When Amazon Internet Providers’ US-EAST-1 area skilled a multi-hour outage on October 20, 2025, a lot of the general public consideration centered on the patron influence. Greater than a thousand web sites and purposes spanning social media, banking, authorities companies, video conferencing, and schooling noticed disruptions as after an inside system failure at AWS triggered a series response that affected a whole bunch of fashionable purposes and on-line companies. Restoration was uneven, and a few purposes remained impaired lengthy after AWS initiated mitigation steps.
For healthcare leaders, the story was completely different. Outages of this scale are reminders that cloud infrastructure has turn out to be a part of the operational core of contemporary healthcare. And since so many scientific and administrative methods are actually hosted on or not directly depending on hyperscale cloud platforms, even a non-security incident can rapidly translate into delays, inefficiencies, and elevated operational pressure.
In at this time’s healthcare setting, cloud companies stay foundational to innovation, affordability, and scalability. However the AWS outage made clear that the sector has not absolutely accounted for the blast radius created when a extremely centralized cloud structure meets a extremely interconnected healthcare setting.
The query is now not whether or not the cloud is dependable sufficient for healthcare. It’s whether or not healthcare organizations are architected to stay dependable when a significant cloud supplier experiences a sudden, widespread failure.
What really occurred and why the influence was so broad
The October 20 outage originated inside Amazon’s U.S. East cloud area which is without doubt one of the busiest cloud hubs on the planet. A core inside system failed, and since so many companies depend on that system to function, the disruption unfold rapidly throughout main purposes and instruments.
Even organizations that weren’t immediately utilizing the affected service nonetheless felt the consequences as a result of their purposes trusted different cloud features that slowed down or stalled. In different phrases, a single failure level created a series response throughout a big portion of the cloud ecosystem.
What’s vital for healthcare leaders to grasp is nothing in regards to the incident was malicious. It was a routine know-how failure inside a extremely mature cloud setting. However the breadth of the disruption confirmed how dependent the world (not simply healthcare) is on a small variety of cloud areas working flawlessly.
This wasn’t a cybersecurity occasion, but it nonetheless created significant operational influence. That’s the core problem healthcare should confront.
Healthcare felt the influence even with out a catastrophic failure
A number of healthcare organizations publicly reported results from the outage. These weren’t all headline-grabbing occasions, however they have been operationally significant.
Within the U.Okay., at the very least ten NHS websites utilizing Oracle methods hosted on AWS entered downtime eventualities. Trusts briefly reverted to paper workflows, and digital well being leaders described the incident as disruptive to affected person care throughout a number of places.
In the USA, Tufts Medication reported system slowdowns and delays in processing lab outcomes, noting that scientific care continued however workflows have been impacted.
And in New York, Westchester Medical Middle communicated that its doctor follow name middle and scheduling methods have been taken offline as a result of world AWS outage.
These examples share a sample: outages that didn’t rise to the extent of disaster nonetheless created operational friction. A delayed lab outcome will not be a life-threatening occasion, and a name middle outage might not halt care supply. However every one represents misplaced productiveness, slower throughput, schedule disruption, and elevated administrative burden.
In an trade already working with tight margins and workforce shortages, even quick intervals of cloud-related downtime can turn out to be pricey.
The hidden dependencies executives can’t afford to disregard
What the AWS outage demonstrated is that healthcare organizations are extra depending on underlying cloud infrastructure than many notice. This dependency isn’t simply in regards to the methods they explicitly migrate to cloud platforms. It consists of:
1. Third-party SaaS suppliers
Many scientific and administrative instruments run on cloud infrastructure with out the shopper ever seeing that dependency. A single area’s degradation can influence purposes that hospitals assume are geographically redundant.
2. Legacy purposes refactored “simply sufficient” to run within the cloud
Purposes lifted into the cloud with out architectural modernization typically stay tightly coupled to a single area or availability zone.
3. Area monoculture
For causes of comfort, value, and historic defaults, many healthcare workloads (each direct and inherited) run in US-EAST-1. The outage uncovered how concentrated the trade’s cloud footprint has turn out to be.
4. Restricted visibility into cloud structure
Executives and even safety groups steadily can’t see:
- which property are uncovered externally,
- how identities and permissions are structured,
- the place misconfigurations create pointless threat,
- or how dependencies chain throughout cloud companies.
This isn’t an indictment of cloud know-how. It’s an acknowledgment that healthcare’s fast cloud adoption typically outpaced cloud governance.
The enterprise value of cloud fragility
Downtime in healthcare not often reveals up as a single main quantity on a monetary assertion. It accumulates in smaller, harder-to-track methods:
- A morning of delayed lab outcomes can ripple into slower discharge occasions.
- An offline scheduling system can create appointment backlogs that take days to clear.
- Handbook workarounds improve labor hours.
- Interruptions to revenue-cycle instruments delay claims and fee cycles.
- IT groups are diverted to troubleshooting as a substitute of strategic work.
Analysts estimate the worldwide direct enterprise influence of the AWS outage within the a whole bunch of thousands and thousands of {dollars}. Healthcare’s share of that’s troublesome to quantify, however the operational results are plain.
When an outage in a cloud area 1000’s of miles away impacts scheduling, lab workflows, or entry to affected person portals, it raises an vital set of questions for healthcare boards and executives:
- The place are our single factors of failure?
- How resilient are the cloud companies our distributors rely on?
- How rapidly can we detect and reply to misconfigurations or outages?
- Do we now have the visibility to grasp our cloud footprint in actual time?
These are governance questions as a lot as technical ones.
The place healthcare leaders go from right here
No cloud structure can eradicate outages fully. The objective for healthcare organizations must be to scale back blast radius, enhance visibility, and construct operational resilience.
1. Enhance architectural resilience
Healthcare methods ought to overview whether or not mission-critical workloads depend on a single area or availability zone. Multi-region replication, improved failover design, and vendor transparency are all a part of decreasing dependency threat.
2. Modernize cloud governance
Cloud environments evolve rapidly. New companies get deployed, identities proliferate, and configurations drift over time. With out steady monitoring and robust controls, organizations can’t successfully handle cloud threat.
3. Undertake Cloud Safety Posture Administration (CSPM)
CSPM options present visibility into cloud property, configuration drift, id constructions, region-level dependencies, and potential publicity factors. They function an early warning system and a governance instrument for management, not only a safety product.
4. Replace downtime and continuity planning for cloud realities
Most healthcare organizations have sturdy plans for ransomware or EHR downtime. Fewer have plans for cloud service degradation, API failures, or third-party SaaS outages. The AWS incident demonstrated that these eventualities are actually a part of regular working threat.
A extra reasonable framework for cloud resilience
The AWS outage didn’t break healthcare, and it didn’t signify a systemic failure. Nevertheless it was a well timed reminder that cloud resilience is just not merely a technical concern. It’s a management duty tied on to operational stability, monetary efficiency, and the continuity of care.
Cloud adoption will proceed, and it ought to. However as extra of the healthcare ecosystem relies on large-scale cloud suppliers, govt groups should guarantee they’ve the visibility, governance, and architectural resilience to resist the subsequent unplanned disruption whether or not it lasts minutes or hours.
The objective is to not predict each outage. It’s to construct an setting the place an outage in a distant cloud area doesn’t have an outsized operational influence on hospitals and the communities they serve.
Picture: shylendrahoode, Getty Pictures
Baxter Lee is President of Clearwater. He was promoted to President in September 2025 after serving as Clearwater CFO starting in Might 2018. Mr. Lee is accountable for main the corporate’s strategic progress plan and managing the corporate’s total operations.
Previously, Mr. Lee was CFO of Entrada Well being, a cell well being documentation and productiveness platform for healthcare suppliers, acquired by NexGen Healthcare (NASDAQ: NXGN) in 2017. Earlier than his position with Entrada, Lee held a number of positions with Change Healthcare (fka Emdeon), a multi-billion greenback healthcare IT firm. His roles included divisional CFO of the Ambulatory and Payer Providers divisions and director of company improvement. He centered on mergers, acquisitions, and company technique throughout Emdeon’s 4 working divisions. Previous to becoming a member of Emdeon, Mr. Lee was an affiliate within the Non-public Fairness Group at Harbert Administration Company and assistant vice chairman of underwriting within the Healthcare Finance Group at Merrill Lynch Capital.
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