The Everett Clinic
Washington, United States
With eight locations and 25 buildings spread throughout the state of Washington, The Everett Clinic’s mission is to provide the best-coordinated patient care – from the trusted family doctor to the skilled surgeon. To do this across multiple communities, the clinic relies on a variety of critical network applications, including the Epic healthcare software suite that helps The Everett Clinic manage clinical (health care records) and revenue information. The performance of these applications is of great importance, and doctors must be able to access the information they need, when they need it; making sure patients get the level of care they’ve come to expect from the clinic. When a problem does arise, the IT team must be able to quickly identify the source of the problem and fix it before it affects the quality of care or health outcomes.
NetScout's TruView™ and OptiView™ XG Network Analysis Tablet
The Everett Clinic selected TruView to gain instant and complete visibility into application performance for Epic and other critical applications. To visualize performance data, the clinic installed large-screen monitors throughout the clinic to give managers a better real-time view of all patient care applications at a quick glance. If a problem does emerge, TruView instantly notifies the IT team and helps isolate the source of the problem – either the network or specific application – so they can quickly fix it before it affects doctors, patients or staff. The detailed information provided by TruView enables the application team to quickly share network or application performance information with other IT teams (such as architecture, desktop, or business intelligence) when solving problems, working on projects or upgrading systems. If further testing is needed, the IT team uses the OptiView XG to perform in-depth, end-to-end site performance testing to augment the testing already done with TruView.
NetScout's TruView™ and OptiView XG® Network Analysis Tablet
Network infrastructure and applications are critical to patient care today. Whether it is one of our keystone healthcare applications like Epic, or some other application, they all matter to someone in the healthcare ecosystem. We have to make sure performance is high enough to meet the needs of our customers, which include doctors, medical and administrative staff, and – of course – patients. TruView and the OptiView XG give us the tools and insights needed to meet those performance expectations and solve problems fast.” – Don Lester, network and telecom manager at The Everett Clinic
The Everett Clinic was founded in 1924 and is still owned and operated by its physicians. Today, the clinic offers complete and coordinated patient care, from trusted family practice doctors to skilled surgeons, which is made possible by a single electronic medical record system. The clinic has 25 buildings spread throughout eight communities in Western Washington. Its 2,200 employees serve 307,000 active patients that log more than 880,000 visits annually.
The Everett Clinic relies heavily on its expansive corporate network to meet the demanding needs of its doctors, staff, and patients. With all of its geographically disbursed locations connected through a central data center in Everett, Washington, the clinic runs hundreds of software applications to support billing, diagnostics, networked medical equipment, scheduling and many other clinical or administrative functions. One of the largest software applications is Epic, the clinic’s primary system for maintaining electronic health records (EHRs). It is incredibly important to ensure that Epic runs well and is meeting the information needs of clinical and office staff focused on patient care is incredibly important.
“Epic is a huge multi-tiered application suite that includes several smaller applications. These smaller applications bounce from server to server, gathering data requests from different sources and funneling back responses to our clinical and administrative teams. For example, when a doctor in an exam room wants real-time patient data, he uses the Epic system,” said Don Lester, network and telecom manager at The Everett Clinic. “If the performance among these servers and applications runs too slow, it can result in poor patient care.”
Poor patient care can be as simple as delays in writing prescriptions, problems with billing, or impact on diagnostic systems. For example, if the Epic application is not responsive enough, a doctor may not be able to enter his notes into the system while with a patient. The doctor would have to manually take notes and enter them following the appointment, which could put the doctor behind schedule, creating a domino effect through the rest of the scheduled appointments for the day.
“We have hundreds of critical applications, and IT is in the unique position of having three distinct customers – doctors, staff and patients. Everyone relies on optimal network and application performance to do their jobs, stay connected, and provide high-level care. We can’t afford to have these systems impact the quality of service the clinic provides,” said Lester.
The Everett Clinic evaluated several solutions before selecting TruView and OptiView XG from NetScout. TruView uses key data sets (including packet storage, application response time, transactional decode, NetFlow and SNMP) to measure performance of hundreds of applications and then report the results through a single dashboard. The comprehensive overview of both network and application performance provides IT with a clear picture of performance and, when issues arise, helps quickly identify the root cause.
If the IT team needs more granular packet-level data, the OptiView XG Network Analysis Tablet can deliver end-to-end inline performance testing, fully integrated with TruView. Its network performance testing can give detail on bandwidth, latency, jitter, packet loss and much more for line speeds up to 10 Gbps.
“Network infrastructure and applications are critical to patient care today. Whether it is one of our keystone healthcare applications like Epic, or some other application, they all matter to someone in the healthcare ecosystem. We have to make sure performance is high enough to meet the needs of our customers, which includes doctors, staff, and – of course - patients. TruView and the OptiView XG give us the tools and insights to meet those performance expectations and solve problems fast,” said Lester.
Today, The Everett Clinic considers TruView a necessary system for ensuring operational efficiency and network productivity for the clinic. Beyond its monitoring functions, the IT team uses TruView to evaluate top talkers (i.e., applications) on the network, identify unknown applications, identify the most-used at any moment, and measure other indicators of network health. TruView delivers this information via simple graphs and alerts that trigger when minimum performance thresholds aren’t met.
“TruView helps immediately narrow down the scope of performance problems, so we can do further analysis on a specific node or server. It can eliminate hours of diagnostic time and point us precisely in the right direction,” said Lester.
For example, when Lester and his team used TruView to identify which applications were affecting network performance the most, they were surprised to find a marketing screensaver as the main culprit. The team discovered that the screensaver (which runs on hundreds of computer screens and is displayed in every patient room) was not deployed properly. Instead of caching information from each individual computer’s hard drive, it was pulling high-resolution images and marketing materials from remote servers and serving them to desktops. This created a huge amount of traffic every single day, but without TruView, the IT team may not have recognized this unnecessary bandwidth-intense application as a problem.
“TruView helps us tell right away when a problem happens and the scope of the issue. If something is slow, we can tell the location or application affected. When it’s a multi-tier application, we can see which element is the problem and don’t need to involve the vendor – it’s eliminated a lot of the troubleshooting frustrations we used to have,” said Lester.
TruView also helps identify small issues to help the IT team tweak and adjust the network. With so many applications talking to each other all the time, the data-intensive environment is ripe for performance issues.
For example, occasionally medical or administrative staff will run batch jobs during the day instead of at night when overall traffic is lower. When the IT team sees this happening, they can remind users not to run large batch jobs during normal working hours.
“TruView reduces the time my team normally spends on network and application monitoring and troubleshooting, which means we can focus on other projects,” said Lester. “And the team at NetScout has been very open to us providing feedback on the solution, so we get to play a role in future development and feature enrichment. I’ve been very pleased with TruView, and we’re excited to see the solution continue to evolve.”