If your a computer user, and I know you are, you probably have seen technology change on a constant, consistent basis. What you buy today could be outdated in 6 months. It’s been happening for years and will continue to happen. That is why upgrading is important. Once you fall behind, it is difficult and expensive to catch up.

Why Upgrading is Important

I went on an IT support sales call around 3 months ago. This is a fairly large practice and they have no IT support. They have a “superuser” in the office and they seemed to have been “getting by”. In comes Tier3MD to look things over to give them a quote. This is what I found.


1. No antivirus on more than half the PC’s.
2. No patches and security updates have been performed
3. No security measures in place or documented
4. Old PC’s with very little RAM and processing power
5. Bad cabling which causes the PC’s to have multiple interruptions throughout the day.
6. Poor backup strategy (if any)
7. No disaster recovery plan
8. Shared passwords
9. EMR roles not set up
10. Wireless network was wide open

For Tier3MD to quote this practice, would have to quote the following:

1. A cost per PC to add the antivirus, patch management, encryption where needed, and malware support.
2. We would have to update all the patches on every device.
3. We will help put security measures in place and document them.
4. We would suggest upgrading/replacing PC’s but that could follow 3-6 months down the road.
5. We would want to fix the cabling as soon as possible.
6. It would be imperative to put in a backup system immediately.
7. Putting in a disaster recovery plan would be a priority.
8. We would need to educate the users on the importance of not sharing passwords, and change them all.
9. We would help set up EMR roles so that the clinical staff cannot run an A/R report and view financials.
10. We would password prospect the wireless network and segment it onto it’s own network.



To go from no monthly IT cost, to any monthly IT cost, is always sticker shock and the answer to the quote is almost always “NO”. Had this practice understood why upgrading is important, they would have a much smaller amount to pay each month because of the following:

  1.  Better equipment = less downtime
  2.  Patched and updated PC’s and Servers = better performance and better security.
  3.  Security = less chance of downtime
  4. Better cabling = better performance and less downtime
  5. Better backups = less risk of losing ALL of your ePHI and sensitive information
  6. A disaster recovery/ Business Continuity plan would allow you to be back up in running in a MUCH shorter time than a full bare metal repair, installation and backup restoration.
  7. Your EMR and ePHI would be safer with roles established
  8. Your wireless network would not be exposed to the outside world.
  9.  You would have our helpdesk to call so your high paid clinical staff would not have downtime, and your employees would not have to spend time they aren’t paid for fixing computers. (which they are not trained to do)
  10. Your office would gain numerous advantages when using technology to efficiently run your practice.


Through my experience, not having a managed service provider for your IT support will eventually kill your practice. You need to have PROACTIVE IT support and the break fix/fly by the seat of your pants model is no longer working. Once you get behind, it is too costly to get your practice where you need to be. It is much easier to upgrade a PC here and there than upgrading ALL the PC’s. Not to mention the cost of downtime if you get a virus, or a biller can’t bill for a day, or your expensive office manager is out fixing a PC. It’s time…It’s time for professional managed services.

HIPAA compliance will be a whole other story!!

That is why upgrading is important!