The following is a guest article by Michael Ohayon, GM Nexcess Managed Cloud at Nexcess
Broadcom acquired VMware and changed how its software is sold. Perpetual licenses are gone, subscription prices are rising, and legacy contracts are expiring. This leaves you to pay more for existing infrastructure or transition to an alternative platform.
For clinics, the biggest hurdle to switching platforms is the fear of migration downtime. While infrastructure doesn’t replace the core EHR application itself, it powers everything surrounding it, like clinical databases and scheduling software to billing systems and PACS imaging. If those underlying systems go offline, doctors can’t open patient charts, digital prescriptions stall, and workflows grind to a halt.
Evaluating alternative platforms gives your health system an opportunity to find new architecture that supports HIPAA requirements and fit the management bandwidth of your internal IT staff. For many clinics, switching to a Hyperconverged Infrastructure (HCI) platform like Nutanix provides the architecture needed to migrate without going offline while simplifying long-term management.
Understanding Hyperconverged Infrastructure
Hyperconverged Infrastructure (HCI) replaces separate server hardware, storage networks, and hypervisors with a single operational system.
Instead of managing three separate layers, your IT team operates everything through one platform. Existing medical software, clinical scheduling tools, and supporting databases migrate over as-is, eliminating the need to re-architect or modify application code for your non-EHR workloads.
To transition off VMware without taking clinical systems offline, IT teams use a continuous replication approach:
- Parallel Setup: Your new HCI platform is configured alongside your active VMware environment.
- Background Mirroring: Data copies over in the background while doctors and nurses continue seeing patients as normal.
- Off-Hours Cutover: Once synchronization is complete, the final switch happens during a brief, scheduled off-hours window, leaving the legacy VMware setup intact as a safety net.
Beyond the migration itself, HCI improves daily clinical performance. IT teams can isolate resource-heavy applications, like X-ray imaging, into dedicated resource pools so large image files never slow down your primary EHR. Additionally, combining compute and storage into defined nodes removes surprise fees and locks in predictable licensing costs.
Maintaining audit-ready compliance
Healthcare auditors and cyber insurance providers require proof that clinical systems are protected. HCI platforms like Nutanix build compliance safeguards into the system.
Instead of requiring extra software add-ons, Nutanix handles technical security automatically. Patient files are encrypted at rest, user access is restricted based on job roles, and daily system activity is logged continuously so you have the documentation when auditors ask for it.
When setting up an HCI environment, you can choose between two models based on your risk tolerance. Both options isolate patient records to align with HIPAA guidelines.
- Multi-Tenant Model: Your health system shares physical server hardware with a small, group while keeping patient data logically separated.
- Dedicated Model: Your health system uses server hardware reserved exclusively for your organization, eliminating shared-tenant exposure entirely.
Using managed cloud to reduce internal IT workload
Before switching platforms, you need to decide who will execute the transition and handle day-to-day server maintenance: your internal staff or an external managed partner.
Once you select an HCI platform, someone still has to configure the parallel environment, manage data replication, apply monthly security patches, and respond to hardware alerts. When lean IT teams spend hours troubleshooting hardware and patching backend servers, they have less time to support front-line clinical needs.
Partnering with a managed cloud provider addresses both the transition and ongoing maintenance. Engineers manage the parallel configuration, monitor background data replication, and execute the off-hours cutover so your internal team does not bear the operational risk alone. Following the migration, the provider handles ongoing patching and hardware monitoring. .
When health systems pair a hyperconverged platform like Nutanix with a managed cloud partner, they gain built-in data security, resource isolation, and predictable costs without overburdening internal staff.
Michael Ohayon is with Nexcess, a managed hosting platform that provides HIPAA-aligned infrastructure and migration support for specialty practices, regional health centers, and healthcare SaaS platforms.
