A decade ago, losing the internet in a nursing home meant email stopped and the office was annoyed. Today it can mean the cloud-based EMR is unreachable, the phone system is down, eFax stops, remote pharmacy and lab connections fail and some nurse call or monitoring features degrade. As more of a facility's critical systems move to the cloud, the internet connection starts to look like a utility, like power or water, and deserves similar planning.
Start by listing what actually fails when the internet goes down. Walk through each department and ask:
Is the EMR or EHR hosted in the cloud, such as PointClickCare?
Does the phone system use internet-based voice (VoIP)?
Do pharmacy, lab, imaging or e-prescribing systems connect online?
Does eFax or document exchange rely on it?
Are cameras, door controls, or nurse call features cloud-managed?
Do billing, payroll and state reporting portals require access?
Is resident Wi-Fi expected to work, which affects satisfaction more than operations?
The answers help you decide how much downtime is tolerable and what the business impact looks like.
True redundancy means that a single failure does not take you offline. A second internet account from the same provider on the same cable does not give you that. Think about these layers.
Two different providers. If one has an outage, the other may still work.
Two different technologies. For example, fiber or cable as the primary and fixed wireless, cellular or satellite as backup, since a backhoe cutting a buried line often takes down every wire in the same trench.
Physically diverse paths. If possible, have the two circuits enter the building at different points.
Automatic failover equipment. A firewall or router that detects a failure and switches traffic without staff touching anything.
Power. Make sure the modems, routers, firewall and switches are on battery backup, and that the backup lasts long enough to matter. Add generator support if your equipment room is on the emergency circuit.
Two common designs:
Active-passive: the backup line sits idle until the primary fails. It is simple and usually the lowest cost, especially if the backup is a modest cellular or wireless service.
Active-active: both lines carry traffic and share the load, with either able to take over. It makes use of the capacity you pay for, but it needs more careful configuration.
For many single-building facilities, an active-passive design with a lower-bandwidth backup is a sensible start. Prioritize critical traffic, such as EMR and voice, so that when you are running on the backup, those get the capacity first and resident streaming does not.
What is the contractual uptime and what happens when it is missed?
How long does a typical repair take, and is there priority repair for business or healthcare customers?
Does the backup share any infrastructure with the primary?
What bandwidth does the backup provide in practice, and are there data caps?
Who monitors the circuit, and will you be notified of outages or must you call?
If your phone system rides on your internet connection, consider how calls will be handled during an outage. Options include automatic call forwarding to a mobile number, a small number of traditional phone lines for emergencies, and cellular failover built into the voice gateway. Test it. Many facilities discover during an outage that the forwarding was never set up.
Redundancy costs money, but so does downtime. Rather than quoting a figure, compare the monthly price of a backup circuit with the cost of your own operational impact, such as manual documentation, delayed billing, staff overtime and any risk to resident care. For some facilities the answer is a second line. For others, a well-tested cellular backup and a good downtime procedure is enough.
Test failover during a planned window by unplugging the primary and confirming the backup takes over.
Document circuit numbers, account numbers, support phone numbers and equipment locations, and keep a printed copy on site.
Set up monitoring so you know a circuit is down before staff call to tell you.
Include internet loss in your emergency preparedness and downtime plans, with paper forms ready.
A network assessment can map what depends on your connection and show whether a backup path is worth the cost. UnityCare IT designs, installs and monitors redundant connectivity for care facilities in Oklahoma, Texas and Arkansas, and can help you compare options without overbuying.
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Existing customers: support@unitycareit.com
Address: UnityCare Technologies, 2524 N Broadway Ste 554, PMB 947974, Edmond, Oklahoma 73034-4172