Contributed by Chuck Vondra, Communications Strategies:

Why, When and How Health Care organizations should consider Cloud migration for their communications platforms

Organizations began seriously considering cloud communications platforms in the 2010–2012-time frame. At that time adoption was most prevalent among less risk averse industries like high tech startups, small, less capitalized businesses and multi- location organizations. Like other technology trends the technology originated in the consumer residential market with products like Skype and Vonage.

As the technology moved into the business market the primary motivators were:

  • Less physical infrastructure to procure and maintain
  • Low up front capital expense
  • “Pay as you go” model

Challenges faced by the cloud providers included:

  • Higher Total Cost of ownership (2X over 5 years)
  • Reliability (4- 9’s max uptime guarantees)
  • Security concerns with unproven technology (customer sensitive data in the
  • Lack of feature parity with legacy PBX platforms

Cloud adoption grew year by year in the general business community with the exception of specific industry segments in Healthcare, Finance and Government where any potential benefits were outweighed by perceived risk. And then the pandemic hit.

The pandemic provided a kickstart to the cloud migration as companies were forced to support a remote workforce and depend heavily on non-traditional forms of communications. Some organizations rushed to deploy cloud technology and others simply relied on cell phones for communications. The pandemic forced business to re-evaluate many business practices including communications. Pre-pandemic our clients favored on premises solutions over emerging cloud technology. Post-pandemic that trend was reversed, including market holdouts like healthcare, finance and government.

Looking at 2024 and beyond the healthcare industry is re-evaluating its cloud migration strategy in light of current market realities:

  • There are still solution providers committed to supporting on premises platforms
    (Avaya, Cisco, Mitel)
  • The general industry direction is cloud first, claiming a majority of R&D focus
  • Cost per seat has dropped by over 50% in the last 10 years, improving ROI
  • Reliability and uptime for cloud solutions has improved, while still not on par with
    on premises solutions
  • Product enhancements on cloud platforms is outpacing that of on-prem solutions

Many large healthcare organizations are still maintaining legacy on-prem technology and are needing to formulate a going forward strategy that includes the following options:

  • Continue investing in and supporting on-prem solutions
  • Move to the cloud
  • Develop a hybrid strategy, leveraging on-prem solutions while slowly introducing
    cloud communications technology

Specific cloud challenges for healthcare organizations include:

  • Maximum 99.99 uptime SLA guarantees
  • Survivability of off-site locations
  • Integration with ancillary “bolt on” technologies
    • Paging
    • Nurse call
    • Analog devices
      • Fax
      • Patient telephones
      • Monitoring and alerting devices
  • LAN/WAN readiness
  • Budgeting – shifting from a CapEx model to an OpEx model
  • Support – shifting from white glove to DIY models
  • Older cabling and networking infrastructure
  • Existing contractual commitments with carriers, solution providers
  • Compliance
    • HIPAA
    • E911
      • Kari’s Law
      • RAY BAUM Acts
      • State and local regulations

Cloud migration is not a new concept for healthcare, many organizations have already moved email, desktop applications and Electronic Medical Records (EMR) systems to the cloud.

Considerations and action items for cloud migration:

  • Understand product and support roadmap for current legacy platform
  • Document all 3rd party “bolt on” applications and integration points
  • Document menus, call flow and Automatic Call Distribution (ACD) applications
  • Verify all cable infrastructure meets VoIP requirements
  • Validate network infrastructure and ability to support cloud technology
  • Document all existing communication use cases
    • Nurse stations
    • Patient rooms
    • ER rooms
    • Receptionist stations
    • Admin call coverage
  • Identify all critical life safety applications
  • Identify all locations requiring communication survivability
  • Work with finance to determine budget feasibility to move from CapEx to OpEx
  • Review existing carrier and solution provider contracts and commitments
  • Research cloud design options
    • multi-tenant, single tenant
    • Geo-redundancy
    • Site survivability
    • Public cloud/private cloud
  • Research relevant cloud providers
  • Based on above information, prepare a comprehensive requirements document
  • Identify internal and external resources needed
  • Develop a deployment timeline

Many healthcare organizations find it beneficial to leverage independent subject matter experts to assist in their planning, procurement, and deployment process. Communications Strategies (Com-strat) can be a valuable resource for organizations seeking to develop a successful communications technology strategy.


Charles (Chuck) Vondra is a senior consultant at Communication Strategies, a comprehensive voice and IT Communication consulting service firm that assists with network design, strategic planning, technology acquisition, and project deployment. Chuck has over 30 years of experience in his role as a senior consultant and is a member of the Society for Communications Technology Consultants (SCTC).

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