Tech Glitches That Derail a Medical Practice

Derrick Berger knows what it's like to be frustrated by technology. Even though the manager of Brazosport Urology in Lake Jackson, Texas, came into his role with several years of IT experience, the practice until recently was plagued with recurring system outages, some lasting up to a half day.

To reduce outages, the practice talked its Internet service provider into installing a high-speed broadband network on top of its existing DSL line, which then became a backup line. Now, even in the event of a service interruption, the practice can still function.

"It will reduce our downtime to less than a few minutes by switching over to our DSL line as our backup in the event that our primary Internet connection goes down," Berger explains.

Service downtime, slow hardware, and website weirdness are among the common tech glitches modern practices experience. Some are annoying, some very costly, some potentially dangerous to your patients.

Fortunately, there are steps that even the least-IT-savvy practices can take to avoid the most common practice IT glitches.

Slow machines

Does it take you several minutes to download a file that should take seconds? If so, you're in good company, as slowness is one of the most common tech glitches to plague a practice.

"The biggest thing that we need to focus on is networking speed," says Minneapolis/St. Paul-based MGMA consultant Derek Kosiorek. "It's the biggest issue and it can be a dangerous issue."

Case in point: If a physician uses his mouse to check off a checkbox in his EHR and doesn't see the box checked right away, he might click the screen again. Meanwhile, the network may misinterpret his action as checking and unchecking the box. The result: A submission of incorrect information.

Unfortunately, slowness can be difficult to pinpoint, as are there are many reasons machines can get sluggish, says Stephen Bennett, vice president of infrastructure and managed services at Burlington, Mass.-based consulting firm Arcadia Solutions, which works with practices.

Start your investigation by ruling out the most common culprits. "When installing the EHR, you can't underestimate the amount of bandwidth you're going to need, especially when you have images going over the network," says Kosiorek. "So a practice needs to talk to the EHR vendor about how much bandwidth is needed per user. If you outsource with a system like athenahealth, you need different speeds to and from the Internet than if your system is hosted in your own building in your own room." Try to get the vendor to guarantee that you'll have the bandwidth you need before your installation. Too late for that? If you’re now having problems you didn’t anticipate, then raise the subject anyway.

Second, make sure employees are not hogging bandwidth for their own personal purposes, like streaming music.

Another big problem: not updating required applications and software.

"What happens is applications get installed, various virus management [software] doesn't get updated, spyware definitions don't get updated, and then the client itself becomes corrupted and unusable," says Bennett.

Service interruptions

Anyone who has ever tried to open an application and found that it locks up regularly or doesn't open at all knows the pain of service interruptions, an especially frustrating technology glitch.
Trying to save money by not forestalling hardware updates is a big culprit, says Bennett, noting that three-, four-, or five-year-old technology might not support current bandwidth requirements of today's applications and software.

"It's sort of penny-wise, pound-foolish, by not looking at … the opportunity cost [you] lose by trying to troubleshoot a problem and live with it versus investing in new equipment."

Using incompatible equipment, such as newer software on older machines (or vice versa) is a common cause of both service interruptions and slow machines, says Kosiorek.

Instead of replacing all your computers every four to five years, consider budgeting to replace one-fourth or one-fifth of the computers annually, suggests Kosiorek.

Interface issues

Does the computer screen display look funny or load incorrectly? Is your website not displaying correctly? Problems such as these fall under the category of user-interface issues, which can mean anything from how a page displays to how quickly it loads for the user.

What makes the problem of interface errors worse is that patients are ultimately affected - and can grow frustrated - if they are trying to access, say, your practice's patient portal or home page, and see a bunch of squeezed or stretched letters, or missing navigation panels.

"It's very common for practices to not look at technology from a patient point of view," says Kosiorek.

And not easy to consider all potential points of view, as patients speak and read many different languages and use dozens of different computer models.

If you are investing in new technology, such as a patient portal, "log in and look at it from a patient's point of view," Kosiorek advises. "Is it easy to navigate and is the information laid out intuitively for the patient? If you don't see a button that allows you to save [information], that makes your practice look bad."

Try looking at your technology with different web browsers, on Macs and PCs, and on mobile devices such as phones and tablets, too.

Overall system failures

Perhaps the worst glitch of all - the one that could have the greatest impact on your practice - is a system that goes down completely. This can happen for any number of reasons, including hardware failures and programming errors, says Overland Park, Kan.-based technology consultant Tom Walsh.

"Practices have a greater dependency on their practice-management or EHR systems," says Walsh. "And when your system goes down, you're in trouble."

Practices can lessen the likelihood of a system failure by keeping hardware and antivirus software up to date.

"Antivirus software will take care of 99 percent of virus problems," says Berger. "The Internet is now like a utility, so users will continue to use it and not always be prudent, and so viruses spread. I had to recently reinstall the operating system on one such system here. It was over the weekend so it wasn't a big deal, but it would have cost me an entire day of [downtime] had I done it during the week."

In addition, practices need to make sure they have a data-backup plan in place, even if it's as simple as keeping documents stored on backup tapes or through a cloud-based data-storage backup system. (We prefer the latter option, but if you go with the former, make sure those tapes are somewhere other than your office, in case of a natural disaster.) Walsh recommends using data-server technology to take a "snapshot" of the data - make a virtual copy, instead of a physical copy, that captures the data at an exact point in time - once a day.

Marisa Torrieri is an associate editor with Physicians Practice. She can be reached at marisa.torrieri@ubm.com.

This article originally appeared in the July/August 2012 issue of Physicians Practice.