Healthcare – Bigleaf Networks

Enhancing quality of life with Bigleaf’s network optimization solution in senior living communities

Bigleaf Networks — Mon, 29 Apr 2024 14:00:00 +0000

In senior living communities, reliable internet connectivity is not only important to residents’ quality of life but also plays a critical role in their health and safety. Bigleaf works with several organizations who support the needs of aging individuals, from traditional senior care residences to assisted living communities to memory care facilities. For these communities, many with multiple locations across county and state lines, ensuring that reliable connection is a complex task.

Addressing “The Internet Problem” head-on in senior living communities

There are over 30,600 active assisted living facilities in the United States alone and the market is expected to expand at a compound growth rate (CAGR) of 5.53% from 2023-20302. When we started working with one senior care facility, they initially consisted of a couple of communities in Virginia, Pennsylvania, and New York. Since then, they’ve added more than 20 new locations. Like most fast-growing organizations they experienced technology challenges, the most glaring centered around what employees and residents referred to as “the internet problem” — the reliability of its in-building Wi-Fi and VoIP phone systems and the impact it had on staff productivity and residents’ quality of life.

Fixing “the Internet problem” has become a fundamental strategic imperative

In a cloud-based system, when the internet goes down, so, too, do the phones. For elderly care communities, that means adult children are unable to call their family members and nurse call systems are rendered inoperable, taxing both staff and residents of each community.

Adding to the challenges, when a company has broadly distributed locations, they rely on different local internet service providers for their cloud-based phone and IT systems; meaning problems can’t conveniently be solved by any single ISP.

When internet problems occur, their IT departments also get hit with a constant stream of internet-related support tickets. Frustratingly, all they can typically do is call their local ISP and hope for a resolution, which doesn’t often come. Rather, they’re given the run around as ISPs try to absolve themselves from blame or responsibility, which leads to frustrated employees and residents.

IT teams tell us, “When the internet is unreliable, people complain. Phones don’t work. Computers slow down. And staff respond by either finding a work around or just ignoring the problem. Then they stop complaining to IT because they assume IT can’t help. They just accept that this is the way it is, which doesn’t allow us to create long-term and reliable solutions.”

Putting network optimization to work for “Mom’s Kitchen Phone”-level reliability

For one of our customers with a lean IT team who manage more than 700 computers across their company’s 38 locations, the IT director ripped out the existing infrastructure and installed new phones and better connectivity. He also introduced redundancy and intelligence into the IT system. The strategy behind this solution was rooted in an unlikely place — his mom’s kitchen phone.

The Kitchen Phone Philosophy is a throwback to the days when the IT director could pick up the phone in his mother’s house and knew it would work every time. He wanted to architect an infrastructure that would give every employee and resident that same sense of predictable performance.

To make the IT system as reliable as his old kitchen phone he needed to redesign the whole system from the ground up by upgrading the Wi-Fi, network, and firewall systems. But he knew that none of that would matter without a reliable internet connection at every location. For that he needed two things:

Redundancy
Something that could make use of the redundancy in real-time without his limited team getting involved.

For redundancy, he added a second circuit to each community location. To manage those circuits, he installed Bigleaf’s network optimization solution at each location. With those two components in place, the communities were equipped with multiple paths to the internet and real-time, bi-directional QoS, load-balancing, and failover to ensure that those paths were used to provide a flawless user experience.

Their network had now become as reliable as Mom’s kitchen phone! And that’s when they began to notice something interesting.

Reaping the business benefits of truly reliable internet connectivity

“Since installing Bigleaf, we don’t get calls about internet problems. We get calls about people thinking that the internet is down. But it always ends up being a computer has lost its Wi-Fi capabilities, or somebody misconfigured something while they were working on something else. The internet just doesn’t go down anymore.”

No longer confined by low expectations, the residents and staff started paying attention to the network again.

“When we would get calls about network problems, we’d ask people about their experience: when was the last time they remembered the Internet going down or where does the WiFi not work in their building. And they’d have a hard time recalling when that was. That was when I knew what we had built with Bigleaf’s network optimization solution was a success — because they started thinking about it again.”

Fixing “the internet problem” has become a fundamental strategic improvement for the company. Shoring up their network meant they now have time to think strategically instead of reactively, as many IT departments are forced to do.

Several IT directors we work with agree, “It allows you to take a proactive approach to technology when you’re not constantly putting out fires. That’s the real value of Bigleaf.”

Since deploying Bigleaf’s network optimization solution we’ve heard from customers that their help desk tickets have dropped an astonishing 30%, even as network usage increased. IT is now seen as a source of solutions and innovations.

More strikingly, this has inadvertently created a competitive advantage for these senior care facilities. The reliability of Wi-Fi and internet connectivity has turned into a key, competitive selling point used to attract new residents and provide comforting assurance to their families that they were all in good hands.

The outcome of the kitchen phone approach, using Bigleaf’s network optimization solution, extends far beyond the network. Staff at senior living facilities can now provide better care for their residents, and their residents experience a better, more connected quality of life.

Ensure internet reliability for all assisted living communities

Enhance the quality of life for residents and staff across various types of long-term care facilities, including assisted living homes, memory care centers, and recovery and rehabilitation facilities.

Seamless connectivity empowering assisted living technology

Amy Chan — Fri, 26 Apr 2024 14:00:00 +0000

The evolving landscape of assisted living technology

The future of assisted living is undergoing a profound shift driven by the growth of specialized care services, available services, and digital innovation. Assisted living care now extends beyond traditional senior care facilities to encompass memory care, rehabilitation and recovery centers, drug and alcohol treatment facilities, in-home services, and other programs tailored to meet the diverse needs of aging individuals and those requiring longer term care. This expansion has led to an unprecedented development and embrace of assisted living technology by both care residents and care providers.

From remote monitoring systems and smart home devices to virtual healthcare consultations and medication management apps, technology is revolutionizing the reality of assisted living. This digital integration not only enhances the quality of care but also improves efficiency and accessibility for residents and caregivers. The expansion of online platforms for health care services, such as telehealth appointments and activity scheduling, underscores a move towards a more interconnected and convenient assisted living experience.

Why reliable internet is essential for assisted living tech

To navigate this evolving landscape effectively, assisted living facilities require a robust network infrastructure. Reliable internet connectivity is no longer a “nice to have”; it’s now considered a fundamental right for residents in assisted living communities to maintain open lines of communication with their loved ones and engage with the world around them. This drives a critical need for reliable network infrastructure and seamless connectivity to form the foundation of accessible, quality care for residents and caregivers alike.

In this era of growth and expanded choices for assisted living technology, choosing the right technology partners is crucial. Organizations must select vendors that can support them through the implementation and management of the appropriate technologies. This is where Bigleaf emerges as a keystone of support and innovation.

Bigleaf Networks offers unparalleled expertise in ensuring robust internet connectivity and network optimization tailored for the unique demands of assisted living facilities. With a commitment to seamless service and a user-friendly approach, Bigleaf can enhance your facility’s technological integration, while helping to ensure optimized performance and thereby maximize the overall value of the investment in assisted living technology.

Request a demo today to explore the possibilities and take the next step towards a connected, empowered future in assisted living care.

[Infographic] Network Health: The Bedrock of Healthcare Cloud Migration

Amy Chan — Thu, 01 Jun 2023 21:45:54 +0000

Network health: The bedrock of healthcare cloud migration

As healthcare organizations navigate the digital shift, the cloud is not just a buzzword but a beacon for progress and innovation. By 2025, it’s projected that a sweeping 90% of these entities will have achieved healthcare cloud migration, creating a digital backbone for key services such as practice management, electronic medical records, patient communication, and especially telehealth visits. The dependency on cloud technology underscores the criticality of an unwavering internet connection for service delivery and patient care.

Network health is imperative

The importance of reliable network health in this migration is highlighted in our insightful infographic. With telehealth’s adoption increasing by 25% since 2022, the implications of network interruptions are not just inconvenient—they can be critical. A robust network is now an indispensable component of healthcare delivery.

Encouragingly, 94% of IT professionals champion cloud migration for its benefits, which include simplified compliance with regulatory standards like HIPAA. Pioneering this endeavor, Bigleaf Networks assures uninterrupted, secure connectivity—a cornerstone for modern healthcare operations.

The impact of network health on healthcare cloud migration

Understand the impact of network health on healthcare cloud migration, enriched with real-world applications and insights, through these curated resources:

Discover insights on why internet uptime is a significant investment for IT leaders, especially within healthcare, reflecting on the growth of SaaS and the crucial role of reliable internet connections.
Explore how Bigleaf’s SD-WAN solution addresses the critical needs of medical offices and care facilities, ensuring PHI is protected and HIPAA compliance is seamless, all while enhancing the digital experience.
Healthcare leaders looking to maintain the optimal performance of cloud technologies will find invaluable support through Bigleaf’s SD-WAN, ensuring continuous uptime and quality care delivery.
The increasing reliance of healthcare operations on internet technology demands a robust network solution. Bigleaf’s offerings aim to bolster the industry’s digital transformation.
A case study from DP Fox Ventures showcases how Bigleaf’s SD-WAN can sustain business operations and prevent costly downtimes, reflecting Bigleaf’s ability to maintain business continuity during critical cloud migration efforts.

Learn More About Bigleaf

For healthcare organizations poised to enhance care delivery via cloud services, the journey starts with a solid network foundation. Download our infographic for a deeper understanding and schedule a demo to discover how Bigleaf can enhance the reliability and performance of your healthcare applications in the cloud.

Download infographic

Telehealth patient experience depends on a healthy internet connection

Amy Chan — Thu, 25 May 2023 19:52:55 +0000

Virtual medicine, including telehealth, started to take hold in healthcare organizations long before 2020, but its use was limited by state regulations, insurance rules, and preference to specific medical specialties and situations.

Technology was also a limiting factor until recently. Telehealth services surged during the COVID-19 pandemic, to support social distancing for the duration of the public health emergency. Post-COVID, telehealth remains popular, as patients, practitioners, and healthcare organizations appreciate the convenience and cost-effectiveness of remote care. In 2022, the U.S. market for telehealth services grew to more than $35 billion and it is expected to continue expanding rapidly.*

While this model of remote patient care offers many benefits, it also creates new technology challenges for the IT pros who deal with choppy and dropped calls that degrade the patient-provider experience.

Telehealth services are particularly challenging for IT pros because the real-time interactions between providers and patients depend on a secure, flawless internet connection. The connecting circuits are not controlled by the HCO’s IT group directly, but IT is nevertheless responsible for maintaining a stable connection with 100% uptime to support telehealth effectively.

Telehealth – and connectivity – fill many essential roles in the modern healthcare organization:

Remote consultations

Homebound patients rely on telehealth visits and many others prefer the convenience of these remote consultations with healthcare providers. However, any disruption, such as frozen or jittery images or poor sound quality, can interfere with important discussions about symptoms, diagnoses, and proposed treatments.

Access to medical specialists

Specialized medical expertise can be unavailable locally, especially in rural or underserved regions. Telehealth can bridge this gap by connecting patients with distant medical specialists. Reliable internet connectivity ensures smooth communication so patients and doctors can share medical records, diagnostic images, and other essential information.

Health information exchange

Patients benefit from coordination among the healthcare professionals on their care team. Video conferencing tools make collaboration more effective, as providers can share observations, test results, and treatment choices interactively across different healthcare organizations and geographic locations. A smooth, seamless internet connection supports these vital interactions and preserves the practitioners’ valuable time.

Online communities

Virtual support groups and other online communities give healthcare providers more ways to connect with their patients and offer guidance and motivation. These interactions may be conducted through interactive or asynchronous chat as well as video conferencing.

In summary, internet connectivity is a critical component that makes telehealth possible. Telehealth – and network health – support effective and efficient delivery of services to patients regardless of their location or personal mobility.

Bigleaf Networks provides end-to-end optimization to maintain flawless operation of telehealth and all internet- and cloud-enabled medical technologies.

Schedule a demo to learn how Bigleaf helps healthcare organizations to succeed in the cloud.

* Global Market Insights, “U.S. Telemedicine Market.”

Why uptime is critical for healthcare and how to increase yours

Amy Chan — Wed, 30 Jun 2021 17:31:09 +0000

Effective and efficient patient care depend on uptime

In today’s medical offices and clinics, many of the applications and technologies you rely on are now cloud- and internet-based. There are numerous advantages to this for you and your patients, but if you don’t have the uptime you need, it’s almost impossible for you and your team to use these technologies to provide the best quality of care.

Here are some of the biggest reasons uptime is so important for healthcare organizations, followed by seven concrete ways you can improve your uptime.

Electronic health and medical records aren’t just a nice-to-have

To treat your patients safely and effectively, your providers need to be able to access their electronic health/medical records — and update them — at any time, in real time.

If they can’t, there’s a good chance this downtime will make appointments take longer, introduce potential issues if notes are stored offline, or otherwise affect the patient’s overall experience.

Telemedicine and virtual care stop without reliable connectivity

If the internet at your medical office or clinic goes down, so do any virtual appointments your providers were having with patients. And your internet doesn’t even have to go down for your video calls to drop — performance issues like jitter, latency, and packet loss can topple them, too. Odds are, these interrupted appointments will leave you with frustrated patients and backed-up appointments.

Scheduling is important for both your patients and business

Internet downtime adds to the challenges your patients and staff face when trying to schedule and manage appointments in real time, via VoIP phones or online. When this key function operates consistently you can avoid frustrating the patients or overwhelming your staff.

Patient communication shouldn’t be put on hold

Your team needs a reliable way to communicate with patients and your patients need to reach the team, to share test results, answer follow-up questions, and provide treatment recommendations. And everyone will be happier and healthier if that communication happens at the right time and without interruption.

Uptime matters for a lot of other reasons, too

So many work activities rely on the internet in one way or another. You need reliable uptime to support billing, data, and communicating with a pharmacies, among many business-critical tasks.

Ways you can improve your healthcare organization’s uptime

Change your connection type

All connections experience downtime, but some connection types are more reliable than others. Looking at the data from thousands of Bigleaf customers, we found these average uptime rates for different connection types:

Connection type	Uptime (%)
Fiber	96.034
Enterprise Fixed Wireless	95.412
Cable	95.123
Copper	93.040
T1/T3	92.983
Other Fixed Wireless	92.473
DSL	89.243
Cellular	85.251
Satellite	75.568

Keep this in mind: a single fiber connection typically has the best uptime at 96%, but the remaining 4% can pencil out to 29 hours of downtime per month. That is a lot of disruption for most businesses — especially for healthcare organizations. So, while upgrading from something like copper or cable to fiber can help, it isn’t enough. Plus, some of these connection types may not even be available in your area, so those particular upgrades wouldn’t be an option.

Get multiple internet connections

If you haven’t done it already, get set up with more than one internet connection. That’s one of the most effective ways to improve your uptime. Instead of putting yourself at the mercy of one connection and the average amount of downtime associated with it — at a minimum, 4% for fiber — you can implement two or more connections with a failover option that can take over when your primary connection goes down. Even if you have two connections with lower uptime percentages — like 93% for copper and 85% for cellular — having a backup in place will almost certainly ensure more reliable uptime than if you had a single fiber connection.

Increase your ISP and last-mile diversity

If all your connections come from the same ISP or carrier, you may still experience downtime when there’s a problem on that carrier’s network. When the carrier has a problem, it will affect all of your connections. Instead, it’s best to vary the ISPs you have plugged into your sites. You’ll have a better chance of routing around issues when one connection is affected, so you can keep your uptime as close to 100% as possible.

You’ll also want to consider redundancy in the last mile to your buildings. For example, we recommend using physically diverse paths from unique providers, such as fiber and cable, DSL and wireless, or T1 and cable. That way, if someone with a backhoe accidentally cuts one physical line, you should still have another working internet connection.

Keep the same IP address when a circuit goes down

It’s common for companies that are using multiple connections to have one that’s just there as a backup. This is referred to as an active-passive configuration because one of the connections is in use while the other is idle, waiting to be activated only when the primary connection goes down.

While this is certainly better than not having another connection at all, it isn’t ideal. For one thing, you have to pay for a second connection with enough capacity for all your traffic, even though you won’t be using it most of the time. But more importantly, this active-passive configuration means you can’t move traffic between those ISPs without manually changing your IP address. During a manual failover, anyone on a telemedicine or video call, VoIP call, VPN session, or other real-time application will have their call or session drop. Additionally, your users will experience downtime with other cloud and internet applications while you manually change your IP address.

When you have same-IP address failover, your traffic automatically divert to your second connection and keep your staff and patients from even noticing the switch. This setup will also allow you to leverage an active-active configuration. That’s when you’re using both connections at the same time and traffic is automatically routed down the circuit that will provide the best performance for each application.

Document and share your disaster recovery plan

Should your healthcare organization ever experience a disaster — like a flood or power outage — that takes your essential systems down, you’ll almost certainly be able to get things up and running faster if you have a written disaster recovery plan that your staff knows and understands.

Your disaster recovery plan should identify potential problems, lay out steps to take to avoid or solve them, and clarify your team’s roles and responsibilities. When you have a disaster recovery plan for your cloud- and internet-based technologies, you will be much better prepared to handle problems and minimize the downtime that could disrupt your business operations.

Consider working with a managed service provider (MSP)

If you don’t have a dedicated IT team, or they’re stretched thin, enlisting the help of an MSP is one way to improve your uptime and free yourself up from worrying about it. Many of the medical offices, senior living centers, clinics, and other healthcare organizations we work with turned to an MSP to keep their mission-critical technology working at all locations. If you’d like to connect with a great MSP in your area, email us at sales@bigleaf.net and let us know where you’re located.

Get there faster with SD-WAN and AI

While you and your team can do many of these things to improve your uptime on your own, you may decide it makes more sense to let an SD-WAN do the heavy lifting so you can focus on other priorities.

Here at Bigleaf, we combine proven SD-WAN technology with groundbreaking AI software to automatically steer your important application traffic around internet issues. This way you can give your users an ideal experience and maximize your uptime and application performance without spending time creating and updating policies or tweaking manual configurations. To learn more about Bigleaf, check out our product page or request a demo.

Is there something you’d add to this list? Email us at stories@bigleaf.net.

Why medical offices and care facilities rely on Bigleaf

Amy Chan — Mon, 07 Dec 2020 19:06:03 +0000

Healthcare is moving to the cloud

More and more of the day-to-day operations of the typical medical office, assisted living facility, clinic, and care facility rely on the internet. They’re turning to cloud-based tools to more efficiently and effectively connect providers, patients, and data.

Patient medical records and communications are being managed digitally. Phone systems are using VoIP so medical professionals can be contacted whether they are in their office, on rotation, or even at home.

Through cloud-based technologies, medical offices are connecting their phone, messaging, and email systems to their appointment scheduling, billing, prescription refill, and referral tools. And more providers are offering telemedicine visits as an alternative to in-person appointments. All of these interactions are 100% dependent on the internet working on their end.

Unfortunately, many healthcare organizations struggle with internet that just isn’t reliable enough.

An SD-WAN can optimize your connection to the cloud — without touching PHI

An intelligent software-defined wide area network (SD-WAN) is a cost-effective way to optimize your internet connection so you can make sure all of your important cloud-based apps work when and how you need them. There are different types of SD-WANs that have different advantages, though, so it’s important to pick the one that is best suited for your needs.

Bigleaf’s SD-WAN was built for the cloud, with a unique Cloud Access Network that controls traffic from your location both to and from the application source in the cloud. Our intelligent software auto-detects your application needs and adapts in real time to internet performance and connectivity issues before they impact your business — without technical complexity or need for expert staff.

And because many companies and organizations have very intentional security measures in place to protect sensitive information, we designed the Bigleaf SD-WAN to sit outside of the firewall. So, you don’t have to disable any of its features or change any configurations. This makes Bigleaf a popular choice for anyone who handles protected health information (PHI) and has to think about HIPAA compliance.

Here’s how a few Bigleaf customers are using our SD-WAN solution to make things better for their staff and patients:

Senior living community wanting to improve their residents’ quality of life

When a new IT director started at a company that operates several senior living communities on the East Coast, they quickly learned the internet connection was unreliable at many of their communities — and that it was much more than a minor nuisance. Like many companies, they have a cloud-based phone system, and when their internet goes down, so do the phones. That means residents can’t call or receive calls from family members. Nurse call systems are also rendered inoperable.

The IT director’s small team was getting a constant stream of internet-related support tickets. Unfortunately, all they could do was to call the local ISP and hope for a resolution. But this often ended with very little support and led to frustration among employees and residents.

The IT director knew they needed a reliable internet connection at every community location. To accomplish that, they added a second circuit and installed Bigleaf’s SD-WAN at each location. With those two components in place, their communities were equipped with multiple paths to the internet, plus real-time quality of service (QoS), load balancing, and seamless failover to ensure that those paths were used to provide a flawless user experience.

A plastic surgery office starting to offer televisits

When the COVID-19 shelter-in-place orders started, this plastic surgery office in the Pacific Northwest started offering televisits, or virtual video appointments, so they could continue serving their patients. They used their existing internet connection, but since it was shared with others in their building, it would slow down when several people tried to use it at the same time.

As a result, televisits often suffered from lag and video quality issues that made it difficult for the doctors and patients to communicate and understand each other.

It became clear that they needed an optimized and reliable internet connection to effectively offer televisits to their patients while also running all of their critical business applications, including a cloud-based electronic medical records platform. The clinic’s administrator talked to their network consultant and telecom agent to get their ideas and advice. They decided to connect through two solid fiber lines and deploy Bigleaf’s SD-WAN solution.

Right out of the box, Bigleaf’s Dynamic QoS prioritized the clinic’s mission-critical applications above the rest of the traffic. Bigleaf’s intelligent load balancing utilized the two internet connections to provide real-time traffic shaping and steering that improved stability. This minimized the jitter, packet loss, and latency issues that had affected video call quality — so now the televisits just work. Plus, the other applications they rely on are working better, too.

A primary care clinic tired of phone outages

This clinic in the Rocky Mountains relies heavily on their phones, for everything from scheduling appointments to reminder calls and communicating with patients about lab results or follow-up care. Their old PRI phone system relied on a T1 internet connection that would go down for long periods of time, which had a very real impact on their business and their patients.

In a little over a year, their phones went down three times for more than a day each time — with one outage lasting three days. The office manager at the clinic had talked with their telecom company multiple times about the outages. The telecom replaced several parts that were supposed to fix the problem, but the clinic continued to experience entire days of downtime.

After that three-day outage, the clinic’s office manager was fed up. Fortunately, the managed service provider (MSP) who manages their IT and internet connection knew just how to help.

Since the clinic already had a very reliable fiber line, the MSP recommended that they move to a cloud-based phone system supported by Bigleaf’s SD-WAN. Even with the single circuit, Bigleaf’s SD-WAN would manage their sensitive VoIP traffic and deliver the reliability they needed. The MSP’s recommendation was highly credible and trusted because his company used Bigleaf, too.

Give your staff and patients reliable internet

Today, a reliable and optimized internet connection is crucial to avoiding disruptions to your business operations and ensuring quality patient care. It’s the difference between things like your phones, telemedicine appointments, and scheduling system working well and keeping your business running smoothly and being frustrated daily while dealing with issues like garbled audio, freezing video, and applications that lag and can’t keep up.

If your office, clinic, or care facility is struggling with internet issues, you can solve the problem with Bigleaf’s SD-WAN — and it’s probably simpler than you think.

Have a question or want to learn more? Don’t hesitate to contact us. We’d love to help.

Streamlining HIPAA compliance with a “conduit-exempt” SD-WAN

Amy Chan — Wed, 18 Sep 2019 22:23:16 +0000

If you’re in the healthcare business, or if you provide technology to healthcare businesses, then you’re familiar with the Health Insurance Portability and Accountability Act (HIPAA.) You’ve probably also learned that HIPAA compliance can be complicated and costly. When you start moving patient health information (PHI) to the cloud, it can get even more complicated and costly.

It’s no wonder that businesses, especially those with cloud-based PHI, are always looking for opportunities to streamline their HIPAA compliance requirements. One such opportunity exists around the internet contingency/continuity requirement. Bigleaf’s& cloud-first SD-WAN addresses this while making use of the “conduit exception” to ease the process.

The HIPAA conduit exception makes deploying Bigleaf’s SD-WAN an easy project. But there’s a lot of confusion about the conduit exception, what it means, and why it applies to some vendors like Bigleaf. This post will break it all down for you.

HIPAA, business associate agreements and you

To understand the conduit exception, we need to start by explaining business associate agreements and why they’re so critical to your HIPAA compliance. A business associate agreement (BAA) is a written contract between a covered entity (CE) — that’s you — and a business associate, defined as another vendor or company that works with you.

To maintain your HIPAA compliance, it is required that you maintain a BAA with any business associates that interact with your PHI, and for good reason. Patient records need to be protected and anyone accessing or storing those records needs to be held to the same high standard of privacy and security that you are as the CE.

The penalties for not having a BAA are steep. In fact, a covered entity in Minnesota recently agreed to a $1.55 million fine for not having a BAA in place with one of its business associates. So, we can understand why businesses default to requiring this kind of agreement.

But the onus of these agreements can be costly to both vendors and CEs. Not to mention, it can delay the deployment of new technologies. But the good news is, the Department of Health and Human Services (DHH) identified certain types of vendors that don’t require a BAA. These vendors are covered under the “conduit exception.”

Understanding the conduit exception

The conduit exception was introduced to remove this burden for both CE’s and the vendor where it wasn’t needed. The full text of the conduit exception can be found under Section 160.103 – Definitions:

We do not require a covered entity to enter into a business associate contract with a person or organization that acts merely as a conduit for protected health information (e.g., the US Postal Service, certain private couriers, and their electronic equivalents). A conduit transports information but does not access it other than on a random or infrequent basis as may be necessary for the performance of the transportation service, or as required by law. Since no disclosure is intended by the covered entity and the probability of exposure of any particular protected health information to a conduit is very small, we do not consider a conduit to be a business associate of the covered entity.

This exception means that services you use to simply transport PHI from, say, your office to another server or cloud service are not considered as business associates and therefore do not require a BAA. Simple, right? Well there’s some nuance.

When does a vendor meet the conduit exception?

The DHH has some great guidance on the subject of the conduit exception. According to an FAQ on their website

As explained in previous guidance,[14] the conduit exception is limited to transmission-only services for PHI (whether in electronic or paper form), including any temporary storage of PHI incident to such transmission. Any access to PHI by a conduit is only transient in nature.

To ensure that a vendor like Bigleaf satisfies the conditions for the conduit exception, there are two qualifications that you should look for.

1) The service must be “transient”

The conduit exception applies to things like internet connections and roads that are “transient” in nature relative to the PHI in question. That means that the vendor cannot store persistent copies of the data as a part of the service offering, whether or not the data is encrypted. For instance, when you mail something to a patient, PHI is technically traversing the road but information in the letter is never stored or recorded anywhere along the way.

Likewise, Bigleaf accepts encrypted data from your network and transmits it to our PoPs where the data is handed off, still-encrypted, to your cloud application. Bigleaf doesn’t offer persistent storage of files or other data.

2) The service must not have access to decrypt the data in transit

To meet the conduit exception a vendor must not have access to the encryption key used to secure and open the data “package.” This restriction may rule out an SD-WAN that also provides firewall functionality, as the system could potentially be able to decrypt PHI in transit (if the PHI is not first encrypted by the application).

Bigleaf, on the other hand, sits outside of the firewall and operates independently of any security or encryption that’s provided by the application and/or VPN.

Look for a proven solution

With so much at stake, it never makes sense to gamble with HIPAA compliance. When considering whether a vendor meets the conduit exemption, always ask for references or case studies. We also recommend consulting with your attorney. To learn more about Bigleaf’s role as a conduit, read our partner interview on “Simplifying HIPAA compliance for healthcare providers.”

To learn more about SD-WAN and HIPAA compliance, and how Bigleaf can help, schedule a demo today.

Simplifying HIPAA compliance for healthcare providers

Amy Chan — Thu, 23 Aug 2018 12:00:47 +0000

Simplifying HIPAA compliance for healthcare providers

The global market for cloud-based healthcare technologies is expected to grow at an average rate of 17.6% to cross the $201 billion mark by 2032 — with the U.S. accounting for 51% of that total — according to a 2023 report by Market.us.

The rapid growth is not surprising, as cloud-based communications and patient record systems can be deployed with significantly lower cost and complexity, compared to their legacy counterparts.

In the U.S., healthcare companies looking to benefit from these cloud technologies must ensure that they’re staying compliant with the Health Insurance Portability and Accountability Act of 1996 (HIPAA.) New networking technologies like SD-WAN can help.

To help explain more about HIPAA compliance and how Bigleaf can help, we reached out to one of our partners, James Bowers II. As the owner of Input/Output, James consults with companies to help them achieve and maintain their HIPAA compliance. His clients have seen a lot of success using Bigleaf’s SD-WAN to address HIPAA requirements.

Q: So, what exactly is HIPAA and why is it such a big issue for healthcare companies who want to use cloud technologies?

James Bowers II
Security Architect, Input/Output

James: HIPAA was initially introduced to help consumers keep their insurance coverage, but it also includes another set of provisions called “administrative simplification” aimed at improving the efficiency and effectiveness of the healthcare system. The administrative simplification provisions cover:

Electronic transmission of common administrative and financial transactions (such as billing and payments)
Health data and identifiers for individuals, employers, health plans, and heath care providers
Privacy and security standards to protect individually identifiable health information

These kinds of protections ensure that patients are protected and that healthcare data is kept private and secure.

That being said, HIPAA compliance is extensive, complex and, for a lot of companies in the healthcare field, required by law. A lack of proper HIPAA compliance can lead to extensive civil and criminal penalties. So these companies are understandably slow to adopt new technologies that might put their compliance at risk.

But competition is pushing companies to adopt faster, cheaper, cloud-based technologies for critical applications like patient record management. To stay HIPAA-compliant through their cloud journey, companies need to be able to show that they have contingencies in place to maintain a connection to cloud-based patient records in the event of an internet outage.

At Input/Output, we’re focused on helping companies make this cloud move as painlessly as possible while maintaining their HIPAA compliance. So SD-WAN felt like the perfect technology to provide our clients with an outage-proof Internet connection that allows them to benefit from the speed and cost-effectiveness of cloud-based technologies without putting their HIPAA compliance at risk.

Q: What kinds of companies need HIPAA compliance?

James: Any company that stores, transmits, or that may come in contact with electronic protected health information (ePHI) falls under HIPAA in some way. Apart from traditional healthcare providers like urgent care centers and assisted living centers, there are quite a few entities that are covered under HIPAA that you may never think of like:

MSP providers
Data backup providers
IT providers
Office cleaners (not fully HIPAA themselves, but proper confidentiality agreements are required to be in place)
Copier companies (I have one from last week that may get a HIPAA audit because one of their clients is getting audited)
ISPs

Most of my clients fall into the traditional healthcare provider role, but these others are also required to perform HIPAA risk assessments, and there is quite a bit that they have to provide to stay compliant. It warrants a further conversation with them as it depends on what precisely they are doing but in some cases, they have more requirements than the provider themselves.

It’s eye-opening for a lot of providers.

Q: How does internet connectivity fit into the HIPAA requirements?

James: Covered entities — entities that are required to follow HIPAA guidelines — are required to have a written plan in place that specifies how they will maintain access to ePHI in the event of an emergency. Access, or the lack thereof, to ePHI in a critical patient situation could mean the difference between life and death.

Less drastic, but still required, is that ePHI must be available to patients if requested. A lack of access to ePHI can impede a covered entity’s ability to provide care to their patients, which can have a tremendous impact on the entity’s bottom line and reputation. For these reasons alone, a contingency plan is an essential consideration.

Q: How does Bigleaf’s SD-WAN help your clients with HIPAA compliance?

James: The best contingency plan to an emergency internet outage situation (that could restrict access to ePHI) is to avoid the outage altogether, and Bigleaf’s 99.99% uptime guarantee can help a practice do just that.

By leveraging multiple internet connections along with Bigleaf’s intelligent SD-WAN platform, a covered entity can reduce their internet downtime to less than 53 minutes per year. Compare that to the hours and sometimes days of downtime companies experience with other internet solutions.

Q: What makes Bigleaf’s SD-WAN a particularly good fit for HIPAA compliance?

James: The key to Bigleaf’s SD-WAN, relative to HIPAA is in its simplicity. Simple solutions like Bigleaf can drastically reduce the HIPAA ePHI contingency planning required. Instead of heavily-documented manual procedures, Bigleaf provides an automated solution with built-in backups and failover protection. Add in some considerations for large-scale disasters, perhaps keep local copies of ePHI for upcoming procedures, and a covered entity has a robust, cost-effective, and compliant solution.

A simple contingency plan leveraging Bigleaf SD-WAN is also considerably easier to implement. The Bigleaf router installs transparently without any changes needed to existing firewalls. So deployment can be done quickly and reliably. Once installed, their intelligent platform automatically detects, prioritizes and routes traffic over the right connection without the need for complicated policies and rules. This ensures that a covered entity not only maintains access to their ePHI, but also provides the best care to their patients and reduces mistakes, which keeps a covered entity protected.

Complex solutions, plans, and processes introduce mistakes or are ignored entirely. At Input/Output, we provide solutions that seamlessly integrate with a company and their business model. To support this seamless integration, we rely on simple, secure and reliable solutions like Bigleaf SD-WAN. Once installed, a covered entity can focus on their business and patients, not their technology or compliance requirements. That’s the way it should be.

Q: Any final thoughts for a company that may be struggling with HIPAA’s contingency requirements?

HIPAA can seem intimidating and impossible to manage, but it doesn’t have to be. The key is to understand all your options and choose technologies and solutions that eliminate complexity wherever possible.

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A big thanks to James for sharing his expertise and insight. If you have any questions for James or would like to learn if Input/Output could help with your own HIPAA compliance challenges, reach out to them today at (561) 408-0007 or visit their website at www.inputoutput.tech.

If you’d like to share your own partner perspective in a future Bigleaf spotlight, email us any time at stories@bigleaf.net. We’d love to share your story!