Case Study - PrecisionCare

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Overview:

PrecisionCare is a healthcare provider specializing in precision medicine with offices across the United States. The company has a main office in New York and three regional offices in Chicago, Los Angeles, and Miami.

Existing Environment:

Active Directory Environment

The network contains two Active Directory forests named corp.precisioncare.com and rd.precisioncare.com. There are no trust relationships between the forests.

• corp.precisioncare.com: A production forest that contains identities used for internal user and computer authentication.
• rd.precisioncare.com: Used exclusively by the R&D department, which is restricted to on-premises resources.

Network Infrastructure:

Each office contains at least one domain controller from the corp.precisioncare.com domain. The New York office contains all the domain controllers for the rd.precisioncare.com forest. All offices have high-speed internet connections.

An existing patient management system (PMS) named HealthApp1 is hosted in the data center of the New York office. HealthApp1 manages patient data, appointments, and treatment plans. It has a web tier that uses Microsoft Internet Information Services (IIS) and a database tier that runs Microsoft SQL Server 2016. Both tiers are deployed on virtual machines hosted on Hyper-V. The IT department uses a separate Hyper-V environment to test updates to HealthApp1.

PrecisionCare purchases all Microsoft licenses through a Microsoft Enterprise Agreement with Software Assurance.

Problem Statements:

The use of HealthApp1 is unpredictable. During peak periods, users experience delays, while resources are often underutilized at other times.

Requirements: Planned Changes

PrecisionCare plans to move most of its production workloads to Azure in the coming years, including virtual machines that rely on Active Directory for authentication. As a priority project, the company aims to establish a hybrid identity model to support an upcoming Microsoft 365 deployment. All R&D operations will remain on-premises.

PrecisionCare plans to migrate both the production and test instances of HealthApp1 to Azure.

Requirements: Technical

PrecisionCare has identified the following technical requirements:

• Website content for HealthApp1 must be easily updated from a single point.
• User input must be minimized when provisioning new instances of the web app.
• Existing on-premises licenses must be used whenever possible to reduce costs.
• Users must authenticate using their corp.precisioncare.com UPN identity.
• All new deployments to Azure must be redundant to ensure availability in case of an Azure region failure.
• Deployments must use Azure's Standard pricing tier when possible.
• IT Support (email distribution group) must be notified of any issues related to directory synchronization services.
• In the event of a failure in the connection between Azure and the on-premises network, Azure-hosted virtual machines must still authenticate with Active Directory.
• Directory synchronization between Azure Active Directory and corp.precisioncare.com must not be interrupted if the connection between Azure and the on-premises network fails.

Requirements: Database

PrecisionCare identified the following database requirements:

• Database metrics for HealthApp1's production instance must be available for analysis, so database administrators can optimize performance.
• Database downtime during migration should be minimized to prevent disruption of patient access.
• Database backups must be retained for seven years to meet compliance requirements.

Requirements: Security

PrecisionCare has identified the following security requirements:

• Company information, including policies, templates, and data, must be inaccessible to anyone outside the company.
• Users on the on-premises network must be able to authenticate to corp.precisioncare.com if an internet connection fails.
• Administrators must be able to authenticate to the Azure portal using their corp.precisioncare.com credentials.
• All administrative access to the Azure portal must require multi-factor authentication (MFA).
• Testing of HealthApp1 updates must not be visible to anyone outside the company.