Tackling downtime in rural regions

Aug. 26, 2015

In Northern New England, quaint, bucolic towns dot a rustic, mountainous landscape. Drive a few miles outside any city, and you’re likely to spot more moose than medical facilities. While this sets a majestic scene, it doesn’t always make it easy for residents to get the healthcare services they need – especially during the winter months marked by road-closing snowfalls. ClearChoiceMD (CCMD) set out to change this, launching dozens of state-of-the-art urgent care facilities that now serve thousands of patients in towns spanning Vermont, New Hampshire, and Maine.

As a start-up company, CCMD began making the usual investments and evaluations around infrastructure, employees, technology, and more. From day one, the company knew that it wanted most, if not all, of its technology resources to be delivered in the cloud in order to leverage the well-known economies of unlimited scalability, flexibility, and innovation.

Scott Kinka, CTO, Evolve IP

For voice and data, CCMD initially worked with a provider that could not deliver the quality of service CCMD demanded, due in part to their reliance on public Internet delivery. Even with an additional failover system through another provider, CCMD callers would experience significant delays, disruptions, or get dropped altogether when there was any kind of Internet service interruption.

“The quality of service suffered significantly, as did data speeds,” says Alex Fuchs, IT Director for CCMD.

“Since the bulk of our computing infrastructure is centrally located, consistent bandwidth delivery is paramount to reliability. Conventional bonding and failover methodologies simply weren’t compatible with the Internet service providers that serve our rural locales.”

Evolve IP’s Cloud Connect network bonding service offered hope. Cloud Connect brings all of a company’s various network connections together in the cloud, while monitoring all traffic to ensure lines are healthy and uptime is optimized. Internet connections of all types, providers, speeds, and latencies can be bonded.

Cloud Connect makes available the total combined bandwidth of all connections – DSL, cable, fiber, fixed or mobile wireless, and T1 – and compresses traffic to increase the aggregate throughput by up to five times. Customers can select the most appropriate and available bandwidth for each location rather than defaulting to an expensive T1, for example, in hard-to-reach areas where many of CCMD’s clinics are located.

After careful consideration, CCMD selected Evolve IP for voice services at its clinics. “Evolve IP offered a brilliant, unique solution to our problem with the Cloud Connect bonding service. Cloud Connect meshes all of our smaller ISP lines together to create one super, high-performance connection. The solution also promised dramatically improved reliability on the data side. Where we once had connectivity issues sending e-prescriptions direct to pharmacies, for example, now there are none,” says Fuchs.

Operating in the highly regulated healthcare industry, CCMD was also attracted to Evolve IP for its HIPAA-compliant data center, since CCMD data would also be transmitted through Cloud Connect. HIPAA is the federal Health Insurance Portability and Accountability Act of 1996, and it requires companies to protect the confidentiality and security of healthcare information. No other vendor offered this key attribute.

After installing the new bonding device across all of CCMD’s urgent care facilities, connectivity instantly went from frustratingly erratic to faultless. Prior to the switch, CCMD experienced frequent outages, sometimes for four hours at a time. “Now, we enjoy uninterrupted service,” Fuchs adds. “With Cloud Connect, we have eliminated intermittent phone and Internet service drops, and increased the reliability of daily business tasks like writing e-prescriptions. We’ve even resolved printing issues. “

Employee productivity soars

CCMD invested to make the initial switch to Evolve IP voice services, but are already reaping 30 percent return on the investment in terms of improved productivity and service levels. According to Fuchs, before adopting Cloud Connect the company had been spending at least 20 hours per week, the equivalent of one part-time employee, just to manage service outages. Management was distracted from more strategic activities like building the business – mission critical, especially for this rapidly growing start-up. “The switch to Cloud Connect is a dramatic cost and time savings for me … and the rest of our team,” says Fuchs.

In addition, CCMD is saving time for patients, resulting in a more positive experience that not only helps retain customers, but also attracts new business. Post-visit surveys attest to these improvements, as do recent jumps in patient volume across all urgent care facilities. Healthcare professionals at the clinics, who had repeatedly voiced their frustration over past connectivity problems, are now enjoying a more efficient work life. For example, in the past, staff was forced to temporarily use paper charts and scripts with every service disruption, which more than doubled their workload. Since moving to Evolve IP, not a single location has resorted to paper – everything is handled electronically for increased productivity. According to Fuchs, complaints have stopped too.

“The best thing is for me to hear nothing from our urgent care clinics,” says Fuchs. “I used to have weekly calls with each clinic over service concerns. With Evolve IP, I have none of that anymore. No more putting out fires.”

What about quality of service (QoS)?

Traditionally, to ensure connectivity, companies had to choose between slow, unreliable, inexpensive broadband Internet and costly leased lines. Neither option was perfect. With Evolve IP Cloud Connect, companies gain reliable voice service at a reasonable price without sacrificing quality.

Packet by packet, Cloud Connect streams data without disruption by ensuring instantaneous stateful failover; so if one line goes down, the other one knows the state of the sessions and can continue to run without having to restart or re-establish new connections. This is key. Unlike other network bonding mechanisms that stream data session by session, Cloud Connect streams data on the packet level – a finer, more diminutive breakdown – to detect a failed connection instantly and remove it from the bond. The installed Cloud Connect device intelligently selects new paths and immediately re-routes data when it identifies network degradation or outages. This means voice calls don’t drop, virtual desktop sessions aren’t interrupted, and data backups remain current.

“Even compared to enterprise-grade systems, Evolve IP provides the highest QoS by far, bar none. We have not experienced any issues concerning voice quality, which is in stark contrast with any other system we have used. All of the quality components contribute, but Cloud Connect brings them together to ensure voice quality,” says Fuchs.

Just days after implementing Evolve IP’s solution at a New Hampshire location, CCMD unknowingly put the new technology to the test. Fuchs described the event: “There was a major car accident near our Portsmouth clinic, and instantly, the Evolve IP device initiated failover. It was seamless. Staff remained on the phone the whole time, and no one noticed a single blip – voice services remained steady.”

Business continuity in the cloud maintains critical patient services

Without the right plans in place, IT disasters can dramatically impact a business – in fact, an Evolve IP survey of over 1,000 businesses showed that of those that had experienced an IT-related disaster, over half were down for more than a day. Of course, this translates into lost revenue, but also – in the case of CCMD –
it can mean a patient doesn’t get the care they need when they need it. That’s why CCMD is working toward an advanced business continuity plan leveraging Evolve IP that will ensure patients are never left without crucial medical care.

In just the 12 months since the business launched, CCMD has already been thrust into business continuity situations resulting from the harsh winters of New England. Due to snowstorms and ice, CCMD had to close a few clinics, impossible to access with two feet of snow on the ground. Now, however, with Evolve IP’s advanced unified communications services, CCMD is enacting strategic business continuity plans and leveraging Evolve features to set up automatic call re-routing and other contingencies in the event of a clinic closing unexpectedly.

Additionally, CCMD will be leveraging the Evolve IP OneCloud solution to protect data by deploying disaster recovery as a service. Evolve IP provides near real-time RPO (recovery point objectives), meaning customers like CCMD recover systems exactly from the point in time when the incident occurred so nothing is lost, and can access it in minutes. Staff just point and click or make a call, saving manhours and preventing major financial losses.

“It’s a huge advantage to us that Evolve IP also offers disaster recovery as a service in addition to voice and data services delivered in the cloud,” notes Fuchs. “It’s important to have a trusted source for all, and it’s more efficient for a smaller operation like ours to have multiple business services from a single vendor.”

As CCMD continues to deliver crucial medical care and high-quality customer service to the rural residents throughout northern New England, it will likewise continue its incredible growth rate. With Cloud Connect, CCMD can open new offices without worrying about voice and data infrastructure services. The cloud allows companies to grow and scale quickly. More importantly, Evolve IP enables CCMD to provide high-quality services to its patients – and that’s the ultimate key to future growth.

“Literally, Evolve IP’s voice and cloud services have saved our business, plus provided the technology launch pad to catapult us even higher,” Fuchs says.

Sponsored Recommendations

ASK THE EXPERT: ServiceNow’s Erin Smithouser on what C-suite healthcare executives need to know about artificial intelligence

Generative artificial intelligence, also known as GenAI, learns from vast amounts of existing data and large language models to help healthcare organizations improve hospital ...

TEST: Ask the Expert: Is Your Patients' Understanding Putting You at Risk?

Effective health literacy in healthcare is essential for ensuring informed consent, reducing medical malpractice risks, and enhancing patient-provider communication. Unfortunately...

From Strategy to Action: The Power of Enterprise Value-Based Care

Ever wonder why your meticulously planned value-based care model hasn't moved beyond the concept stage? You're not alone! Transition from theory to practice with enterprise value...

State of the Market: Transforming Healthcare; Strategies for Building a Resilient and Adaptive Workforce

The U.S. healthcare system is facing critical challenges, including workforce shortages, high turnover, and regulatory pressures. This guide highlights the vital role of technology...