Deciding on the IT infrastructure and model for your medical practice can seem daunting and confusing to the best of us. Technology is changing at such a rapid pace it is hard for anyone to keep up. We also find ourselves in a new age where hosting or cloud services are proving popular over onsite or on-premises installations for many practices. These systems can provide a valuable service to your medical practice as it can elevate, some or all of the IT capital outlay, downtime and day to day maintenance from your practice. Many of these services will also automatically provide your compliance requirements for IT security and privacy.
This guide will help you understand what technologies are available, what are the pros and cons of each and how they compare in cost structure. This guide will also provide guidance dependant on your size, culture and geographical locations. I have omitted actual costings from the cons and pros charts below, because unless you are going to roll out an on-premises solution and try to keep that server running for a decade, most of the costs come out the same, the only difference is cost structure. Lets be clear, PIP will still support your 10 year old server, we do it everyday, but if that’s what your looking to do, this informational page is probably not for you.
As with everything and this includes medical practices, everyone is different and this guide is designed as primer just to get you thinking how your medical practice can leverage technology and resources to make it more efficient, compliant and profitable.
Also please note, many practices also use a combination of Private Cloud Hosting and Hybrid Cloud hosting, whereby management and doctors may go for a hybrid hosting setup and support staff utilise the complete cloud. This system allows management with the flexibility they require to fulfil there roles and at the same provides the efficiencies, security and hardware cost savings to support staff.
Private Medical Cloud Hosting
PIP has been providing world class private cloud server hosting to its clients for as long as businesses have had computers. This model takes complete advantage of a central location for your medical practices core business software needs. A private cloud server setup provides healthcare providers a complete turnkey IT infrastructure under the one central, secure system. This hosting solution is entirely configurable and lockable, to provide each staff member with the exact resources they need to facilitate efficiency and security. If your medical practice spans more than one office or has more than 5 employees this is the solution.
Under a private cloud system, we build an entire Microsoft Windows server network, dedicated to your medical practice. This IT system, includes Windows Domain Controllers, Fileservers and Microsoft SQL server for you very own, private backend IT system. This is identical to the system we may roll out for your on-premise or onsite setup. The only difference is that these servers are physically situated in one of are Australian Data Centres. Providing complete security, cooling and enterprise grade redundancies.
A private cloud server solution is the perfect hassle free medical hosting solution for health care practices with either more than 5 users or any organisation that has multiple practices, work from home or remote requirements. It provides 24×7 access and complete peace of mind of the security of patient information.
What are the redundancies ?
The redundances for our medical hosting servers is beyond an enterprise grade. All systems are doubled or tripled to ensure that your servers never stop to provide you with the ultimate in patient care. Every server has 6 to 8 networks, multiple replicated storage locations and seamless high availability so an entire server can fail and your clinical software will keep working. Power is supplied from two completely independent feeds and in case of total city cut of is then backed up by batteries and generators.
Cooling is supplied by two sperate cooling systems and every server, rack and isle is separately monitored and alarmed to provide active alarms in case of any rising heat.
Ultimately, your servers will be ruining, unhindered without any down time for as long as you need them to. Under this scenario, hardware failure, downtime and maintenance is not even considered.
How secure are my servers ?
Our data centres are located in Australia, in capital cities. They are unlabelled. concrete fortresses with high mesh/barbed fences. They have checkpoints, guard houses and mentored video surveillance. Security personal man them 24×7. Anyone that enters must have had a full background check and be an authorised personnel. Everyone that enters will be scanned and security checked. Hardware and other items must be introduced via a quarantined method.
Again, security is not an issue, no one is stealing, damaging or destroying your servers, software or sensitive data.
All client access is performed via secure links and two factor authentication to ensure the highest of security for all your systems.
Private Cloud Hosting Client Access
Separate to your back office servers we roll out a farm of Virtual Desktops for your clients to access. These are exactly what the label says, virtual or better still remote desktops. Each desktop is private and personal to each user just like the desktop on there office PC. The only difference with this desktop is it is stored in a central location that way every user can access this desktop from anywhere or with any device.
Typically a medical practice will allow the installation of, the Microsoft suite of software, either Microsoft Office or Microsoft 365 , your practice management software such as Best Practice, Audit 4, HCN, Medical Director or Genie, and your standard Email client and web browser. But of course you can install any software you like on all, some or one of the remote workstations.
Clients access their desktop from a simple icon, shortcut or in the case of your mobile device an App. After launching the connection the user will be required to enter their designated username and password credentials. Once successful, a multi factor authentication system will be enacted, typically an approval on the users mobile phone and the users desktop will open and replace the original desktop.
Many of our cloud users, utilise designated terminals to access our cloud, these devices are just large monitors with keyboard and mice, as soon as the switch on they prompt the user for their credentials and again after a two factor authentication they display the emote desktop as the only desktop on these devices. These devices are cheap and eliminate the need to purchase a separate Windows license for office desktops,
What about data security and permissions ?
A cloud platform provides you the most security for your medical business. Since the entire secure cloud hosting infrastructure and all your data is in the one system in the one location you have complete control over the security and access. You can control, when a user can access the system, how long they can access, where the can access from and exactly what thy have access to. You have complete granular control, right down to, whether they are allowed desktop wallpaper or your company logo is a permanent feature there. We also typically remove all access and menus items for things like the control panel, printer settings and all other non essential items.
Private Cloud Backups ?
Every private cloud server owned by your medical practice will be backed up its entirety every day. That means, all electronic patient records, emails or documents your practice owns will be backed up security everyday. We take full server backups everyday to ensure if you need anything restored from patient data to an entire server we can do it in minutes. Eliminating downtime for your practice, removing any anxieties and letting you get on with the job of running your practice. We can also retain backups for as long as you require, whether that be 7 days or 7 years, we have you covered.
Private Cloud Support ?
Our helpdesk is located in out head office in Sydney. It is manned by our friendly technicians, 24×7 to support your private cloud server day or night. All our helpful staff can remotely connect to either your servers or your remote device to quickly resolve your issue to enhance patient care . Typically under our medical clouds, your support requirements will be minimal.
Private Cloud Server Pros & Cons
| Private Cloud Pros | Private Cloud Cons |
|---|---|
| One monthly fee for your entire IT system | Is reliant on an Internet connection |
| Complete control over systems and staff members. | Not designed for heavy CAD, Graphic Design or Video Design desktop work. |
| A use anywhere, anytime on any device system, without needing software installs | |
| Enterprise security, privacy and infrastructure | |
| A complete security, governance and privacy package. |
Hybrid Hosting you Medical Software
Hybrid hosting is where we can utilise the advantages cloud computing but at the same time provides you with the flexible desktop experience your used to. This system is more tailored for medical professionals or specialists who keeps up to date with technology especially on their users desktop environments.
Under a hybrid solution we take advantage of PIPs private cloud servers, Microsoft Azure and the Microsoft 365 Suite all whilst still running your own, in house desktop infrastructure and local network as your core IT backbone. This approach provides complete software flexibility on a personalise platform all whilst removing the need for expensive computer hardware and servers on premise. This system will also remove the burden of supporting your backend IT systems and preforming those daily backups. It will however require some level of IT support as the majority of processing under this scenario will be met by the desktop PC’s.
How does Hybrid Hosting Work ?
Hybrid hosting works by taking he key core components of cloud services and adapting them to your private medical office network. The idea being that we want to eliminate all the headache, costs, security and skill set required to manage the backend systems, yet keep the functionality and flexibility of having everything severed to our modern desktop PC’s.
We achieve this by combining the PIP private cloud infrastructure and Microsoft’s Office 365 Suite of cloud services. PIP has been a partner of Microsoft’s since the 80’s and has seen the office suite of products evolve extensivity over this period. The migration of the Microsoft Office suite, has enabled us to create a Microsoft Domain Controller and Fileserver in a cloud environment for your medical staff. We then roll out a private medical data base server in the PIP private cloud that hosts your selected practice management software. Check out “What is Microsoft 365” for more details.
What does Hybrid private cloud hosting look like for end users ?
This is probably the best advantage of a hybrid cloud system. Your PC operates just like it would in a standard on-premises network, except there is a enterprise backend system doing all the heavy lifting for your practice management software and office suite. This medical hosting backend, ensures compliance, integrity and security for your core business. All the while, users have the advantage of using powerful, personalised desktops. Customised PC setups that seamlessly, runs their daily productive software, whilst still being able to install personal software, play games, watch TV or experiment with other applications.
What about data security and permissions ?
Just like the complete hosted scenario, security and permissions are completely controlled in one central location and can be altered on a per user / per group basis. Just like you would do for an on-premise installation. However since access is not cloud controlled, users cannot be as easily controlled on when. how and where they access company data. Their desktop or laptop is ultimately controlled by them and therefore it is a more mature workspace.
What about hybrid workspace backups ?
As in the hosted version, your medical practice software server and will be backed up in it entirety everyday. Combined with that, we also take a complete backup of your Microsoft 365 back office system daily and store this with your medical data. We also perform a complete backup of your Microsoft 365 files server data (SharePoint).
We typically don’t backup PCs under this hybrid cloud arrangement as it is expected all staff will save business data to one of the cloud systems. Of course, for software this is not possible or not wanted such as the companies books, we can easily also backup entire PCs to the PIP private cloud.
What IT support do I need for a Hybrid Cloud Setup ?
The support for this system is split three ways and each one can be handled separately depending on your practices IT skill sets.
The easiest one is your practice management software server that is being hosted in PIP’s private cloud, all support for this is covered in the hosting fee and you have complete support 24×7 for this system.
The Microsoft 365 system is typically supplied by PIP and any support lodged in the Microsoft 365 portal will be forwarded to PIP. If you require support and management for your Microsoft 365 system, PIP can provide wither a managed services agreement or on call ad-hoc support.
Onsite and desktop support. PIP can also provide both a managed support package or am ad-hoc support arrangement for your onsite work that also covers your PC, printers and scanners.
Hybrid Cloud Pros & Cons
| Hybrid Cloud Pros | Hybrid Cloud Cons |
|---|---|
| All applications are delivered to your personal desktop PC | Your PC hardware is the power house and needs to be kept up to date. |
| Access to your complete work environment from anywhere. | Your desktop, notebook or device must be setup, it is more than just an icon. |
| Enterprise security, privacy and backend infrastructure. | |
| A complete security, governance and privacy package. | |
Onsite or On-premises Medical Software Hosting
Microsoft is making it ever so much harder to own our own infrastructure and run our own software on our own system in house. Even so, PIP are dedicated to providing your medical practice with the solution you require. This unbiased advise will come from IT professionals that have decades of experience with all systems from small business through to the largest of enterprises and government departments.
An on-premises solution, provides a stable and enclosed solution. This system involves the practice purchasing their own server or many to preform the functions of the back office systems. As with t he above scenarios this server/s are utilised to perform core functions such as Windows Domain Controller, Windows File Server and a Practice Management Software database system.
This server/s are typically setup over a day or two by PIP technicians and installed in a secure location in one of your medical offices. Some focus needs to be considered as to the environment of these servers, as to cooling, security risk and noise. In larger practices an IT cupboard or “server room” is typically constructed.
This server farm acts as your backend hub for all client PCs or terminals to connect to. Just like the private cloud system above, many practices still utilise remote desktops to serve company applications to the staffs desktops. The only difference here is that the system is hosted in house instead of PIP’s datacentres. Although of course in many smaller, single clinic practices we may just install a single spruced up PC to act as a server for just a couple of users.
Depending on the level of outside engagement with cloud providers, an on-premises setup can create a heavy responsibility in todays requirements for security, backups and data privacy. PIP is of course here to help with every step to make these responsibilities as simple and as automated as they can be.
What about clinical data security and permissions ?
These factors rely heavily on the platform and design you utilise for your on-premises network systems. With an on-premisses setup we can design it to be the most secure and restricted system in the world or as simple and easy to manage as you want.
What are my options for on-premises automatic backups ?
Data loss and High Availability is always the hardest to manage with on-premises backup systems. Backups need to be done regularly and they must be taken off sight to eliminate the loss of patient data from physical theft. To achieve this you have three options, all are valid and all are used by our clients.
1. Typically using tapes or if size permits removable drives. Tapes or drives are rotated on a 5 day rotation and are either taken home or are picked up by a secure service. This method requires strict management and dedication to ensure devices are changed appropriately and checked regularly.
2. Medical practices with multiple practices, can preform nightly backups to their locations. The multiple locations just need to have secure servers or NAS’s where the data will be stored. These system must be tested at minimum monthly and a complete restore done at least yearly.
3, Utilise a cloud provider like PIP to perform nightly cloud backups. Although this one will cost a few dollars a month, this backup will ensure your electronic health records are stored safely and securely and provides peace of mind. Our staff monitor ever nights backup and alert you of any issues. PIP performs monthly random file restores and complete restores once per year.
Can PIP provide IT support for our onsite setup ?
Absolutely, PIP has been supporting medical IT systems onsite since the 80’s. We understand every business has its own IT requirements, cultures and experiences, we are just here to assist you in achieving yours. PIP offers both managed services and add hoc support for any IT system your organisation chooses to run.
Hybrid Cloud Pros & Cons
| On-premise Pros | On-premise Cons |
|---|---|
| No internet required. | IT responsibilities for security, privacy and threats. |
| Completely closed in houses systems. | Backup integrity and management. |
| Single capital outlay (perhaps tax deducible at the time of writing), if self managed | High availability of systems mean purchasing and maintaining of two identical systems. |
| Infrastructure requirements – cooling, security and noise can be an issue. | |
Contact PIP for Cost Effective Medical & Healthcare Data
PIP is your one stop shop for all things Medi Tech. We offer cost effective technology health solutions from the smallest of practices up to multi national clinics. We support and service every vendor of practice software. Our core focus on privacy and security gives you peace of mind that patient records will be protected 24×7. Leaving you, to you patients health, wellbeing and protection.
