Diagnosing Correctly - Best Networking Practices for EHR

Best practices for an EHR networkElectronic Health Records (EHR) for the medical industry is more than just a Federal mandate required in order to maintain existing Medicaid and Medicare reimbursement level. It is becoming an expectation from the patients and  their care-givers to be efficient, effective and less prone to human errors. Patients also expect an integrated way of sharing information between medical professionals that is secure and simple from the patient’s perspective. However, treating Electronic Health Records solutions as applications in isolation, without considering how it fits within the larger framework of your IT, may create problems.

Since the patient records will be shared between multiple entities over time, where the care givers may not be colocated, there is no other choice but, for the data to live in a cloud, hosted or private, that is remotely accessible. Currently, regulations force the data storage to be in private clouds and accessed remotely via encrypted tunnels. Like many other cloud-based applications, the performance bottleneck of the EHR service is typically caused by the performance of the clinic’s Wide Area Network (WAN) connectivity to that cloud data center. In many cases, the application performance can be throttled because of not enough bandwidth, or high latency, or simply purely managed Internet traffic polluting the available WAN connection. So, what are some of the best networking practices to optimize your EHR application performance?

Some legacy WAN Optimization solutions such as caching and compression-solutions unfortunately will not work since regulations do not allow for the data to be cached. Compression will also not work with encrypted data or already encrypted files such as image and video. A modern Broadband Bonding enabled Software Defined WAN (SD-WAN) approach can provide a much needed performance and reliability boost to the WAN network to eliminate the performance choke on the EHR application.

A key concept to consider is the inherent capability of Broadband Bonding, i.e. being able to intelligently manage 2 or more WAN Internet connections so that the application performance (in this case cloud based EHR) can be optimized for the metrics that matters most for this application. EHR applications provide a mixed set of requirements, where latency, throughput, and reliability of the connectivity take center stage for the best end-user experience. So, we recommend a Broadband Bonding solution of at least 2 wired connections with an optional 3G/4G/LTE/5G backup link that can take over the connectivity in case of wired lines failing. It is also important for your SD-WAN solution to support session keep alive. This will enable your EHR application to run smoothly even during wired WAN outages.

Of course, if you are a mobile clinic, or a remote medical center that doesn’t have access to wired Internet lines, then you have no choice but to use a Broadband Bonding appliance that can bond multiple wireless 3G/4G/LTE/5G modems. This way you can significantly increase the reliability of the WAN connectivity for your remote clinic, as an SD-WAN device capable of Broadband Bonding will smooth out the unavoidable fluctuations of the cellular modems and provide a much more streamlined, high performance connection that has built-in failsafe.

No matter your clinic size and WAN connections, for effective EHR roll-out it is fundamental to include a Broadband Bonding strategy to make sure the WAN resources don’t become the performance bottleneck.

Cahit Akin, CEO, Mushroom Networks, Inc. 

Mushroom Networks is the provider of Software Defined WAN and load balancing solutions capable of Broadband Bonding that enables self-healing WAN networks that route around network problems such as latency, jitter and packet loss.



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