Electronic health records (EHRs), also known as electronic medical records (EMRs), have received a lot of attention since the Obama administration committed $36 billion in stimulus funds in 2009 to encourage hospitals and healthcare facilities to digitize patient data and make better use of information technology. 2009 also ushered in the Health Information Technology for Economic and Clinical Health Act (HITECH), created to establish the guidelines for the $36 billion in available funds.

Since then, there has been a lot of debate and confusion within the Healthcare and Technology communities. On July 13^th of this year, the Center for Medicare and Medicaid Services (CMS) released their 864-page document entitled “Meaningful Use.” This “final rule” established measures that physicians using an EHR will need to meet in order to receive their HITECH Act incentives. Currently, only 17% of physicians in the world have adopted EHR in their practices.

So what does all of this mean? There’s money available for local healthcare practices to implement and correctly employ EHRs! Eligible (non-hospital-based) healthcare providers can qualify for up to $44,000 in HITECH incentives for “meaningful” use of an EHR between 2011 and 2015, and a three-provider practice could receive $132,000 in Medicare incentives through HITECH. It’s important to note that providers who do not adopt EHR technology by 2015 will be penalized.

Things to consider when rolling out an EHR:

1. Budget: Organizations commonly assume that expenses such as equipment, training, support, suppliers, and needed services (i.e., Internet, server space, etc.) are included in the EHR vendor cost—but they’re not! Be sure to have a comprehensive budget that accounts for all aspects of the project so funds will be allocated appropriately.
2. Technology: Technology is one of the most important factors in the successful implementation of an EHR. Regardless of an organization’s size, EHR systems integration can require server(s), data storage, and a network switch to connect your system to others. Proper setup is required to ensure reliability of service, high availability, and secure accessibility.
3. Administrative Staff: Successful project deployment hinges on preparing a selective group of your staff as “champions” or “early adopters.” This group should consist of strong leaders that can mold the staff and help guide them through the change. They should be prepared for both the best and the worst case scenarios. As the backbone of your organization, they will lead the others through all of the changes to come.
4. Implementation Plan: Developing timelines and roll out plans in advance will save precious time when you are ready to bring the EHR online. When determining timelines, think of the following:

• Staff readiness and availability
• Organization strength
• Milestones throughout the year (screenings, drives)
• School year schedule
• Holiday schedules

Above all, do not rush the process. Work with staff and your EHR vendor to develop timelines that will meet all your needs. Speeding through the process can cause unnecessary setbacks that will disrupt the entire project, create chaos, and push staff to lose focus.

With 2015 not so far off, the task can seem overwhelming. Starting now can ensure a successful return on your investment of resources!

Dispatching 101: One morning with Sarah was four hours in the hub of Fandotech. Sarah’s world is about managing technicians, managing client expectations, managing hardware delivery and installs… So it’s an understatement to say she’s got a lot going on.

The biggest thing that struck me is how many means of communication she and our team use to get the job done day in and day out! From Twitter and tickets to IM and texting, she does it all—and it’s effective. I found it overwhelming, since I myself don’t really dabble in IM or texting, let alone twitter (just ask my kids)! Honestly, I find email and a cell phone to be quite enough, but Sarah has found a rhythm that works for each individual technician based on their communication style coupled with the particular client they’re working with when she’s looking to connect with them.

Jolted from my wonderment as large thunderstorms and tornado warnings disrupt a large number of clients simultaneously, dispatch begins to hustle the field techs, TAC, and Level II Engineers to meet the challenge.

Despite the diverse and plentiful means of communication, I could see how affected clients could be left feeling alienated and out of the loop when looking for status updates. The reality is, although our location is up and running, the clients’ communication outlets may be down. When there are storms, Internet and phone service can be spotty. Plus, when our full team is on a project of such magnitude, it’s sometimes impossible to call each client with meaningful updates quickly enough. This can give the appearance that nothing is happening to rectify a situation, when in reality everyone’s on it and the resolution is imminent.

So the challenge I identified? What solution, or solutions, can we implement to have the latest streaming info available through multiple channels, accessible even when a client’s local Internet and phone lines are down? The team is on it; we’ve already discussed several ideas and are convinced the answer lies in multiples. Hey, it works for dispatch!

Stay tuned for our full implementation plan. Thanks to Sarah for the inspiration and commitment to making stressful times easier for our clients!

Dispatched: Fast forward two days later… I’m in the field with our very own Mike Winters. So, to be honest, the hardest part of this portion of the Under Cover Boss assignment was trying not to act like the boss! At every turn I was distracted by opportunities to engage the client in an account manager role. I was seeing ways to update and improve processes for our clients, but why wasn’t Mike seeing what I was seeing? Oh, because (I said to myself sarcastically) he’s busy working on technical issues! Which, incidentally, I hadn’t noticed because I was busy chatting with the staff about their business concerns.

I think I often oversimplify how easy it is to multi-task. And, perhaps more importantly, how inefficient multi-tasking really is. I directly or indirectly ask things of my staff that just can’t be accomplished. For example: be an amazingly adept technician with 100% utilization during a 40 hour work week while still acting as an account manager engaging the client in business chit chat that results in program recommendations to solve their every problem.

Ok, so maybe that’s extreme, but I think that’s the message I sometimes send. I think, well, the technician is on site, he can fix everything, install and troubleshoot…and find time to engage the staff about the business concerns. However, one day with Mike helped me put things in perspective. I certainly couldn’t accomplish the two tasks well enough to deliver the level of service Fandotech is committed to.

So what did I learn? Let’s be realistic. Yes, our technicians are our eyes and ears when interfacing with the clients, but are there ways that the management staff could better support them? Of course! The technicians need to be able to hand off the business obstacles to the account managers for digestion so the account managers can follow up and work on a remediation plan. I’m now joining the weekly Thursday morning technical meeting to listen to the bits of valuable insights our staff continuously collects so that I can extract the details that demand a follow-up business level check-in.

Bottom line? Our technicians do an amazing job assessing both technical and business concerns of our clients, oftentimes even stepping into an account management role. They go above and beyond and now it’s up to management to see the technicians get the proper support to make them, and by extension, our clients, successful!

“The network is down!” Four words that strike fear in the hearts of business owners, large and small. Loss of productivity is a huge concern of any business and for small businesses in particular. Every minute without system access costs companies real dollars. That is why system availability is so important.

So can outsourcing IT stop downtime? Unfortunately there’s no way to insure against downtime when mechanical parts are involved. But, with a Managed IT service delivered via the cloud (Internet) you can reduce your risk of losing network connectivity.

How is downtime prevented?

Cloud-based service providers build their services to scale with a maximum amount of fault tolerance to serve hundreds (maybe thousands) of customers on their computing platform. The provider attracts potential clients by providing services that most companies cannot afford to build for themselves. Similar to a high-end co-op living arrangement; all owners benefit from communal resources that maintain their standard of living at a fraction of the price it would cost to sustain the services individually. Everybody wins.

The shared resources you should look for in a service provider?

• Redundant Bandwidth: Multiple Internet service providers are crucial for data centers to offer redundant bandwidth availability for their services. Internet circuits are engineered to failover in the event of any one provider experiencing an outage, providing you seamless service at all times.

• Redundant Power: The best cloud-based providers have multiple uninterrupted power supplies (UPS) and diesel generators to support services in the event of a localized power outage. These systems are automated to take over in the event of a utility service power loss. The average Small to Mid-sized business cannot afford to purchase a generator for these infrequent power loss events. (Which is why many outsource.)

• Redundant Cooling: Most Small to Mid-sized businesses house their servers in closets, under desks, or in “data rooms” which are often unventilated and overheated areas of the office. Proper cooling is one of the most frequent contributors to server failures. An outsourced provider not only has enough cooling to keep the servers running, but will also have a redundant system at the ready in the event of mechanical failure or to aide in combating the dog days of summer.

• Redundant Infrastructure: Because the provider is building an Infrastructure to support hundreds or thousands of clients, availability of those systems is a key component to their success. Cloud service providers invest heavily in redundant hardware and software solutions to support the services they are selling, as a customer, you are get an enterprise class IT service for a fraction of the cost of building yourself.

Usually as part of a cloud based IT solution included in the monthly cost is all system administration services and access to the service provider helpdesk are included in the monthly fee streamlining not only operations, but support. You get access to the skill sets you need to match the problem you are experiencing, a qualified professional at the ready.

The sum of the parts?

Availability. An outsourced IT service can provide you with maximum availability to your data from anywhere, anytime. A complete turnkey solution costs a fraction of the cost of hardware and software that would be required would far exceed the outsourced costs. Layer on the expense of support personnel to operate and maintain those services you can see that a cloud based solution not only increase system availability but can also make better financial sense.

“What I worry about most is what I can’t control – what clients, prospects and even employees are saying in the social media arena and what sensitive information is flowing in and out of this office via email,” lamented a good client of mine.

Ah yes, “reputation risk”. The above sentiments are a hot topic among SMBs these days.

Companies rise and fall on the basis of their reputation. Consider some notorious examples.

Data Breach: In 2004 the loss of Intellectual Property (in this case Personal Data) was a big stain on ChoicePoint’s reputation as nearly 160,000 citizens suffered a breach of security exposing their personal data. This initial incident, as well as the failings of the company to properly mitigate the damage, resulted in a number of new regulations and laws taking affect to safeguard private information. Persisting as a black cloud over the company to this day, most only know the company for this infamous event.

Social Media Campaign: More recently, the world watched as BP’s reputation literally changed overnight. In real-time, social media kept the containment failures in the forefront. Even the best PR efforts were thwarted by the immediate and relentless use of social media outlets. The company’s valuation has reduced significantly. If BP can ever bounce back, it will have a tough time rebuilding a good reputation.

So how can business leaders be proactive and guard against costly missteps?

• Educate your staff. Establish an Acceptable Use Policy so employees have clear direction. More and more companies are extending their Internet AUP’s to include Social Media and express that your views be consistent with those of the company’s to avoid being suspended or terminated. These AUP’s extend beyond the work place.
• Monitor the chatter. Monitor Twitter, Facebook and other social media outlets to keep tabs on what’s being said about your company or brand. Engage those with negative opinions of your brand and see what you can do to improve your product or service perception.
• Secure incoming and outgoing company communications. Email encryption protects data leaving your offices via email. Rules can be setup to automatically encrypt an email based on keywords. Certain information can be blocked completely to insure that Intellectual Property is not being sent from the office to home or personal accounts. And scanning emails for profanity and other negative keywords promotes appropriate communications between your employees and clients.

Among these steps, email encryption definitely hits home with me! I routinely discuss Intellectual Property via email, both my company’s and my clients. This can include network diagrams, technology reviews, and other sensitive information gathered as part of a consulting engagement. This is why it’s imperative that we utilize a comprehensive end-to-end email encryption tool.

That being said, I’ve invited the contact quoted above to join us on July 27 at 2PM for a walk through of how I protect my company’s reputation in the email arena. You’re invited too! Click to register>>

It has been a tough couple of years for many small businesses. Tough staffing decisions included layoffs, outsourcing, or a combination of both. Many companies (and mine was no exception) looked at for ways to cut costs without compromising the level of service to their clients.  Discretionary spending diminished as we focused on how to optimize our business while preserving capital.

Okay enough with the doom and gloom!

As businesses begin to recover we can reflect on the number of lessons learned. Companies now employ strategies that allow for better scaling of services to map their business needs. While the 80’s and 90’s thrived on excess and companies lived by the Gordon Gekko credo of “Greed is good”, economic analysts expect frugality to become the new norm.

No industry benefits more from this concept than IT. Emerging cloud technologies and a stronger adoption to Managed Service Provider (MSP) support models have allowed traditional businesses the ability to be more fluid in down times and poised to expand quickly as the economy rebounds.

An ‘elastic’ vs. a ‘zip tie’: An elastic band can expand and contract based on what needs to be held inside. But a zip tie? Have you ever tried to budge a zip tie? Good luck. Traditional networks are like zip ties. Steadfast? Yes. Accessible? That depends. Scalable? Not so much.

On the other hand, networks that successfully leverage cloud technology are like elastics. Reliable? Yes. Accessible? Yep! Scalable? You betcha! Elasticity implies the ability to expand and contract as required. “Zip tie” networks reach a point when servers can’t be expanded and systems can no longer support newer versions of operating systems and application software. So it’s out with the old and in with the new. This can be costly, both in time and money.

But, leveraging the cloud enables us to:

• Expand resources without requiring new hardware.
• Reduce resources to reduce cost in down periods.
• Spin up test environments for upgrades in parallel to production systems paying only for the resources and duration those systems are in use.
• Software upgrades for operating systems, productivity suites, and applications are part of the service offering.
• Reduce future capital expenditures by eliminating server hardware costs.

Also, users expect IT to evolve as quickly in their businesses as it does at home. I’ve previously written about users wanting better remote accessibility to their data and applications. Our end users are asking for more! How do we expand resources at a time when IT staffing is already being asked to do more with less?

Let’s start with the infrastructure. Even if you have an IT staff you do not need to necessarily host your own IT infrastructure. One of the first things you can do to become more elastic in delivering IT services is to move application services to the cloud. Email was one of the original “cloud” applications until someone decided it would be better to host email on-site. If you are a business owner or responsible for your companies IT budget, you know hosting your own email is not cheap. This is the easiest application to push back to the cloud.

Most of today’s mission critical applications (CRM, Finance, ERP, etc.) are being developed as web-based applications.  Many companies have already opened secure access (SSL or VPN) to those applications for remote and field employees.  In essence they’ve become their own private cloud providers.

With so many companies already making applications hosted at the office accessible from the outside world, why wouldn’t you host more in the cloud and take advantage of resource scalability?

Scalability is not limited to infrastructure. As discussed in my previous post, “The IT Rockstar…Outsource IT” , the need to scale resources and a need for varying talents is what has always driven business to look outside. Initially, most data centers started as real estate plays, providing their customers a place to store equipment securely, with enough power, bandwidth, and security to meet their demands. Data center engineers insured that the infrastructure supporting their clients was operational at all times while client application and hardware was managed by the clients whose staff  would make on-site visits for changes, patch updates, and other day-to-day support activities.

Today the story is playing out slightly differently with client services being outsourced back to the data center engineering and support staff. Rolling traditional infrastructure support and day-to-day maintenance into one neat package saves clients big.

So in summary…ramp up services quickly or dial ‘em down as need be. Outsourcing IT is one way of insuring that your company is fluid and adaptable to the forces that drive your business.