Case Studies > Cloud Technology Case Study

A lot has been written about running a business with information systems in the “clouds”. “Cloud computing” is a hot buzzword. You hear a lot about the idea of running a business with information systems in the “clouds”, but you don’t hear much about anyone who is using it or how they actually migrated their technology from physical hardware to cloud computing.

This case study was documented in February of 2010 to provide an example of the successful implementation of a cloud computing business solution for a New Jersey doctor's office.

Overview: DeckerWright Corporation (DWC) recently designed and implemented a cloud computing system for one of our medical clients. After being part of an existing medical practice for over ten years, a doctor in Monmouth County (NJ) decided to open a private practice. In establishing his new practice, the doctor wanted to use “state of the art” technology for their information systems. A primary concern was implementing cost efficient data solutions that could be easily upgraded as the practice and its information needs grew.

DWC consulted with the doctor and their business manager in reviewing all of the options for practice management systems (PMS), electronic medical records (EMR), and phone systems. After evaluating the practice’s requirements and investigating all available options, DWC recommended a complete virtual solution as the option that best served the needs of this new medical practice. The doctor agreed and decided to implement cloud computing in their office.

Solution: The foundation for cloud computing was created by having Verizon FiOS 20/50 service, the fastest internet service available, installed at the doctor’s new office location. Because the doctor was the first tenant in the building to get FIOS service, the install took longer than normal. Fortunately enough time was built into the project plan to resolve the provisioning issues prior to the practice opening. The security of the FIOS internet service was created using a SonicWall firewall to provide security and a Unified Threat Management system with enough processing power to support the high speed access needed for the PM and EMR, as well as unforgiving applications like Voice Over Internet Protocol (VOIP).

Rather than installing a “premise based” traditional phone system, DWC installed a “cloud” based IP Centrex system utilizing the internet as the transport mechanism for phone calls. The system, hosted by Cooperative Communications, provides six phone lines plus a fax line using “plain old telephone service” (POTS). The “cloud” based phone system offers basic phone system features including voice mail, auto attendant, call forwarding, conference calling and call transfer. The only equipment located physically on site in the medical offices are Polycom SoundPoint 450 telephones combined with a Linksys Power Over Ethernet switch with Quality of Service. The benefits of implementing this technology became apparent even before the office opened: the doctor was able to advise patients of his new phone number and take calls at home to schedule appointments while the facility was being completed. As a result, the doctor had a full schedule in their first weeks of operation.

The practice management and electronic medical records systems are integrated together in a system offered by doctor.com. It provides templates for capturing data during the visit and coding assistance for electronic claims submission. Rather than having a billing staff on-site, the system was setup so the doctor could outsource the entire billing function to a service that is part of the doctors.com system. The on-site equipment for the “cloud” based practice management and medical records solution includes HP laptops in every exam room, and HP desktop computers in reception, the medical assistant’s office, and doctor’s office. A single multi-function Lexmark printer provides network printing and copying. While the multi-function printer could be used for scanning, the doc-tor.com software required local scanners attached to computers to capture paper data like insurance cards and paper patient medical records so a high-speed Fujitsu scanner and a Canon flat bed scanner were installed to support those functions. A credit card magnetic stripe reader was also added to the system to provide internet-based credit card processing.

Electronic interfaces to the doc-tor.com system include lab results, inbound faxes through eFax, electronic claims submissions, and electronic document submission to the billing company. The net result of applying “cloud” based technology to setting up the systems needed by this new medical practice is a staff head count per patient visit that is significantly lower than the head count in a typical doctor’s office. Lower up-front costs and lower employee costs are offset by higher recurring monthly fees for services provided in the “cloud”. Based on the preliminary financial models and early results, we anticipate the doctor will be more profitable than a typical single doctor’s practice. This is largely due to both the “cloud” technology and an enterprising doctor who was able to leverage their reputation using “state of the art” technology to have a full waiting room on Day One.

Results: DeckerWright Corporation is a leader in the design and implementation of “cloud” based solutions. Working in partnership with TriNet Technologies, DeckerWright Corporation offers virtual servers, virtual desktops, and virtual PBX services. With the pending introduction of DeckerWright Corporation’s Virtual Care System, companies planning for the future can confidently move their voice and data systems into the “clouds”. The Virtual Care System will provide for real time system monitoring, centralized desktop management, system backups, patch management, and security needed to support on-site equipment with no dedicated staff.