Franciscan Health’s Journey to the Cloud: Pioneering Epic on Microsoft Azure

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Charles Christian: [00:00:00] there’s a lot of stuff around finance and strategy and all those types of things, and that’s very, very important.

Charles Christian: But building, uh, effective teams, uh, and understanding your own self in order how you are a leader, uh, and understanding that, you know. People are observing you. you have to walk the walk, uh, as well as talk, the talk. 

Narrator: From Healthcare IT leaders, you’re listening to Leader to Leader with Ben Hilmes. Our guest today is Chuck Christian, chief Technology Officer at Franciscan Health. Chuck discusses his team’s pioneering move to host Epic in Microsoft Azure, the financial discipline behind cloud cost management and the strategic role of virtual care.

Narrator: He also reflects on decades of leadership in healthcare, IT emphasizing humility, teamwork, and the importance of asking the right questions.

Ben Hilmes: Welcome Chuck. Glad to have you today. It’s uh, we are gonna cover a lot of topics in the next half hour. You’ve got such a diverse [00:01:00] background. the stories you can share are gonna be really, really valued by our listeners. So you’ve been a CIO, you’ve spent, a large part of your career around interop, which is a very important topic, uh, at the largest information exchange in the country there in Indiana.

Ben Hilmes: And now you’re at Franciscan Health wearing the CTO hat. So maybe we just start there. talk to me about Franciscan Health. Talk to me about the CTO role and. And then we’ll dive off from there.

Charles Christian: I’ve known this organization for a very, very long time. The previous CIO was a good friend of mine, bill Laker. Uh, bill and I. You know, we ran the same stack of software. I was A-A-C-I-O in southern Indiana. Uh, and Bill had a much bigger system, so he had a bigger stick when it came to helping, uh, US mutually, convince our vendors that, that they were incorrect. Uh, and needed to service the organizations a little bit differently. So I got to know Franciscan really, really well. Deep regard and respect for this [00:02:00] organization and the mission, uh, of servicing the people that need healthcare. every organization needs to make money, you know, because without, uh, a margin, there is no mission. But we really work hard to service a population that, uh, otherwise would not receive healthcare. So. as being in the CTO role, people say, well, Chucky was the CIO. Why do you want to be a CTO? And so, a couple of things is I like technology, 

Charles Christian: I’ve been around a long time, but I love what I do. and I have an outstanding crew. I, I get to work with some of the smartest people, and we’ve done some really interesting things. you know, I have a tendency to ask difficult questions, my team has learned that you know, I’m. Pointing a finger. I’m a curious guy. I’m the, I’m typically the guy in the room that asks the stupid questions, uh, because I’m just a dumb country board from Alabama. Uh, and it’s not because I wanna pry, it’s just ’cause I really want to learn. Uh, and I think that, you know, we’re putting this earth if we’re not learning [00:03:00] every day, we we’re missing an opportunity.

Ben Hilmes: So you’ve done something that’s, you know, a lot of people are contemplating and that is moving my epic,

Ben Hilmes: you know, platform to the cloud and you chose Azure and I know as a journey, right?

Ben Hilmes: But I’d love for you to share a little bit about, you know, what drove that project, how did it go? What were some of the, the outcomes? Some people think, oh, it’s gonna have this massive return on investment. You know, all of those things. Just curious to see how you guys built that framework of thinking and then how the journey went.

Charles Christian: it sounds more romantic than it truly was a taser. I actually had hair, uh, when we started, so, no, I’m just kidding. It truly was a journey, uh, and, uh, it took us about 18 months to get there. Uh, I think that, you know, we learned a lot of things. when I first joined Franciscan back in 2019, one of the gifts that Bill gave us, uh, right. [00:04:00] He retired, he signed an agreement with Dell Technologies, which is Virtustream to, and we were the first, uh, customer to host in, uh, Dell Data Centers. I joined in April of 2019 and we transitioned to their platform in in May. Uh, I got to

Charles Christian: take credit for it. 

Charles Christian: and you know, we had a five year agreement. 

Charles Christian: we really were going to resign with Dell Virtustream. but they made a decision they wanted out of the hosting business and so that gave us an opportunity to do something else. And so, you know, Charles and I had a lot of conversation about that and, actually Charles decided that we were gonna do the cloud because we knew that we were gonna wind up there eventually. you know, why take an interim step? Let’s just go. And we knew that nobody, our size, uh, our size databases and stuff had moved to Azure. Microsoft was telling us, yeah, you can do that. you know, some other folks that, you know, good [00:05:00] friends of mine, CIOs were moving to AWS for a variety of reasons, but nobody had done it yet. we’ve been first a couple of times, uh, and you know, we. played the pioneers and you know what pioneers get, don’t you? You get the arrows. but you know, uh, I have a great team.

Charles Christian: you know, you mentioned ROI. everybody’s asked me, well, Chuck, how much money have you saved? And I just look at him. I says, well, you know, just go ahead and get your Prozac out because you know you’re a little delusional,

Charles Christian: uh, because you know anybody that’s doing this and has moved any, You know, large infrastructure to the cloud understands that, over time, you’re, you may see some savings, but the savings is not because you just moved to the cloud. There is no magic bullet to that. the magic comes in as being able to manage the cost. 

Charles Christian: so what I did is I created a position called a cloud cost analyst, and I had a, An analyst that worked on, on the infrastructure side, uh, that was doing a [00:06:00] lot of work. And, he was just great with details. 

Charles Christian: cloud costing. Is extremely difficult to understand. It’s almost as bad as licensing is that there are so many options and so many things. You know, you can have reservations, you can have quotas, you can have all this stuff, but if you’re not watching it every day, uh, you’re going to be caught with your pants down.

Charles Christian: And I will tell say that between my cloud cost analyst and the consultant that we brought in from another company that knows how to do the, power BI and pull

Charles Christian: that data out of Azure so we can visualize it. Uh, we’ve saved multiple hundreds of thousands of dollars a month. Uh, and so you’re talking millions of dollars a year.

Charles Christian: I mean, Eric and, and, and team I get a weekly report, uh, about what our estimated spend is gonna be. I share that with my boss, uh, and I share it with our financial partners. We have two guys, uh, that work in finance, that are our [00:07:00] partners. we have, uh, a transparency on cost in the cloud like we’ve never had before.

Charles Christian: and we can predict, uh, what our cost is gonna be. I, I spent, you know, 20, 25, 26 years trying to predict what my cost is gonna be running in my own data centers. I couldn’t do it. I could, I could estimate it, but I couldn’t, I couldn’t predict it.

Ben Hilmes: I love the advancements. Uh, I love that, you know, you’re, trying to simplify a complex thing. Uh, it feels like,

Charles Christian: because I’m just a Dumbo country boy from Alabama. I, it has to be simple,

Ben Hilmes: uh, but you’ve talked about workload placement strategy, and I think that’s what you just walked us through, which is, you know, right assets, right place, right time, and, and trying to figure out that constant, uh, maneuvering of those assets to, you know, manage cost, quality time, et cetera.

Ben Hilmes: So

Charles Christian: Well, we did, uh, what, what we called a workload placement, uh, review. Uh, and we did it. kind of, uh, [00:08:00] you know, followed Gartner’s approach to taking a look at it. You know, it is kind of the four box approach. You’ve got some stuff that it just can’t move. It’s gotta stay in your data center, it’s gotta stay on prem.

Charles Christian: I mean, those are things like, uh, infant security, uh, for your, fetal monitoring, uh, those things have to be there. Uh, and then you have other things that have to have edge servers like PAX and, and those types of things. But then you have other things you can consolidate.

Charles Christian: Uh, you know, one of the things we did is we consolidated, having all the hospitals and having all the critical cares we had. Uh, servers for our, our cardiac monitoring in each one of those facilities. Well, didn’t have to have those. So we consolidated those and we shut down about 75 or 79 servers and we could run all of those, actually have to run two sets because of time zones.

Charles Christian: Uh, but we moved them into a data center. And so I asked Philips, I said, so, can I run [00:09:00] that in the cloud? They said, oh, sure. You want to be first. No. Uh, and so I’m gonna let somebody else be first. 

Ben Hilmes: you seem to like being first on some of these

Charles Christian: uh, I, I, I wanna keep the rest of my hair. I mean, the thing about it is, you know, when you’re talking about something as critical as your, you know, your cardiac, you, you’ve got your sickest patients that are being monitored.

Charles Christian: I’m not fool with that. that’s a dash role I’m not taking. Uh, and I have a great partner, in the, uh, administrative, uh, director of, HMT, clinical Engineering, whatever you want to call it this week. Uh, and she’s great. Uh, got a world of experience, and we’ve done a lot of consolidation on a lot of different things.

Charles Christian: We just are wrapping up. Consolidating, uh, the biological monitors, uh, for all of our cardiac labs, uh, that was also a big one. we changed out our, uh, all of our integration in all of our ORs, uh, with a different piece of technology, which is now owned by Philips. Same thing with our [00:10:00] events.

Charles Christian: And so we’re trying to standardize and consolidate, and hopefully in that it simplifies a little bit.

Ben Hilmes: That’s great. That is great. So. pivoting a little bit. You spent a lot of your career or, or chunk of your career focused on, and actually when you opened, you started thinking about interoperability back in the eighties, and then you migrated at some point in the middle of your career to the Indiana Health Information Exchange. Give us your perspective on, you know, look, HIEs have, I think, provided tremendous value, Are they today? Where are they going? Where do you see, you know, that whole topic, how is that gonna continue to evolve?

Charles Christian: I’m not as plugged into that, uh, today, uh, as I, as I once was, but, you know, years ago, I had the pleasure when Mitch Daniels was governor of Indiana, he appointed me to two. Different, uh, commissions. Uh, one I was able to serve on the [00:11:00] other one I was not, but it was related to, at that time, Indiana had five health information exchanges.

Charles Christian: they were trying to figure out, this was before high tech, this is before meaningful use, before all of that. the one thing about it is, is the asset that Indiana has called the Indiana Health Information Exchange Group, A lot of the exchanges out there today were built because the government, uh, and I’m gonna use the word, forced us to do that, you know, it was a carrot and then the stick.

Charles Christian: Uh, but in Indiana, uh, a group of clinicians, physicians got together some 30 odd years ago. And, you know, part of the, the nuance of Indianapolis is you have all these large health systems. But they share medical staffs and, you know, iu, uh, school of Medicine, they service a lot of those, physicians and their interns or their medical students, uh, service a lot of those hospitals.

Charles Christian: And so you have, uh, somebody that’s pulling a rotation at that time it was [00:12:00] Wishard, which is the county hospital. our safety net hospital, they were pulling a shift there in the evening, and then the next night they were pulling a shift at the I at Methodist or iu. Uh, at that time they were separate, uh, and they were seeing the same patients.

Charles Christian: But they couldn’t get the records of what happened the night before or, you know, last week. And so, uh, working with Regenstrief Institute, uh, and some, really, uh, interesting, uh, folks there, researchers, and, you know, they wrote the code for the Indiana Health Information Exchange, which has transitioned over to ihi, uh, over time, which they maintain it.

Charles Christian: Uh, control it today. And I think that was one of the reasons that they were so successful. but they wanted to share that information from a clinical standpoint. and it was, you know, patient, very patient focused. And I think that was the genesis that made it so successful. 

Charles Christian: 

Ben Hilmes: That’s awesome. Um, let’s land on one more. So, you know, it’s interesting [00:13:00] you keep saying you’re not a pioneer, but everything you do, you are a pioneer. And one of those, uh, is you spearheaded a lot of the chime, uh, CIO bootcamp efforts,

Charles Christian: I wouldn’t say spearheaded. I had the pleasure of teaching, of being a faculty member, uh, for about nine years. Uh, and so, uh, that was, a great learning experience for me. 

Ben Hilmes: we always talk about, you know, a leadership component in the Leader to Leader podcast. And um, I’d love for you to just give, you know, a few comments around your work there with the CIO bootcamp because I don’t think there’s, when you think about leadership legacy and you think about the influence you’ve had on so many.

Ben Hilmes: CIOs that have gone through that over the, that nine year period. I’d just love to hear your, your thoughts on that.

Charles Christian: the beauty part about it is, is that one of the tenants that Chime was founded on back in, uh, 1994. was the, [00:14:00] uh, the premise of educating, if you go back in, you know, in the time machine, there really wasn’t a thing called a healthcare. CIO At that point in time, we were just starting to get there.

Charles Christian: You know, they had some, uh, great leaders, John Glasser, and a few others that were really instrumental in putting this, uh, organization together. And I’ve had the pleasure of being a member since the very beginning. Uh, actually it was 92, I think. I’m a charter member and I’ve had the pleasure serving on the board twice.

Charles Christian: and I got to work with other, uh. Just outstanding CIOs in, in the country. Made a lot of great friends. And the really fun part for me is some of the people that were, even in the, some of the early classes, the cohorts of, uh, folks, uh, I, I still run into ’em, uh, at HIMSS and it chime and, uh, to watch their careers because a lot of them have gone on to be healthcare CIOs.[00:15:00] 

Charles Christian: Uh, and I also know some folks that went through the bootcamp and said, I don’t wanna do this. Uh, and, and, which is fine. I mean, I think 

Ben Hilmes: to fail fast, 

Charles Christian: yeah. I mean, I think it’s kind of of a, an epiphany moment where you can learn is, Hey, this is, uh, you know, I think I wanna do this. And they go, oh, hell no.

Charles Christian: I do not want to do this. Because, you know, the bootcamp it’s not a shakedown cruise. It’s, we worked a lot on the softer skills of, of being a healthcare, CIO, there’s a lot of stuff around finance and strategy and all those types of things, and that’s very, very important.

Charles Christian: But building, uh, effective teams, uh, and understanding your own self in order how you are a leader, uh, and understanding that, you know. People are observing you. you have to walk the walk, uh, as well as talk, the talk. 

Ben Hilmes: there’s a lot of words I could use to describe you, a leader, a teacher, a pioneer, but you know, through this dialogue, I mean, it, you’re an absolute treasure.

Ben Hilmes: [00:16:00] 

Ben Hilmes: Chuck brings a wealth of experience to his role as Chief Technology Officer at Franciscan Health. Here are three key takeaways from our discussion. First, Franciscan Health was among the pioneers in migrating EPIC to Microsoft Azure, a strategic decision that enhanced scalability, agility, and built a future proof infrastructure.

Ben Hilmes: Second, Chuck introduced a dedicated cloud cost analyst paired with robust reporting tools. This initiative provided greater transparency into cloud spending and resulted in substantial monthly savings. Third, Chuck’s leadership style centers on supporting his team rather than commanding from the top.

Ben Hilmes: His approach driven by collaboration, curiosity, and continuous learning is left a lasting impact on both Franciscan Health and the broader healthcare IT sector. So what resonated with you most from Chuck’s story? We’d love to hear from you on our social media channels. Or drop an email on our website, healthcareitleaders.com.​[00:17:00] 

Narrator: Thanks for joining us for Leader to Leader. To learn more about how to fuel your own personal leadership journey through the healthcare industry, visit healthcareitleaders.com. Don’t forget to subscribe so you don’t miss any insights and we’ll see you on the next episode.