Konica Minolta's progress to Postgres - curing the healthcare sector's database dependency on Microsoft?

Profile picture for user slauchlan By Stuart Lauchlan July 7, 2020
Summary:
Konica Minolta moved from Microsoft to open source Postgres to underpin its radiography platform, a shift that saw the provider need to convince customers it was a sound one.

Konica Minolta Healthcare
(Konica Minolta Healthcare)

The platform that we're running on today is really kind of ‘sky's the limit’ for us.

A bold statement of confidence from Adam Bunch, Director of Engineering & Architecture, Konica Minolta Healthcare, regarding his organization’s decision to bet the business on the Postgres open source database. The choice of platform may surprise many in the healthcare industry where Microsoft remains a popular enterprise choice, but Konica Minolta’s path to Postgres has been successful for the company, according to Bunch: 

it's an exciting time for us to scale and change as the industry changes. As we're seeing today with all the changes in the way we work and how COVID has changed the industry as a whole, healthcare is adapting with it. But we all know healthcare is the one tech sector that is always a few steps behind everybody else. With the platform we have, we're uniquely positioned to stay in lockstep with the rest of the tech industry.

Konica Minolta is the developer of a software platform that is used by radiologists, hospitals, healthcare providers and imaging clinics. The platform itself has been around in one version or another for almost two decades, but about five years ago a decision was taken to rebuild the entire thing from the ground up. One reason for this was a desire to break free of the constraints of Microsoft SQL Server, recalls Bunch: 

We settled on looking at an open source database for a number of reasons, one of those obviously being licence costs. Every customer that we have of any decent size eventually hit a limit with Microsoft SQL where they started paying way more for Microsoft SQL than they were paying for our software. That became problematic for everybody. On top of that, we saw scaling issues with Microsoft SQL. So, when we started to rebuild the platform we looked at all the different places from an open source perspective that would make sense for moving from a Microsoft SQL relational database platform to an open source one.

In the end, the software choice came down to Postgres, he says:

We chose Postgres because just from a performance perspective it seemed to scale better than anything else that we were looking at. So we we settled on that platform. It was kind of an easy choice for us, it made sense at the time. It was something that our customers didn't really see initially when we started moving them to this new platform. A lot of this is in the background. A lot of these customers that had been with us forever didn't really look at what was under the covers.

So, we were moving them to a new platform that had a lot of open source components from a platform that didn't. But at the end of the day, they were upgrading to a platform that was much better than the platform they had before.

Convincing customers

This was a big shift for Konica Minolta to execute, admits Bunch:

It took a lot of dev time, it took a lot of manpower and took a lot of work to get us to shift our entire thinking from a sort of in-the-box, vendor-centric platform to an open source platform and a number of open source technologies used to create what we needed.

But while his company was confident that they’d made the right choice, some nervousness was encountered among the customer base. The nature of the healthcare sector is such that 24/7 availability and reliability are critical requirements and there was a  prevailing sense of ‘you don’t get sacked for buying from Microsoft’ syndrome among decision-makers. Bunch says: 

As we started to go up market and reach out to larger and larger entities, we started to talk to these customers about what was under the covers. All of these large healthcare systems, hospitals, imaging centers, they all have IT shops and all these IT shops, or the majority of them, are filled with Microsoft people who are familiar with the Microsoft platforms. They're running a lot of these Microsoft platforms in use today.

When they started asking about the platform was run on and what technologies are behind this platform, as we started to talk to them about Postgres, a lot of them were very worried about what that meant for running this in their environment…’If I have a problem with the database, I don't have Microsoft to call and get answers. I don't have a Postgres DBA that can manage this database. I don't know anything about Postgres, I don't know anything about open source'. It created a lot of confusion for them and a lot of heartache.

Such concerns meant that there was a sales job to do in convincing customers that there was no reason to worry and that as the platform provider, Konica Minolta would be taking care of everything: 

If you have an issue with our platform, you call us, we're managing everything, including the database. We're going to do the database maintenance for you. We're going to automate that database maintenance, so you don't have to worry about it. We're going to manage your database back-ups. You don't have to worry about having a database administrator managing your back-ups, putting those back-ups somewhere. We'll handle all of that for you.

Security was inevitably another common concern among the client base, again a conversation that needed to be had, says Bunch: 

A lot of times a customer would say, 'Well it's open source, how do I know it's going to be secure? How can I tell my CIO or my CISO that the data in this platform is secure and safe?’. With patient data, that's kind of objective number one for most IT departments -  making sure that the patient data is safe and secure on whatever platforms they put it on. That conversation has always been an easy one for us. We're managing the platform for them, so we know that we're going to patch the system when there's a security vulnerability that's out there. We also tell them that in the majority of cases the open source community patches vulnerabilities faster than any of the major vendors. So we know we can get those patches into the hands and onto the systems of our customers much faster on an open source platform than you can with any other.

And there was always a chance to ‘talk to the wallet’ with a budget-friendly angle: 

It also eased the minds of those in charge, knowing that there wasn't some looming licensing fee in the next year or two years that they were going to have to pay when they scale the platform. A lot of these customers are seeing maybe 100,000 patients, but they intend to grow, intend to acquire other imaging centers, other hospital systems, and they want to maybe double or triple their volume in the next few years. [Licensing’s] always a concern for them. They don't want to worry about, 'In two years do I have to pay Microsoft or some other vendor a large chunk of money just to keep operating the platform?’.

Skilling up 

For its part, in order to deliver on these promises, Konica Minolta needed to beef up its own back-room team. Bunch says: 

I started to run into the issue of having the problem of headcount. I've got all these customers out there, I'm automating a lot of the processes that we manage for our customers, but from a database perspective, I didn't have any DBAs when we started building out this platform. The DBAs we did have were in R&D. I had Microsoft SQL people on my team but I didn't have any Postgres DBAs. That started to become a problem. If we ran into issues with Postgres, I had to escalate them to R&D all the time. So that became very quickly a bottleneck for me and for my customers.

The search was on for Postgres expertise, which initially turned out not to be as straightforward as hoped, with Bunch struggling to find people who wanted to change job or relocate. The solution came in the shape of EDB (formerly EnterpriseDB) and its RDBA (Remote DBA)  offering:

For  less than the cost of two DBAs, I brought on a team of 24/7 experts from EDB to manage all of our customer data. Overnight I went from having a bottleneck to having more people than I had time to give work to. Being experts in the field, being 24/7, I didn't have to go out and hire a number of DBAs that I would have to have on my team and have them rotate on call or have them work different shifts. I now have a team that is 24/7 and works on my entire customer base whenever I needed it.

He adds: 

I've got three or four groups of engineers that I manage and now the RDBA team is just another team of engineers that I work with. They are now just an extension of us and our customers, in most cases, aren't even clued into the fact that our DBAs are not ‘ours’. They belong to EDB, but they work so well with us that we don't have to worry about any delay or any stoppage in work. They are monitoring our customers for us, they’re patching our customers for us, they’re maintaining our customers and oftentimes they know if our customers have a problem before the rest of my team.

All of which frees up Bunch and his team to do other things than keeping the database up and running and the same is true of IT people at client organizations, he says: 

A lot of IT people, especially in these large hospital systems, will say, 'If I'm not managing this platform, then what am I doing?'. I say, 'I'm sure you have a lot of other things to be worried about and concerned about…Let us take that burden off of you’.

And customers themselves often replicate Konica Minolta’s move away from Microsoft, he says:

Most of our customers are Microsoft SQL shops. Even our really large customers have a data warehouse built on Microsoft SQL…The conversation is usually, 'How do I get [my data] out of Postgres into Microsoft SQL, so that we can use our current data warehouse?'. But after a while that conversation usually turns around to 'How do I build a data warehouse that Postgres that's going to meet all the needs of the organization and essentially replace the SQL data warehouse that we have today?’. We've had that happen in a number of cases, that our customers have worked very closely with EDB, even outside of our relationship, to build those data warehouses and in turn, end up using EDB for support for their other platforms as well.