By Howard J. Anderson

Many group practices devote little time and effort to selecting a server when rolling out a new practice management or electronic records system. But Stu Patty says that taking the time to make the right server decision helped him sleep better at night.

As the 17-physician Peoria, Illinois Surgical Group prepared to upgrade its practice management and records systems, Patty decided he wanted to take steps to avoid downtime at all costs. One reason for this concern was that the surgeons wanted to access records around the clock from their homes as well as the clinic. "A lot of our surgeons now put their kids to bed and then go on the computer and look at charts for the next day from home," the practice administrator says.

So rather than buying a conventional freestanding server for about $20,000, Patty spent $40,000 for a box with what amounts to two servers inside it, offering what's known as parallel processing. That way, if one side goes down, the other side takes over. "This is my sleeping pill," he says of the hardware. "I rest assured the system is always working."

Since acquiring the hardware from Stratus Technologies, Maynard, Mass, in June 2006, the practice has had only one day with any down time. And that outage was the result of a massive power failure affecting downtown Peoria. Now, the practice's new office shares a backup generator with 2,000 gallons of diesel fuel - just in case the electricity goes out again.

When selecting a server, "it's not always about getting the best deal," Patty says. "You have to make price secondary to reliability. I'd rather cut corners on PCs than on the backbone. Our foundation is our top-notch servers."

The clinic uses practice management and records software from Sage Software Healthcare, Tampa, Florida It acquired its Stratus equipment through Sage, which recommended it.

Group practices have a number of options when picking a platform for their information systems. Many install one server and hope for the best. Some take the extra step of entering a contract with an offsite data center to use for emergency backup.

Some practices, like Peoria Surgical, choose to buy equipment that provides backup to avoid downtime. One alternative to the Stratus equipment is to use clustering technology to link separate servers that back each other up. Yet another option is to forgo servers altogether and opt for the application service provider computing model, where the practice "rents" an application that resides on a vendor's servers. In this model, clinics access applications remotely, typically via the Internet.

Because most smaller practices have such tight budgets, relatively few give consideration to the need to back up their servers, says Vinson Hudson, president of Jewson Enterprises, an Austin, Texas-based consulting firm.

"Relatively few practices are paying much attention to this," he says. "But backup is more than just backing up applications. It's backing up your equipment." With the price of servers declining, Hudson advises clinics with mission-critical applications, like electronic health records, to spend some extra money for backup servers.

But he sees more practices opting for the ASP model instead because they don't want to "run a data processing shop." The downside, however, is that the practice loses some control over the data, he acknowledges. Patty rejected using the ASP model for his practice management and records systems, based on his limited experience with the model.

For several years, the practice has accessed specialized software for bariatric surgery via an ASP. It's now switching vendors for the narrow application. In making the switch, Patty says it has been difficult to reclaim the data from the original vendor. Nevertheless, he will use a new ASP since the application is so specialized that it's not worth installing in-house.

(c) 2009 Health Data Management and SourceMedia, Inc. All Rights Reserved.

This article was originally published in Health Data Management.

Register or login for access to this item and much more

All Information Management content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access