other healthcare providers, keeping healthcare affordable and preventive care. Gelre managed this ambitious transformation together with Rapid Circle, KPMG and Microsoft.

Gelre ziekenhuizen, one of the largest hospitals in the Netherlands, had the ambition to be the first hospital in the Netherlands to be 100% ready for the future of healthcare. With a data platform and a modern IT infrastructure that offered room for the innovation that healthcare so desperately needs to remain affordable and available. And attractive as an employer.

In 2022 and 2023, the hospital, in partnership with Rapid Circle and Microsoft, migrated 90% of its workloads to Azure.

Towards a data-driven hospital

With hospitals in Apeldoorn and Zutphen and a number of outpatient clinics, Gelre ziekenhuizen fulfills an important regional function in Gelderland. More than 3,600 employees serve a catchment area of 350,000 people. Gelre also plays a key role nationally in certain specialisms. Connection with chain partners, care for patients at home and a valuable working environment for all colleagues are therefore spearheads of the vision. After all, successful care is delivered together. Modern IT is a basic condition for these collaborations.

The EHR in the cloud was therefore not an end in itself. Gelre is about becoming a data-driven hospital and thus ensuring the availability and affordability of care in the future. That is why we previously created a data platform for Gelre that serves as the basis for all kinds of healthcare innovations. Gelre already uses this platform as a basis for better diagnoses, decision support and process optimization. The next step is to connect the chain partners to the platform and thus improve data-driven collaboration.

Cost reduction: 1 million euros per year

In our vision, the step to Azure should mainly be about innovation. About realizing things that otherwise would not be possible at all. Work flexibly and securely with data in a uniform, well-supported environment. Rapid access to new technology. But of course, hospitals are also looking at a cloud migration as a way to save money. The project for Gelre proves that these goals can be combined well.

The project assumed a break-even business case compared to an on-premises installation. But with balanced cost management, we can reduce the total costs (Azure licenses, management by Rapid Circle and external costs) by 1 million euros per year.

Theo Vens, CTO at Gelre hospitals, about the connection between innovation and cost reduction: “Technological progress in healthcare is rapid. There is a strong increase in the number of applications that are linked to medical equipment, we offer more digital care and our employees work from home more often. Our existing infrastructure was not equipped for this, which made the maintenance of the software – a critical point in medical technology – even more complex and took a big bite out of our resources.”

SaaS policy gives room to care

“Quality, accessible and personal care is only possible with modern IT infrastructure,” says Vens. “With the migration to the cloud, we have control over our management environment, our technology is scalable and we are prepared for the future by removing obstacles. The role of technology will not diminish in this. But the focus is on care and the patient, not IT. That is the biggest gain for me.”

Arnold Groot Koerkamp is Service Level Manager at Gelre and explains what this looks like in practice: “Our policy is now to purchase as much Software as a Service (SaaS) as possible so that management, updates and security are guaranteed. If this is not possible, we will look at the possibility of placing this in our cloud with Azure. If that doesn’t work either, we will install the software locally. The majority of our applications now run in Azure. Due to the increased flexibility, we can pay based on usage. We don’t need 100 percent of our capacity at quiet times. In addition, we can respond more quickly to questions and requests from colleagues.”

Due to the relocation of the IT data center, we are carrying out the migration faster than originally planned. Groot Koerkamp: “Thanks to the migration to Azure Cloud, we need less space for data servers. The space that was freed up as a result has now become a nursing ward. In this way we literally and figuratively make room for primary care.”

Pioneer work

Many hospitals worldwide, as well as Microsoft and EHR software supplier Chipsoft, participated in this project. CTO Theo Vens was well aware of the risks of the project: “The EHR is a crucial part of the daily work of a hospital. Before we got started, we therefore first looked at the possibilities and risks with our partners. We only started once we had mapped them out and we were prepared for all scenarios.”

“Of course it remains exciting, because we are the first hospital to take this step, but the advantages of future-proofing and scalability far outweigh the disadvantages. I get a lot of questions from other hospitals that would also like to start this process, our pioneering work in this area benefits the entire sector.”

Partnerships Rapid Circle and Microsoft

Gelre worked closely with Microsoft and Rapid Circle for the migration. Groot Koerkamp: “For this major challenge, we were looking for a company that primarily acts as a proactive partner that provides solicited and unsolicited advice. A big advantage of working with Rapid Circle is that they are familiar with the work in hospitals. They understand better than anyone that updating an application in the operating room is not just an update.”

Rapid Circle is responsible for the management and security of the entire environment in this process. Vens: “We still work together and we are constantly looking at how we can optimize the management of the Azure environment and the implementation of updates. You have to, because during a migration process you always come across unexpected things, such as apps that you have to update to keep them working, or a technological legacy from the past that you have to give a place somewhere. A dedicated Rapid Circle team helps us with this. This way we keep control over our IT.”

Wilco Turnhout, co-founder and CSO of Rapid Circle: “Such a large-scale migration has never taken place in the Netherlands before. You only enter into such a process with each other if mutual trust is high. For this migration, we therefore chose to put together a team that could draw on the extensive experience we have gained at hospitals and in healthcare. This way the lines remain short. The cooperation is very pleasant and the migration is going well. This is a project we are very proud of.”


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