As more of a care facility's tools move to the cloud, the internet connection becomes as essential as electricity. Cloud-based EHRs, e-prescribing, eFax, voice over IP phones, video visits and cloud backups all depend on it. When a single line goes down, which can be as simple as a contractor cutting a cable down the road, charting slows or stops and care teams are back to paper.
A second internet connection is one of the most cost-effective resilience steps available. Here is how to think about it.
Even high-quality providers have outages. Causes include construction damage, storm damage, equipment failure at the provider's end and regional routing problems. If your facility has one circuit, you have a single point of failure. Rural and small-town locations may have fewer choices, which makes planning more important.
Generally the most reliable and fastest, with consistent speeds in both directions. Availability varies. Fiber is an excellent primary link, but if both of your lines run through the same trench, a cut can still take down both.
Widely available, usually cost-effective, and good for backup or secondary use. Speeds upload may be lower than download, and performance can vary at busy times of day since neighborhoods share capacity.
A radio link to a nearby tower. Can be useful in areas where wired options are limited, though weather and line-of-sight issues can affect it.
Business cellular gateways provide an independent path that does not depend on any cable. Speed and cost depend on signal strength and data plans. Many facilities use cellular as a backup that activates automatically if the main line fails.
Low-orbit satellite services can serve remote locations or act as a last-resort path. Latency and cost vary, so check suitability for your applications, especially voice.
Two connections are only as good as their independence. Ask these questions:
Do they use different providers?
Do they use different physical routes into the building?
Do they use different technologies, such as fiber plus cellular?
Do they enter the building at different points and terminate on separate equipment?
Two circuits from the same provider on the same pole offer much less protection than they appear to.
A business firewall or router with dual WAN support monitors both connections. When it detects that the primary is down, it routes traffic over the secondary automatically, usually within seconds. Some systems can also balance traffic across both links, using the secondary for lower-priority traffic during normal operation. Make sure the device is configured and tested, because a backup link that has never been tested often fails when needed.
The backup does not always need to match the primary speed, but it must support what matters most. Estimate the needs of:
Cloud EHR and medication administration
Phone system, if voice goes over the internet
Pharmacy and lab connectivity
eFax
Remote access for vendors and IT
Then plan to restrict lower-priority traffic, such as resident streaming and software updates, while on backup, so critical systems get the bandwidth. Quality of service rules can do this automatically.
A second internet line does not help if other pieces fail:
Put the firewall, switches and modem on battery backup, and connect them to generator power where possible
Confirm that your phone system can fail over to cellular or to forwarding numbers
Make sure DNS and VPN settings work with both connections
Consider whether any systems depend on a fixed public IP address that would change on the backup line, since some vendor connections whitelist addresses
At least a couple of times a year, unplug the primary connection during a planned window and verify that systems continue to function. Notify staff in advance. Record the test and fix any problems you find, such as a vendor that did not receive the new IP address.
A backup line has a monthly cost, plus equipment. Weigh that against the cost of downtime, including delayed documentation, interrupted pharmacy ordering and staff time spent on paper. For most facilities that depend on cloud systems, the recurring cost is modest compared with the exposure.
UnityCare IT reviews facilities' internet dependence, recommends connection options available at your address and configures and tests automatic failover. If you would like to know how long your facility could operate during an outage, we can map your dependencies and put together a simple resilience plan.
Call or text: 405-285-3845
New customers: start@unitycareit.com
Existing customers: support@unitycareit.com
Address: UnityCare Technologies, 2524 N Broadway Ste 554, PMB 947974, Edmond, Oklahoma 73034-4172