Many administrators of small and mid-size facilities start with one person who is good with computers. Maybe it is a business office employee, a maintenance director or a nephew of the owner. That works for a while. Then the organization adds an EHR, a second building, a cyber insurance application and a few close calls with phishing, and someone asks whether it is time to hire a real IT person or hand things to an outside provider.
There is no single right answer. Here is a framework for deciding.
Think of IT as a set of functions rather than a person:
Helpdesk support for staff, during every shift you operate
Maintenance of computers, networks, servers and phones
Security: monitoring, patching, backups, email protection and incident response
Compliance support, including risk analysis, policies and documentation
Vendor management for EHR, internet, copier and phone vendors
Planning and budgeting for upgrades
No single person is equally strong in all of these, and none of them can be everywhere at once.
Familiarity with your people, building and workflow
Immediate presence on site for hands-on problems
A single point of accountability for your organization
Strong fit for large organizations with enough work to keep one or more people busy
Coverage gaps: vacations, illness, nights and weekends. Care is delivered 24 hours a day, but a single employee works one shift.
Skill breadth: the same person may be asked to manage networks, cybersecurity, cloud, phone systems and compliance. Few people are expert in all of them.
Turnover risk: when that person leaves, knowledge such as passwords and configurations often leaves with them.
Cost: salary, benefits, training, tools and recruiting add up, and good IT talent is in demand.
Oversight: one person administering everything has no one to check their work, which is a concern for security and for internal controls.
Access to a team with varied skills, such as helpdesk, network engineering, security and compliance
Coverage beyond one person's schedule, with after-hours options
Predictable monthly costs, often with defined services
Tools and monitoring already in place, which would be expensive to buy and learn alone
Documentation and processes that persist if staff change
Experience across many environments, including other healthcare organizations
Less day-to-day presence unless on-site visits are in the contract
A need for clear expectations, since a provider that does not understand healthcare workflows may respond poorly
Dependence on the provider's quality and stability
Possible mismatches between what is included and what you assume is included
Many organizations combine both. An on-site IT coordinator or help desk technician handles day-to-day requests and hands-on tasks, while a managed provider supplies security, monitoring, after-hours support, engineering and strategic guidance. This keeps local knowledge while filling the gaps.
How many sites, users and devices do we have?
How would we operate if our IT person were unavailable for a week?
Who monitors security alerts at 2 a.m. on a Sunday?
Who owns the administrator passwords and documentation?
Do we have someone who can complete a HIPAA risk analysis and explain it?
Are we spending most of our IT time on emergencies rather than improvements?
What would a single incident cost us in downtime and disruption?
Do you work with healthcare organizations, and will you sign a Business Associate Agreement?
What is included in the monthly fee, and what costs extra?
What are your response targets, and how are after-hours problems handled?
How do you handle security monitoring, backups and incident response?
Who will be our main contact?
Will we own our documentation, licenses and administrator accounts?
What does an exit look like if we part ways?
Can you provide references from similar organizations?
Comparing a salary to a monthly service fee is incomplete. Add benefits, tools, training, replacement costs and the cost of downtime. And compare services, not just prices: two proposals may not include the same coverage.
Whatever you choose, you should hold the keys: administrator credentials, vendor accounts and documentation should be accessible to leadership, not locked in one person's head or one provider's system.
We provide fully managed IT, co-managed support alongside an in-house person and project work for healthcare organizations in Oklahoma, Texas and Arkansas. If you are weighing options, we are glad to review your environment and give you an honest view, even if the best answer is a different model than ours.
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