Hosting any application, let alone a core application, or THE core application like the Electronic Medical Record (EMR) of a healthcare organization can introduce a lot of anxiety... and a lot of support pain.

Several EMR providers offer a hosted version of their application with McKesson being one of the latest looking to move existing customers to their datacenters with Paragon version 13 now ready for release and v16 of what is now OneContent.  Several independent organizations, including Whitehat, offer hosting options as well.   

Working on an IT assessment for one healthcare organization we discovered that the healthcare organizations IT support staff was spending almost 2000 hours a year dealing with printing issues.  The onsite support staff could see and solve the symptoms of the problem which is what they had been doing to the tune of consuming effectively one full time employee per year in support time. 

They did not, however, have the ability to address the source of the problem, which resides squarely in the hosting provider’s network housing the EMR application.  The healthcare organization and the hosting provider were both unwittingly increasing the healthcare organizations support costs with the very solution designed to reduce them.

The issue is not technically a “support” issue as nothing is technically broken on the hosting provider’s side.  Printing does quit, that much is certain, but the problem only manifests itself on the client side of the print equation.  It looks completely normal, at least as measured by the hosting provider.

There is a solution to the technical problem, but to this point there has not been one to the support problem.

A healthcare organization chooses to outsource its EMR for several reasons, but usually at least one of the reasons on the list, from my experience, is a reduction in the time their own support staff is spending supporting the application or at least giving the IT support staff more bandwidth to deal with other technology related issues.

In this one case, though, while the senior leadership was thinking all is right with the world and their hosting relationship, the healthcare organization still found itself paying an unnecessary tax maintaining a level of support for their EMR even with this new hosting relationship in place.

The IT department has not said anything to this point because they did not even realize anything was out of whack.  They get a ticket, they fix it.  The hosting partner thinks all is good because they are not even getting calls on the print issue anymore.

It is a unique problem that will only be solved when the hosting provider and healthcare organization meet, discuss, and truly work through this specific issue.  The language in the contract does not provide any direction for this type of problem, so it will be up to individual people and their willingness to get involved, truly dig in and correct the issue.

If you are in or evaluating a hosting relationship for one or more of your applications, you might keep these tips in mind. 

1. See if there is a contractual mechanism to address issues that might fall into this no-man’s land.  How are you going to collaboratively work together to resolve stubborn issues that will need some work on both sides of the fence?

2. Just because you have outsourced an application and its primary support does not mean your support troubles related to that application are over.  IT leadership should be keeping an eye on support data via a ticket system, etc. to identify where the IT support time and dollars are being spent.  This problem could have gone on for an undetermined amount of time had it not been picked up in our assessment.  It was simply something not being looked at.

3. Monitoring your application at your hosting provider might make sense, or at least having that capability written into your contract.  While it would not have helped this one situation it would help a myriad of other issues and provide a mechanism to make sure your hosting partner is meeting their SLAs independent of whatever tools they are using.