Legacy Health breaks new ground in healthcare IT

Legacy Health is a nonprofit, locally governed health system headquartered in Portland, Oregon, comprising six hospitals and 70+ clinics serving the Portland/Vancouver metro area. Across its network, Legacy Health delivers comprehensive care, from wellness and primary/urgent care to advanced specialty services and behavioral health, all focused on improving community health across the region.

Legacy Health is Oregon's largest private nonprofit health operation, managing eight hospitals and more than 70 clinic locations throughout the Portland area. Serving 1.5 million patients annually, Legacy Health includes specialty centers such as a children's hospital and the Unity Center for Behavioral Health. As a mission-driven organization focused on delivering world-class care, Legacy Health balances the dual challenge of providing excellent patient outcomes while operating on constrained nonprofit budgets.

For Marc Heynderickx, Principal Engineer at Legacy Health, 2023 brought an unexpected infrastructure crisis. The company’s Epic electronic health record (EHR) system was running on Microsoft Hyper-V, making them one of only two Epic customers using that platform. When Epic removed Hyper-V as a supported target, they faced an urgent need to re-platform their most critical application.

"Our data is the foundation for so many parts of our environment, from our electronic health records that our physicians and clinicians work with every day to our PACS imaging for our MRI, CTs, X-rays," says Heynderickx. "Seconds matter in certain situations. Having a performance system in the back end to ensure that's the last thing they think about is really important to us."

Legacy Health’s existing three-tier infrastructure consisting of Cisco UCS, MDS, and Pure Storage had reached end of life. The natural choice seemed to be VMware ESXi, Epic's recommended platform. However, challenges arose, and after missing critical go-live dates, the team had to look in a new direction.

Heynderickx and his team worked with Epic, Pure Storage, and Nutanix to explore something entirely new: running Epic directly from Nutanix virtual machines to Pure Storage using NVMe over TCP. This approach had never been tried in production for Epic workloads.

"This was a theory at best when we started," says Heynderickx. Working closely with the Pure Storage engineering team, the company refined the design until they achieved performance within 5% of Pure Storage internal testing capabilities. Ultimately, they were successful.

In March 2024, Legacy Health became the first Epic customer in production to run their operational database on Pure Storage with Nutanix as the hypervisor, utilizing NVMe over TCP connectivity. The FlashArray//XL™ platform provides the high-performance foundation for Epic while integrating seamlessly with their hyperconverged infrastructure.

"Our infrastructure went from being quicksand, where you never knew which step would lead you down that rabbit hole, to finally made of cement," explains Heynderickx. "Nowadays, our infrastructure is rock solid thanks to Pure Storage."

The transformation extends beyond just reliability. Pure Storage platform represents a fundamental shift from traditional infrastructure management to a data-centric approach that spans on-premises and cloud environments. Legacy Health now benefits from a unified data plane that breaks down silos, intelligent automation that reduces operational complexity, and self-service capabilities that align perfectly with their need to "do more with less" as a nonprofit organization.

Most critically for healthcare operations, their infrastructure enables zero-downtime upgrades and continuous platform evolution. "We're now on a seamless platform where we can change our hardware and just migrate workloads around," explains Hendricks.

The infrastructure modernization directly impacts patient care. Clinical teams now enjoy instant access to Epic data during critical moments like emergency triage, where every second counts. "There's less disruptions, there's less downtimes. It's just a better experience overall," notes Heynderickx.

For the IT team, the Pure Storage Evergreen//Forever™ subscription represents a paradigm shift from disruptive, risky infrastructure upgrades to continuous, nondisruptive platform evolution. In healthcare, where systems must run 24/7 to support patient care, this capability is transformational.

"If I can never do another on-top upgrade again, I'll be happy," says Heynderickx. "With Evergreen//Forever, we get seamless hardware and software upgrades that can be done nondisruptively, without forklift upgrades. That means we can focus on innovation instead of planning for constant disruptions to our clinical teams."

The solution also strengthens the team’s cybersecurity posture, critical for protecting patient data. "Knowing that we're working with Pure really helps my leadership and myself sleep better at night," adds Heynderickx.

Legacy Health’s success represents more than a technical achievement. At a time when healthcare organizations face mounting financial pressures, particularly rural hospitals struggling with rising infrastructure costs, the company has created a reproducible model for modernization.

"To be able to partner with Pure Storage, with Nutanix, with Epic, and put together a platform that is now repeatable for these customers looking for a solution has been a fantastic journey."

The organization has plans to expand their use of Pure Storage technologies, including Pure Storage Cloud for their Microsoft Azure workloads, to reduce cloud costs through compression and deduplication while maintaining the same data management experience across hybrid environments.

 Their pioneering approach demonstrates how healthcare organizations can embrace innovation while maintaining the stability and security that patient care demands.

"Making sure that foundation is as solid and as secure as you can make it is what's key to us right now,” says Heynderickx. “Pure Storage enables us to do exactly that."