Cloud Migration

The Case of the New Clinic


A large agency with multiple clinics just got larger. With a tight budget, they need to integrate a new clinical site with over a hundred staff along with a totally foreign infrastructure . The biggest trouble? They have never had a standardized infrastructure of their own.


Migrate four clinics with over five hundred employees from a makeshift infrastructure to a standardized cloud based one. Shift from substandard email and improvised productivity suite to GSuite. Create a standard Active Directory domain in the AWS cloud and incorporate the foreign infrastructure. Save the day, and the total cost? Barely a blip on the chart of accounts.

The Details

This project came about when one of our clients acquired a new clinic, complete with some one hundred new staff, foreign infrastructure, and a productivity suite that was totally outside the client’s budget.

It became immediately apparent that the client’s existing email system, a third party product that was inherited from long ago, was completely inadequate for the task of accepting the new users. The client admins couldn’t reliably close out old accounts, let alone provision and propagate the new ones.

To compound the problem, the client had no standardized productivity suite, instead relying on a mash of personal and individually purchased licenses.

As we dug in, we found something far more startling. This client, although operating multiple clinics across a large metro area, had no standardized domain. Each computer, of which there were easily over 150, was operating at the mercy of the individual user. This meant that the already thin IT staff was completely overwhelmed by the task of implementing even basic maintenance functions.

So, with a new clinic, a new client pool, a new cadre of staff, a totally incompatible foreign infrastructure, and a non-existent native infrastructure, we got the call.

Our Solution


Much like clinical work, it is rarely the presenting problem the client brings to us which we end up fixing. In this case, the client felt that the solution was as simple as adding users into their existing system. As we investigates, however, we found a far deeper problem. The total lack of infrastructure present before the acquisition became glaringly clear in the presence of this new workload.

Our client also had some unusual operating constraints. The first was that any infrastructure upgrade could not disrupt the existing clinics. The second was that with the new acquisition, funds were incredibly tight. Our solution would need to cost next to nothing.

Given the overworked IT staff, and the lack of available infrastructure, we elected to launch our solution in the cloud.

For our infrastructure, we decided on an Active Directory domain hosted on AWS by Amazon. AWS will cover the licensing costs of most servers launched in their cloud, making this a very cost efficient solution. We purchased two reserved instances and created the domain, linking the clinics together with VPN tunnels.

For productivity and email, we were torn between hosting a solution for the client and finding a cloud provider. In the end, we elected for the third party. This would allow the client to operate without our support, and would make them more resilient to staff changes in their IT unit.

We ended up selecting GSuite through Google for this. Most users were already familiar with GMail, meaning the transition would be easy. Additionally, the productivity suite provided would immediately resolve the mess of licenses. We set them up, provisioned the users, and deployed the changes.

In the end, the clinic acquisition went beautifully, staff greatly enjoyed the improved email experience, and the IT staff were delighted in the new domain. And for the final flourish, when we migrated them to GSuite, we identified a host of old accounts that were no longer needed, meaning their budget barely noticed the change.

About the author: Jeff Cubeta