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Healthcare Database Scaling Issues: DBaaS Has the Cure

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May 14, 2014
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Like no other industry, healthcare in the U.S. is under pressure to improve its quality of service while at the same time reducing costs and extending access to care. Information technology management is swept up in the storm. A confluence of factors is straining infrastructures and staff to keep pace with exploding data management demands, new applications, and data retention and privacy requirements, among other things.

This pressure is manifest in many forms including infrastructure scalability generally and database scalability specifically. Simply keeping up has its challenges, especially when attempting to address these challenges exclusively from inside the datacenter.

Issues of database scalability are leading more people to look to the cloud for solutions. The reason is clear. Scaling is a persistent requirement, which can be managed only by incremental degrees typically by tuning or more money or both. How much more investment in data center expansion and DBA skill sets can healthcare entities realistically continue to absorb? It appears to be reaching its limits.

Do-it-Yourself

Overprovisioning to address healthcare database scaling issues issues or living with degraded performance are how most organizations deal with the problem. Investing in infrastructure for peak demand can be extremely expensive and is often entirely uneconomical, especially when the intervals between needed expansions are shrinking. Degraded performance is certain to eventually garner howls of dissatisfaction from users.

Tuning can improve performance. Database performance tuning is as much about improving code as it is about making the database do less. Better indexes mean you have to sort less, but so does sorting in the application layer, which leads to application tuning — pre-computing complex queries, for example.

Investing in new database technologies to address issues of scale is an option, however, an extremely costly approach to addressing performance and scaling issues. It is no surprise that this is not a popular option.

Why the Cloud?

While tuning is always a good thing, the other investments in time and money will typically generate a poor ROI, and increasingly so as we dive more deeply into this new age of computing. An industry response to these dynamics has been Database as a Service (DBaaS).

Peak 10’s technology partner, VMware, cited five reasons for the increasing interest in DBaaS: (1)

  1. Database Sprawl and Infrastructure Growth – Over time, companies created 100s or 1000s of hardly used copies of databases that sit idle on servers and cost millions. With the growth of data, database infrastructure management has become complicated and introduced many risks.
  2. Self-service Technology – Since IT became a department, it has been overworked. Work-groups (inside and outside IT) got tired of waiting and needed “IT on demand.” When the demand for infrastructure outpaced the ability for IT to deliver, people found answers by putting a server underneath someone’s desk to “serve themselves” or by going to an external service provider. With this trend, compliance, risk, and security have had a hard time keeping up.
  3. Cost Savings from Virtualization – Virtualization has cut billions of dollars of costs from IT and has billions to go as more workloads get virtualized. Ironically, companies are seeing up to 40-50% cost reduction in infrastructure budgets, while database budgets continue to increase.
  4. Data-driven Business Decisions – Every workgroup and department is using applications to improve business operations and companies want to better understand customer usage of the internet and apps.  As we use data more to power our businesses through analytics, “real production data” becomes more and more important.
  5. Cost-Effectively Scaling the Data Layer – While people are using applications and data more than ever, the traditional database/infrastructure model has been expensive to scale at an enterprise level of SLAs. For example, growth in data often leads to new and expensive orders for both hardware and software, and there is too much expense and complexity to make Tier 2 databases highly available.

Healthcare IT professionals no doubt are feeling the pinch and seeking alternatives. For them, Peak 10 has Peak 10 SQL as a Service (SQLaaS), a high availability, secure DBaaS solution. Powered by Microsoft SQL Server 2012, it provides access to a high-performance managed database environment for running, developing and testing Microsoft SQL-dependent database applications.

Alleviating scalability concerns, resource levels can be quickly and cost-effectively scaled based on business needs, without interrupting operations ― all while providing availability guarantees, performance assurances, and reduced costs compared to dedicated database environments. No capital investment is required. Simply purchase the compute and storage you need, as you need it, within an audit-ready HIPAA/HITECH compliant infrastructure.


(1) VMware vFabric Blog, “Why DBaaS? 5 Trends Pushing Database as a Service,” August 24, 2012

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Board Member, Peak 10 + ViaWest