Sentara Healthcare's Princess Anne Hospital Sentara Healthcare, a health system based in Norfolk, Virginia, uses an Epic electronic health record that connects its 12 hospitals and various clinics on the same platform. This has enabled clinicians to access and exchange patient records more quickly. "Epic is presented to clinicians via a presentation layer, which is purely web-based and allows seamless integration with existing EHR products," explained Matthew Douglas, chief enterprise architect at Sentara Healthcare. "We previously deployed our presentation layer through Citrix XenApp, which had a physical infrastructure, making it hard to upgrade and maintain." THE PROBLEM The main challenges Sentara faced surrounded scale and cost. As Epic has increased the frequency of code releases, Sentara had to scale up and add more servers to continuously meet the Epic demand for capacity. From a financial perspective, the health system was not realizing any cost efficiency as the system scaled.