When a group of investors pooled their resources a few weeks ago to put a bid in to buy Skype from eBay, I thought there was a good chance that Skype's legal woes were behind them. Apparently, I was wrong, and a new lawsuit makes it clear just how bad Streamyx Hotline situation is for Skype.Sure, Skype doesn't own its core P2P technology, and founders Janus Friis and Niklas Zennstrom were trying to rip that IP out of the service. But that's all old news from months ago. Surely those new investors wouldn't have committed to paying $1.9 billion for 65% of a company that didn't control its IP? At the time of the deal, people close to the transaction told me that the new investors had a much better relationship with Niklas and Janus than eBay, and the situation would soon Dish Satellite Internet worked out. Our best guess was the two would be given a piece of Skype, and possibly a board seat, and the litigation would be dropped.
Most likely you have a computerized billing and scheduling system in use, whether or not you use Electronic Medical Records (EMR) at the moment. With more than just a single computer in use in your practice, it's more than likely that you're on some type of network. When multi-user, multi-task EMR systems are integrated into the practice, the complexities of capabilities and network designs become essential. Although many practices simply choose to hire an IT consultant or firm to handle these issues, this article will cover some of the most common network design concepts to consider.
Networking Basics: WAN, LAN, or MAN
Some EPM/EMR software might be incompatible with system software or network hardware. This must be determined before you purchase your system, and, if you think you'll be adding other users, it's often more economical to purchase licenses for multi-users rather than individual retail software packages. A Local Area Network (LAN) can connect computers and printers within a limited area such as an office. This LAN can link in with other LANs via wireless or network connectivity.
Unfortunately, some EPM / EMR applications may have compatibility issues between network and operating system software. This compatibility must be assured before going ahead with the purchase of an EMR package. Additionally, if you expect you will add new users, it's often more effective to buy a multi-user software license as opposed to individual consumer licenses at a retail outlet.
A wide area network (WAN) connects smaller LANs or Metro Area Networks (MANs). This can be done over a wider geographic area, as in a series of remote offices. These WANS are often used by large companies. The most widely-known WAN today is called the Internet. The Internet can permit access to a company intranet, where employees communicate with each other no matter where they are located. For an EPM / EMR system that runs between satellite offices, a stable high bandwidth connection is a must in order to keep the practice running consistently and smoothly.
Bandwidth and Topology
The network's bandwidth is the capacity of data that it can carry, usually expressed in bits per second, or bps. Connection speeds vary from 56 kilobits per second, to millions of bits per second. However, actual bandwidth speeds achieved may be limited by the hardware used, at times even the software used. In addition, the overall network speed can be greatly reduced as multiple users attempt to access information from the EMR system.
A fast connection means little if the network speed is slow due to bad planning or underpowered hardware. Network topology is also important. Topology is the physical shape of the network, as in a string of computers which minimize the amount of wiring between them. Still, if one part of this network goes down, it could take out the whole network. The best topology requires more wiring but is resilient to systemwide failure from a single weak point. However, the total amount of machines on this type of network is limited. Large networks use a mesh topology that offers redundancy and allows for better expandability.
Wires
In an average 'paperless' office setting, an exam room contains computers wired to the server, which runs EMR software. However, some physicians who are technically-savvy may like to enter info into a wireless device, carrying it between areas at the practice. The concept of wireless networking adds a new series of points to address.
Signal Strength - We've found that wireless access devices gather less-than-promised ranges when functioning in a typical office setting with many walls.
Bandwidth - Even if your LAN has good bandwidth rates, the speed of access can be limited by the speed of your wireless connection.
Security - Hackers can wreck your network if it isn't properly protected. Even a basic wireless access point must have built-in security which can be enabled easily.
Fat or Thin Clients - Will you use wireless laptops that run software directly on a wireless connection (fat), or will it run software virtually via a remote connection (thin)? Disconnects are simple fact for wireless networks; the thin client allows the software to continue to run in this case, allowing you to pick up where you were interrupted. A fat client solution what has its connection broken may cause a subsequent software crash.
By the way, do you want to learn more about implementing EMR in your own practice? Download my free report "Getting Through The EMR Maze" Click here for the free EMR report Do you want to learn more about increasing revenue and cutting costs in your practice? Download my free report "The 7 Key Strategies To Building A Successful Medical Practice Even In Tough Economic Times" Click here for the free report
Peter J. Polack, M.D., F.A.C.S., is founder of emedikon, a medical practice management consulting firm and president of Protodrone, a software development company specializing in medical practice applications. He is managing partner of Ocala Eye, a large multi-specialty ophthalmology practice.
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