Cloud Computing Lowering Cost and Complexity Barriers in the Healthcare Industry

Transcription

1 We look beyond IT CASE STUDY Cloud Computing Lowering Cost and Complexity Barriers in the Healthcare Industry

2 White Paper Cloud Computing Lowering Cost and Complexity Barriers in the Healthcare Industry Monty Zarrouk, NetApp September 2014 WP-7203 Abstract The healthcare industry is ramping up adoption of cloud computing as organizations recognize the cost benefits, risk reduction, access to expertise, and general convenience of this computing model. And the cost and productivity efficiencies make it possible for IT to provide more responsive solutions that assist clinicians in enhancing patient care and that enable providers to process claims more quickly. To successfully make the transition to this new computing model, NetApp is leading the way with proven technologies to deliver the storage capabilities that will power cloud infrastructures both now and in the future.

3 TABLE OF CONTENTS 1 Overview Adoption of Cloud Computing Different Cloud Models Support Different Business Objectives Cloud Impact on Storage Requirements Manage Volumes of Growing Data Correlate Data to Improve Patient Outcomes Reign in Costs Why Storage Matters in Managing Clinical Data in the Cloud Easily Manage Data Transform Data to Action with Analytics Cost Savings Through Productivity and Operational Efficiencies Case Studies Prairie Health Ventures Xerox Mercy Health Systems Summary LIST OF TABLES Table 1) Reliability: on the premises versus the cloud LIST OF FIGURES Figure 1) Cloud-computing models Figure 2) Public cloud solutions for enterprise use Figure 3) New demands on IT: agility at scale Figure 4) Enable confident cloud transitions Figure 5) Extend clustered Data ONTAP benefits into multi-tenancy environments Figure 6) Benefits of cloud computing Cloud Computing Lowering Cost and Complexity Barriers in the Healthcare Industry

4 1 Overview As the healthcare industry focuses on delivering cost-effective quality care, improvements in the accuracy of patient records, more efficient administration, and streamlined regulatory monitoring and compliance activities are required. IT has been tasked to deliver fast, reliable, and secure access to critical information while handling the growing volumes of clinical notes, images, diagnostics, scheduling, billing, and other information. However, for many organizations, the cost and complexity of healthcare IT can make it difficult to adopt, especially in light of already tight budgets. And with the continued pressure to comply with regulatory demands, healthcare-specific compliance requirements, and guidelines under the U.S. Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health (HITECH) legislation, IT transformation is needed to effectively handle exponential data growth, improve operational efficiencies, and manage limited budgets. To address this technology challenge, many healthcare organizations are turning to cloud computing to lower cost and complexity barriers with the cloud s shared services model. By moving to the cloud, the healthcare industry will find new opportunities for data consolidation or aggregation of patient data to help physicians and clinicians make better decisions. Their organizations should also save money through reduced redundancy and cheaper operational costs. Providers. With real-time data access at the point of care (POC), clinicians can make critical decisions based on the valuable patient and medical information available to them. Educated decisions based on patient history can be made faster, with better outcomes, and can decrease medical errors. Payers. Fast-moving regulatory environments and customer demands are forcing payers to improve their analytical models to better compute risks and identify ways to reduce cost structures. Data management technologies can give payers a competitive edge with the ability to process huge volumes of data, whether it s looking at disease trends over the years, performing complex demographic analyses, or creating predictive models to curtail rising healthcare costs. 2 Adoption of Cloud Computing Although regulatory and security concerns have held back the healthcare industry from widespread adoption of public clouds, the overall cloud computing market in healthcare will grow to $5.4 billion by 2017, according to a report by research firm MarketsandMarkets. 1 Cloud-based infrastructures provide IT services that are dynamic, resilient, and use a shared infrastructure to provide lower-cost services. With the ability to provide access via secure LAN connections, cloud computing makes it possible to deliver clinical and administrative applications such as electronic health records (EHR), billing, scheduling, and other clinical and business applications. With cloud computing, healthcare organizations can: /#sthash.x9jFUrEb.dpuf 3 Cloud Computing Lowering Cost and Complexity Barriers in the Healthcare Industry

5 Improve patient outcomes. Clinicians can securely access pools of shared resources to make immediate informed decisions without compromising confidentiality of patient data. Improve operational efficiencies. By using a shared infrastructure, cloud services save time and money while delivering increased IT efficiencies and service levels. As business demands change, shared resources can be reallocated, eliminating overprovisioning. Support exponential data growth. Cloud computing easily accommodates rapidly growing terabytes of patient data and saves on the costs of storing hardware locally to store big datasets for EHRs, radiology images, research, and claims data. 2.1 Different Cloud Models Support Different Business Objectives Deciding which cloud model offers the best fit depends on the critical nature of the workload and how security and compliance requirements will be handled. Whether a cloud is public, private, or a hybrid, the key to success is creating an appropriate infrastructure in which all resources can be efficiently utilized and shared. And in a cloud environment, implementing the right data storage model becomes even more crucial to effectively support the requirements of a shared infrastructure model. Figure 1) Cloud-computing models. Private Public Cloud Service Providers Performance Access Hyperscale Cloud Providers Protection Availability Governance Security Private Cloud Integrate public resources while retaining control Private Cloud Health providers faced with data privacy and security requirements such as HIPAA may first look at private clouds as a means to reduce cost and increase IT efficiency. By leveraging a scale-out cloudbased infrastructure to support applications including PACS, EMR, and document imaging, providers can provide quality patient care with state-of the-art medical services. A private cloud infrastructure is a practical option for the healthcare industry in which data protection, security, and regulatory compliance requirements can be shared across many departments. Private clouds, available for use behind the organization s firewall, provide an excellent cloud computing model in which maintaining applications and data internally is the driving business factor. Private clouds are about IT flexibility, efficiency, and cost savings. With a services delivery model, IT can offer services to its internal customers with automated processes, meter usage, create showback or chargeback models, and deliver services for greater cost savings, utilization, and efficiencies. Hyperscale Cloud Providers A hybrid data center model spanning private and public clouds gives healthcare organizations elasticity, 4 Cloud Computing Lowering Cost and Complexity Barriers in the Healthcare Industry

6 agility, and economy. New Hampshire based analyst firm Technology Business Research shows that nearly 20% of the 1,600 large enterprise IT decision-makers recently surveyed reported that they use two or more cloud services that were integrated to create a hybrid cloud. 2 With an integrated hybrid cloud platform, healthcare organizations can benefit from a considerably more flexible, powerful, and cost-effective IT infrastructure, with plans to virtualize the majority of its IT environment. Delivering IT services from an integrated storage platform that spans its on-site private cloud as well as public cloud capabilities provides a new level of IT service agility, application portability, and data protection. By leveraging cloud services providers such as Amazon Web Services, IT is able to retain on-premises clouds for mission-critical services for which they can maintain control and provide necessary security for sensitive information, all while benefiting from the large scale and low cost of the public cloud. In addition, NetApp now offers NetApp Private Storage (NPS) for Microsoft Azure, 3 a solution that creates a seamless hybrid cloud environment that allows healthcare organizations to extend their IT infrastructure to Microsoft Azure. This solution allows enterprises to optimize their business by simply and securely extending into the cloud and expanding their options without adding complexity. Figure 2) Public cloud solutions for enterprise use. Hybrid Cloud / Multi-Cloud Benefits: On demand compute Massive scalability Pay as you go Cost effective Multi-cloud connectivity Control/security/compliance Data portability Performance Availability Microsoft Azure + This model provides the best of both worlds healthcare organizations are able to compute in the cloud and store on the premises. By using self-service, on-demand, elastic, and showback and/or chargeback models, IT managers can have their data under their complete control, relieving the stress associated with security, storage, and regulatory requirements. Cloud Service Providers Private Storage Acquiring cloud services from service providers who manage specific workloads, such as archiving of patient information and claims data, allows healthcare organizations to move from a capex to an opex Cloud Computing Lowering Cost and Complexity Barriers in the Healthcare Industry

7 model, enhance efficiencies, provide IT on demand, and accelerate time to market with new services. However, initial service provider selection and planning are critical to obtaining ROI from an outsourced model. Accelerate time to market with on-demand infrastructure. Streamline administrative tasks by outsourcing noncore applications. Reduce IT capital requirements with a pay-as-you-go expense model. Improve data protection with disk-based backup and disaster recovery. Leverage reliable and secure cloud services through NetApp partners. 3 Cloud Impact on Storage Requirements Changes in the healthcare industry have an impact on storage and IT infrastructure. As payers and providers continue the transition from legacy paper-based processes to automated tasks with healthcare applications, more patient information is created and stored online. Applications including PACS, EMR, document imaging, integrated patient records, physician order entry, and claims processing all cause increased storage demand. 3.1 Manage Volumes of Growing Data Healthcare organizations are under extreme pressure to capture, store, and manage the massive volume of data used to run the business, and cloud computing offers a cost-effective approach for rearchitecting storage infrastructures. By evolving from a traditional physical-server infrastructure with direct-attached storage to a more reliable and efficient shared environment, healthcare IT is positioned to benefit from the operational and cost efficiencies that can help optimize staff productivity; meet regulations for retention; and reduce error, fraud, and duplication. However, an important aspect of managing data is to make sure that it is available when needed. In a recent IDC study, 4 the cloud solution was more reliable regarding unplanned outages and it was faster to recover than service run in-house. This resulted in a savings of 95%, or $222 per user (see Table 1). Table 1) Reliability: on the premises versus the cloud. Downtime On the Premises Cloud Savings Advantage (%) Incidents per month Hours per incident Hours per user per year Cost per user per year Source: IDC, 2013 In addition, this study shows that organizations that adopted cloud services were able to launch new services and applications 52% faster in a cloud services model. With the ability to respond quickly to new business opportunities, organizations are positioned to compete more effectively. 4 Cloud Economics: A Financial Analysis of Information Management IT Models, IDC Cloud Computing Lowering Cost and Complexity Barriers in the Healthcare Industry

8 3.2 Correlate Data to Improve Patient Outcomes With big data coming from a multitude of sources, IT requires analytic tools that make it easy to transform data into actionable intelligence. However, with the explosion of both the size and volume of data coming from multiple sources and across multiple systems, it is imperative to have the tools that can aggregate clinical data in a consistent fashion and that can be used across multiple applications. Big data analytics provide providers and payers with greater control, taking advantage of the entire digital data repository and turning clinical data into valuable intelligence. Providers that can correlate patient records and medical data can quickly identify treatment plans. An insurer that has analytical insight to fact-based diagnostics and therapeutic decisions can shift to the new model of value-based reimbursements to drive coordinated care at a lower cost. In addition, to receive EHR incentive funding, providers must demonstrate meaningful use (MU) from their EHR applications related to improving patient care. By extracting data from the production environment and feeding it to specific reporting applications, reports can be produced that satisfy specific MU objectives as well as other internal reports such as those that help improve work efficiencies and reduce costs. 3.3 Reign in Costs Capex constraints prevent investments needed to expand internal, on-premises data center facilities. By offering affordable shared healthcare IT services, providers can enhance patient care and safety while maximizing business operations. Moving to cloud services allows IT to combine internal data centers with external virtual private cloud computing resources to create a transparent, agile IT environment capable of dynamically scaling to meet business requirements. This approach leads to better control of IT costs and the right-sizing of IT investments based on the nature of the workload involved. The IDC study also found that private cloud solutions can reduce the total cost of ownership related to storage management, information governance, and security by up to 36% while eliminating data center complexity, consolidating license fees, and reducing administrative costs for storage, archiving, and e- discovery. 4 Why Storage Matters in Managing Clinical Data in the Cloud NetApp offers cloud services infrastructures that best fit specific workloads. From providing storage as a service to a traditional infrastructure in a data center to a combination of private and public resources, NetApp has the options to help healthcare organizations successfully make the transition to the cloud. There are multiple paths to the cloud, all with the goal of maximizing capacity utilization, improving IT flexibility and responsiveness, and minimizing cost. The Unbound Cloud NetApp clustered Data ONTAP software offers a single storage and data management platform that enables unrestricted, secure movement of data across public and private clouds allowing you to move to hybrid cloud architectures. 7 Cloud Computing Lowering Cost and Complexity Barriers in the Healthcare Industry

9 Universal data platform. Start with a private cloud and evolve to a hybrid cloud environment. You retain the proven storage efficiency, availability, and scalability of the world s #1 branded storage operating system. 5 Reduce your data storage requirements by 50% guaranteed. 6 Use NetApp deduplication technology to reduce your existing data by at least 35%. 7 Dynamic data portability. Integrated data transport, including the #1 replication software and first-ofits-kind hypervisor translation, offers dynamic movement of data and workloads across any cloud resources. This helps you to boost IT efficiency and avoid vendor lock-in. Control the security of data moving in and out of the cloud and meet compliance requirements. 8 Integrate NetApp enterprise-class data management 9 with public cloud services that offer speed, flexibility, and economy. Extensive choice. To facilitate the move to public cloud services, NetApp developed a global network of world-class service provider partners who deliver a comprehensive portfolio of cloud services built on NetApp technology. Leverage open-source options to provision and manage cloud resources with CloudStack and OpenStack. Figure 3) New demands on IT: agility at scale. SLAs Provisioning Availability Economics Negotiated Weeks Maintenance Windows Cost of Ownership Services-Driven Minutes No Outage Windows Exploit Data Infrastructure Silos, Dedicated Shared, Consolidated 4.1 Easily Manage Data Working with NetApp, IT can deploy a unified infrastructure that offers a cost-effective approach for rearchitecting storage infrastructures for cloud computing. Large volumes of sensitive data can now be securely stored and easily managed throughout its lifecycle as defined in retention policies, maintaining compliance with regulations. The key benefits of a unified infrastructure include: Operational efficiency. Achieve improved performance, management simplicity, and reliability to drive improved productivity and cost savings. And with the ability to automatically provision and 5 Source: IDC Worldwide Quarterly Disk Storage Systems Tracker 2014 Q1, June 2014 (Open Networked Disk Storage Systems revenue) Cloud Computing Lowering Cost and Complexity Barriers in the Healthcare Industry

10 optimize storage resources, organizations see significant improvements in efficiency and performance over manual processes. Nondisruptive operations. The ability to transparently migrate data and network connections and to distribute data across the cluster at any time allows organizations to retain access even during updates and technology refreshes. On-demand flexibility. Scale-out storage solutions easily accommodate data growth, supporting a few terabytes up to 20 petabytes using a single unified architecture. Healthcare organizations can start small and grow incrementally with infinite scaling to meet increasing data requirements and keep pace with changing data requirements. Figure 4) Enable confident cloud transitions. EHR PACS CPOE Service Provider for Backup and DR EHR PACS CPOE! Multicloud ready, supporting enterprises and service providers for greater choice! Efficient, high-speed data protection for backup and disaster recovery to cloud! Cloning of VMs in seconds for rapid cloudbursting! Superior connectivity and performance for a better customer experience Hyperscaler for Cloudbursting EHR PACS CPOE Direct-Connect Data Center Private Cloud 4.2 Transform Data to Action with Analytics To meet the growing need for big data analytics, NetApp storage solutions provide healthcare organizations with greater control by taking advantage of the entire digital data repository and turning clinical data into valuable intelligence. Healthcare organizations with analytical insight to evolving healthcare issues can expedite treatment plans and implement effective disease management programs. NetApp addresses the needs of organizations to maintain control of data that requires large, distributed, multisite content repositories. Customers can now store petabytes of data and billions of files or objects across hundreds of sites in a single, location-independent namespace. A single, large repository for unstructured data. Store billions of datasets, such as files or objects, and petabytes of capacity in a single, multisite namespace. Create, manage, and consume data globally. A sophisticated global policy engine can create, manage, or consume data at any location while making sure that data resides where it should, as long as it should, and on the optimal storage tier. Intelligent data classification and access. Using metadata that describes the data stored in the repository, policies can be executed in a highly granular yet efficient way. In addition, data can be managed and retrieved simply by using metadata, such as account numbers or the name of a customer, regardless of where the data is physically stored. 9 Cloud Computing Lowering Cost and Complexity Barriers in the Healthcare Industry

11 4.3 Cost Savings Through Productivity and Operational Efficiencies NetApp simplifies the complexity of managing clinical data with policy-based management. Healthcare IT can now easily support terabytes to petabytes of medical records while reducing the time it takes to perform routine administrative tasks. And with improved policies and processes, IT is positioned to manage more terabytes per full-time employee with the push of a button. IT benefits from the ability to provide fast provisioning for additional capacity, deliver proven reliability (99.999% availability), and have embedded security to protect confidential data and demonstrate compliance with regulations and internal policies. NetApp clustered Data ONTAP software offers a single storage and data management platform that enables unrestricted, secure movement of data across public and private clouds allowing you to move to hybrid cloud architectures. Figure 5) Extend clustered Data ONTAP benefits into multi-tenancy environments. ERP Clinical EHR PACS CPOE VDI NetApp Unified Multi-Tenant Clustered Solution Hypervisor! Securely isolate shared compute, network, and storage resources! Achieve consistent QoS at each layer Clustered Data ONTAP! Manage each resource pool independently as a dynamic asset 5 Case Studies 5.1 Prairie Health Ventures Prairie Health Ventures (PHV) is an active alliance that includes 50 hospitals and more than 500 additional nonacute healthcare organizations. Alliance members span entire healthcare systems to smaller physician practices, pharmacies, labs, surgery centers, homehealth services, and more. PHV has been called upon to identify and offer affordable IT services to help members simplify their increasingly complex healthcare information system (HIS), EMR/EHR, and hospital medical images environments. PHV began streamlining several member environments with progressive technologies such as VMware follow-me virtual desktops and virtual servers, both backed by highly efficient NetApp storage. Although this first phase went a long way toward improving many healthcare organizations HIS experiences, most members were still seeking the assurance that their critical data could be accessed quickly from a remote, secure site, especially after a local or facility-wide outage or disaster. Today, PHV uses NetApp to deliver its Prairie Vault SM, a flexible, secure, cloud-based backup and disaster recovery service that fulfills the varied requirements and budgets of its member hospitals and healthcare organizations Built-in storage efficiencies, high availability and performance, and data protection help fulfill mandate to keep member costs low and the quality of service high. 10 Cloud Computing Lowering Cost and Complexity Barriers in the Healthcare Industry

12 Delivers high I/O performance even in low-bandwidth environments so members don t incur additional carrier costs. Achieves storage space savings up to 90% with deduplication and FlexVol technologies. Chad Jeffrey, Chief Information Officer, Prairie Health Ventures NetApp was a much cleaner, more scalable, and fully integrated solution with absolutely everything we needed to provide the level of fast service our members require. When we built in all the extras needed from the other vendors, NetApp came out far ahead on price as well. 5.2 Xerox Xerox has transformed from its early days as the premier manufacturer of photocopiers and printers into one of the largest business services and outsourcing providers in the world. In fact, as a leading provider of services to healthcare providers and employers, Xerox offers its customers a range of services that ultimately touch two out of every three insured individuals in the United States, serving nearly 2,000 different hospitals or hospital systems and processes more than 900 million claims annually. In providing these services, Xerox is subject to healthcare-specific compliance requirements and guidelines under the HIPAA and HITECH legislation, which includes encrypting personally identifiable information (PII) on storage devices and personal computers. Xerox decided to build a private cloud using VMware vsphere, with NetApp FAS storage systems hosting the virtual machines. Standardizing on a virtual private cloud and offering infrastructure as a service allow Xerox to better manage and predict costs and workflow requirements; it also allows the company to simplify and enhance the solutions it provides to customers. The NetApp technologies are helping Xerox be more competitive and achieve its goals of offering customers faster response times and higher availability. Xerox recently migrated its NetApp storage systems running NetApp Storage Encryption to the clustered Data ONTAP operating system for seamless workload mobility. The clustered Data ONTAP environment allows them to move toward a true zero-downtime environment within their storage layer to even better address their customer SLAs. It also enables Xerox to cost-effectively build out their storage environment, allowing them to scale out and scale up, offering truly flexible solutions to their customers. The combined impact of NetApp storage efficiency technologies deduplication, thin provisioning, and Flash Cache was significant. They decreased their overall storage footprint by 50% and saved 85% in storage costs year over year. By implementing NetApp Flash Cache, they rearchitected their storage design and used lower cost SATA drives without sacrificing performance and throughput. Mathew Dickson, Director, Centers of Expertise, Xerox Services A key part of our competitive advantage is the ability to deliver cost-effective, high-availability solutions. Our private cloud infrastructure based on NetApp supports a best-in-class solution. 5.3 Mercy Health Systems In 2006 Mercy Health Systems made the forward-thinking decision to move its clinical operations to a single patient-centric EHR. To support the EHR and enhance IT service capabilities, Mercy invested in a new data center in 2009 with state-of-the-art virtualized infrastructure that would allow the growing health system to prepare for changing business models of healthcare reform, support its Epic EHR and other applications, enhance IT service levels, and position Mercy to commercialize its data center and Epic services. Leadership at Mercy Technology Services (MTS) was instrumental in planning and executing the health system's IT strategy, providing centralized 11 Cloud Computing Lowering Cost and Complexity Barriers in the Healthcare Industry

13 IT operations for Mercy's 32 hospitals. By implementing a private cloud infrastructure, MTS was able to deliver a unified platform for Epic across its 33 hospitals, achieve its goal of 99.9% availability, and provide a secure multi-tenancy environment that isolates and provides a firewall for each hospital s data to meet auditing and compliance requirements. MTS now offers EHR as a service to small to medium-sized hospitals (up to 400 beds) to help them achieve increased value from their EHR investment. By investing in cloud EHR services, these hospitals benefit from: Economics. Investing in infrastructure is capital intensive. Moving to an opex model is more cost effective, reducing the upfront investment in a commercial-grade data center. Speed to market. Leveraging a functional infrastructure that has been optimized for Epic greatly reduces time to deployment. Hospitals can immediately benefit from meaningful use from their EHR investment and be ready for ICD-10. Data analytics. Hospitals can easily harvest data stored within their EHR, build a data warehouse by integrating with data from other systems, repopulate data back into EHR records, and generate reports that turn data into valuable intelligence. Scott Richert, Mercy's Vice President of Enterprise Services We stuck with blue-chip solutions like VMware, NetApp, and Cisco to get a really high density of compute power in our data center. 6 Summary Cloud usage models offer tremendous opportunity to uncover cost savings, reduce capital expenditures, and provide transparency into how computing services are consumed across healthcare infrastructures. Upfront investments in software licenses and hardware infrastructure coupled with ongoing spending on maintenance and installation services mean that traditional acquisition and deployment models are often time-consuming, budget-burning propositions. NetApp cloud solutions can help healthcare organizations effectively handle exponential data growth, improve operational efficiencies, and manage limited budgets. Our portfolio of data management solutions provides the ability to seamlessly manage data across cloud deployments, simplify operations, provide efficient data storage, protect data at scale, and reduce time to market for new medical services. With reduced overall storage and management costs, healthcare organizations can: Enhance patient care with 24/7 access to critical medical data through sophisticated solutions for restoration, data backup, and disaster recovery. Increase utilization and flexibility with server and storage virtualization. Selecting the right storage solution is a strategic decision that contributes to successfully deploying cloud solutions across healthcare organizations. When it comes to storage for cloud computing, NetApp is a preferred technology partner, whether your firm is building a private cloud infrastructure, working with a system integrator, or outsourcing to cloud service providers. 12 Cloud Computing Lowering Cost and Complexity Barriers in the Healthcare Industry

14 Figure 6) Benefits of cloud computing. Reduce time to provision systems and activate new applications Host multiple tenants on a single, secure shared infrastructure Gain operational and staff efficiencies with standardized management Reduce manual effort with policybased automation Cost and efficiency savings Now is the time to design and rearchitect IT storage infrastructures to drive improved efficiencies and cost benefits across the organization. Working with NetApp, IT can implement successful storage strategies that address both short-term demands as well as a long-term roadmap that will continue to extend improvements across data collection, retention, analysis, and reporting as business needs change. Refer to the Interoperability Matrix Tool (IMT) on the NetApp Support site to validate that the exact product and feature versions described in this document are supported for your specific environment. The NetApp IMT defines the product components and versions that can be used to construct configurations that are supported by NetApp. Specific results depend on each customer's installation in accordance with published specifications. NetApp provides no representations or warranties regarding the accuracy, reliability, or serviceability of any information or recommendations provided in this publication, or with respect to any results that may be obtained by the use of the information or observance of any recommendations provided herein. The information in this document is distributed AS IS, and the use of this information or the implementation of any recommendations or techniques herein is a customer s responsibility and depends on the customer s ability to evaluate and integrate them into the customer s operational environment. This document and the information contained herein may be used solely in connection with the NetApp products discussed in this document NetApp, Inc. All rights reserved. No portions of this document may be reproduced without prior written consent of NetApp, Inc. Specifications are subject to change without notice. NetApp, the NetApp logo, Data ONTAP, Flash Cache, FlexClone, and FlexPod are trademarks or registered trademarks of NetApp, Inc. in the United States and/or other countries. Microsoft, SQL Server, and SharePoint are registered trademarks of Microsoft Corporation. Cisco and Cisco Nexus are registered trademarks and Unified Computing System is a trademark of Cisco Systems, Inc. VMware and vsphere are registered trademarks of VMware, Inc. All other 13 Cloud Computing Lowering brands Cost or products and Complexity are trademarks Barriers or registered in the Healthcare trademarks Industry of their respective holders 2014 and should NetApp, be Inc. treated All Rights as such. Reserved. WP

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