Cerner Boosts Performance and Stability of Mission-critical Applications with Red Hat Enterprise Linux

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May 5, 2014

Cerner Corporation looked to standardize the application hosting environment for its Cerner Millennium® application suite. It migrated the database and application tier of Cerner Millennium to Red Hat® Enterprise Linux® running on HP ProLiant servers, producing a more stable and available system.

Customer: Cerner

“Going forward, we want to use Red Hat Enterprise Linux everywhere we can, everywhere it applies, every time it’s a viable option.” - Tim Erdel, senior director, technology services, Cerner

Geography: North America
Country: United States

Business Challenge:

Cerner Corporation looked to standardize the application hosting environment for its Cerner Millennium® application suite, focusing on stability, performance, and cost.


HP ProLiant DL servers


After migrating to Red Hat Enterprise Linux on Intel-based HP servers, Cerner immediately saw improvements in the uptime, stability, and performance of the Millennium suite.


Founded in 1979, Cerner Corporation is an international healthcare information technology company that provides systems for hospitals and other medical organizations to manage and integrate electronic medical records, computerized physician order entry (CPOE), and financial information. Its systems are licensed by more than 14,000 facilities around the world, including more than 3,000 hospitals, 1,790 pharmacies, and 4,900 physician practices that represent more than 30,000 physicians. The company’s Cerner Millennium platform combines clinical, financial, and administrative information management applications, including tools for managing electronic medical records, patient care, and health information access. CernerWorks is the hosting arm of Cerner and lets clients outsource hosting of their Cerner applications. The firm has more than 14,000 employees around the world.

Business Challenge:

Building a better IT environment on Red Hat Enterprise Linux

Cerner is continually evaluating the technology used to deliver its application hosting services, with the goal of achieving new levels of stability and performance for its clients and end users. In the mid-2000s, Cerner’s primary database vendor, Oracle, began pushing the firm to migrate the database tier of its flagship Cerner Millennium application suite from UNIX running on proprietary HP and IBM systems to Red Hat Enterprise Linux running on Intel x86-based servers. Cerner had already been evaluating the use of Linux to improve the uptime and stability of the Cerner Millennium suite, so the suggestion from Oracle proved timely.

“Oracle convinced us that, as Linux was its primary development platform, we’d get better performance and stability moving to that environment,” said Tim Erdel, senior director, technology services, Cerner.

The Cerner Millennium architecture is the healthcare industry’s first patient-centric integrated architecture. It gives caregivers and supporting personnel the ability to view lab results, medical problems, diagnoses, medications, and other pertinent information about a patient in real time.

Cerner Millennium applications use an Oracle database and common data model that promotes data sharing between applications and eliminates redundant data. The Cerner Millennium suite runs on a variety of networks, processors, and operating systems, and clients can either run it on their own IT infrastructures, or contract it to CernerWorksSM, the company’s hosting arm. Approximately 70% of Cerner Millennium customers choose to host their Millennium application with CernerWorks.

Because the Millennium architecture design allowed the database tier to be abstracted from the application tier, Cerner was able to begin by migrating just the database tier over to a Red Hat-Intel architecture in 2006.

The healthcare data and applications hosted by Cerner are critical, and the scope of Cerner installation base is vast, so the migration represented a high-stakes endeavor. “If things didn’t go well, we’d certainly hear about it, as it would impact such a broad set of clients,” said Erdel. “We were definitely aware of the risks of this project, and made a significant investment in planning and testing to ensure we were successful.”


Promoted by Oracle, proven by experience

Oracle specifically recommended Red Hat Enterprise Linux as the best Linux distribution for running its products, but Cerner was already familiar with the software. Cerner’s Archived Multimedia Manager (CAMM), another client-facing application, has run on Linux since 2000.

“Although that application is limited in scope, relative to our Millennium platform, we’d had success with it,” said Erdel. “This made the migration decision in 2006 an easier one.”

For the hardware platform, Cerner chose HP ProLiant servers. “These were true enterprise-class servers that aligned with Red Hat Enterprise Linux to optimize performance of the database,” said Erdel.

The 2006 decision paved the way for another major architectural transformation that occurred two years later: Porting the entire Cerner Millennium suite of applications—not just the database — over to Red Hat Enterprise Linux.

“We were very pleased with the results of the database-tier migration,” said Erdel. “And so in 2008 we proceeded to move the application tier of our most important product over to Red Hat Enterprise Linux as well.”


Red Hat Enterprise Linux exceeds expectations for reliability, scalability, and agility

After migrating to Red Hat Enterprise Linux on Intel-based HP servers, Cerner immediately saw improvements in the uptime, stability, and performance of the Millennium suite.

“We were confident that performance and stability measures would improve as a result of the migration,” said Bill Graff, senior vice president, technology services, Cerner. “We also hoped that we could drive down the total cost of ownership (TCO) for our hosting services—and all of the above turned out to be true.”

Cerner’s primary motivation was not reducing the TCO of the system. “Our number one goal whenever we make an architectural change is to make sure our client systems are available with high levels of performance,” said Graff. “If we save money, that’s a great side benefit. It allows us to hold down the cost of our services over the long term for our clients. But cost savings is never our primary objective.”

The migrations were also highly successful from CernerWorks’ perspective. “We can say that our systems are high-performing and highly available to three nines [99.9% availability] and above,” said Kent Scheuler, SVP, CernerWorks. “We were pleased that we were able to do this by migrating to a lower-cost platform, as we got long-term savings as well as performance enhancements. And for our clients, the transition was seamless.”

Cerner was also pleased with the scalability of the Red Hat and Intel architecture. Cerner runs its own testing lab to determine performance benchmarks for technologies it is considering deploying. “We found that the combination of Red Hat Enterprise Linux and the Intel hardware architecture provided the same or better scalability than we could get with the proprietary UNIX platform,” said Erdel. Erdel expected some scalability issues when he tested the Intel-Red Hat platform. “But it was one-to-one or better. So far, we found no scalability or capacity limits whatsoever.”

“Every day our healthcare clients are consuming more information, storing more information, and using the Millennium system to generate more rich data around every patient they see,” said Scheuler. “It was critical to move to an architecture with higher availability and an equal, if not better, ability to scale for the sake of these clients. That we could do so at a lower price point and provide higher performance was very gratifying.”

Cerner is also more agile, especially at provisioning new servers to host Millennium clients. “The combination of Intel and Red Hat Enterprise Linux means we acquire and deploy servers to run our systems much more quickly than we could previously,” said Erdel.

Red Hat Enterprise Linux: Cerner's preferred operating system

The performance metrics and costs savings produced by Cerner’s implementation of Red Hat Enterprise Linux were so strong that it is now Erdel’s preferred platform. “Going forward, we want to use Red Hat Enterprise Linux everywhere we can, everywhere it applies, every time it’s a viable option,” he said.

Erdel is currently considering migrating other components of the Cerner technology stack to Red Hat Enterprise Linux, as well as evaluating other products in the Red Hat product portfolio. “When I see a service or capacity or performance limitation with another operating system, I immediately consider Red Hat Enterprise Linux,” he said. “We absolutely consider Red Hat a key strategic partner, and they have a number of other products we are interested in.”

Running Cerner’s most important product suite on Red Hat Enterprise Linux gives Cerner’s IT team members greater peace of mind. “Healthcare is a 24-hours-a-day, 365-days-a-year industry,” said Erdel. “It doesn’t stop on weekends or holidays. We don’t have maintenance windows where we get to take the system down. Stability is essential for us — and Red Hat Enterprise Linux provides that.”

Scheuler agrees: “Our long-term success comes from selling and hosting our flagship product, Millennium, and it is imperative that we deliver ultra-high-performance levels. With Red Hat Enterprise Linux, we’re assured that we can.”

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