Healthcare Provider

Healthcare: Optimization project saves over $600k for US market leader


A large US not-for-profit Healthcare Provider with dozens of hospitals, hundreds of patient care sites, more than 5,000 physicians and nearly 50,000 employees.  With a distributed, complex and demanding IT landscape, there was a strong suspicion that the Healthcare Provider’s SQL server estate was far from optimized, with SQL licenses under-deployed, resources not optimally allocated and databases not used to their full potential. The challenge was to ensure that the Healthcare Provider was maximizing the benefits and savings of Software Assurance, driving greater value to the organization and its patients.


Livingstone’s Contribution

With deep SQL licensing expertise garnered from hundreds of SAM engagements globally, Livingstone’s SAM services were able to quickly identify the current situation and Effective Licensing Position (ELP), providing the Healthcare Provider with clear and compelling advice on SQL consolidation, redeployment and optimization to drive significant cost savings.

Using inventory data from our discovery solution as the baseline, Livingstone’s Microsoft licensing specialists were able to interrogate the database editions, hardware attributes and resource utilization. This was then reconciled against the Microsoft agreements and licensing conditions to identify areas of risk or over-spend.

Ultimately, Livingstone presented recommendations that would save the Healthcare Provider hundreds of thousands of dollars in SQL licensing costs alone. The insights provided by Livingstone have given the IT Operations Team the confidence to engage with Microsoft in a more robust way and Livingstone has now been engaged to deliver a continuous SAM program to help the organization implement license optimization for other Microsoft products as well as additional vendors’ software across its server and desktop estates.


Business Benefits & ROI

Central to the Healthcare Provider’s medical services, like any modern business today, is its reliance on technology to provide best-in-class medical services and facilities. It’s not just the devices used to deliver care, the technology supporting the sweeping changes in healthcare management is equally dramatic – from medical records for its six million annual patient encounters to robotic surgery and remote monitoring.  Key client benefits included...

  • Hundreds of thousands of dollars savings on Microsoft SQL licenses
  • Cost-effective provisioning of SQL licenses
  • Downgrading of SQL licenses from Enterprise to cheaper Standard edition.


Without specialist SAM resources within the organization, the medical provider initially chose to work with Livingstone to get a handle on its SQL licensing and look for areas of optimization and potential savings – it needed experts with deep SQL knowledge to unearth the required data.

Livingstone’s SAM experts focused the scope of the optimization assessment by first looking at the Healthcare Provider’s deployment and consumption of SQL databases. From there it undertook an exercise to see where servers – physical and virtual – could be optimized through consolidation and whether some Enterprise Edition license types could be swapped out for Standard ones.

The Livingstone SAM team was able to quickly create a baseline, thanks in part to inventory information provided by our discovery solution. Our Chief Technology Officer is quoted as saying, “Once we had the baseline, we looked at everywhere that the organization had deployed a copy of SQL with less than four cores. We identified that 230 cores were being paid for but were unused, and based on this under-deployment, we could see that nearly $100,000 annually was being spent on Software Assurance associated with licenses not in use.”

The Livingstone SAM team then turned its attention to virtualization consolidation and identified domains and clusters where VM sprawl could be consolidated, further reducing the required license count for both SQL Server Enterprise and SQL Server Standard with potential savings of more than $250,000.

Our SAM team unearthed even more consolidation opportunities by looking at the utilization across CPU memory and storage. With deeper investigation to ensure that these servers are not using features such as High Availability, Machine Learning or Power BI, the medical organization was able to consider reducing 512 cores to Standard from Enterprise Edition and realize further savings of over $330,000 (with even greater savings possible when factoring-in optimized hardware allocation). Even if the organization chose to only downgrade 75% of these cores, savings could be over $250,000.

With insight from Livingstone the healthcare provider identified potential savings of more than $600,000. Some of these savings can be realized immediately, such as reduced Software Assurance on unused servers or consolidated SQL on primary clusters and some will take a little longer as the organization develops a plan to downgrade some servers from Enterprise to Standard Edition.

Going forwards, Livingstone will continue to help the organization in its software optimization efforts, by providing the SAM skills and resources critical to realizing tangible cost savings, risk mitigation and entitlement optimization.

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