案例分析:MACIPA Uses TruView™ Live to Diagnose and Cure Cloud-Application Performance Issues



Physician Membership Organization

Brighton, Massachusetts

Over the past 30 years, Mount Auburn Cambridge Independent Practice Association (MACIPA) has grown to include more than 500 doctors throughout Massachusetts.MACIPA provides systems for patient scheduling, patient chart maintenance, and medical records.The association uses a cloud-based electronic health records system and operates an IT help desk for end users.Supporting so many independently-run medical practices requires MACIPA to use third-party networks, which can lead to greatly varied end user experiences from practice-to-practice.For MACIPA, the inherent lack of visibility into performance issues made it impossible to fully assess the root cause of delays or disruptions, resulting in guesswork and lingering issues.

MACIPA needed a comprehensive network and application performance management solution that would specifically be able to monitor cloud-based applications.After learning about the capabilities of TruView Live, MACIPA embarked on an ambitious pilot program with 27 of its member clinics.
Despite the distance among all the clinics, getting up and running with TruView Live was easy.Each clinic installed the lightweight TruView Live agent, or Pulse, on its local PCs, where it could silently collect relevant performance and availability data nonstop, without causing additional latency.

MACIPA has found TruView Live to be essential in identifying the cause of issues with confidence, resulting in significantly shorter issue resolution times.TruView Live's ease of deployment, scalability and instant results have already made it a valuable and cost-effective solution.

TruView™ Live

TruView Live has helped us better pinpoint the cause of malfunctions, and we instantly get to see the impact of any enhancements that we make – Jerry Boudreau, IT Manager


Established in 1985, Mount Auburn Cambridge Independent Practice Association (MACIPA) is a customer organization for more than 500 physicians that run practices throughout eastern Massachusetts.MACIPA provides support systems that help these doctors, their clinicians, and support staff manage tasks such as patient scheduling and maintenance of patient charts.With the introduction of Electronic Health Records, the support offered by MACIPA and its EMR platform has become invaluable.


Serving so many clinics under a decentralized umbrella means MACIPA must work with the network infrastructure specific to each individual practice.Network environments can vary significantly from clinic-to-clinic, even for something as simple as the speed of internet service or reliance on a third-party network for clinics to access MACIPA's WAN.The lack of end-to-end visibility made it nearly impossible for MACIPA's IT team to identify why delays or disruptions were occurring at each clinic.Typically, end-user calls to MACIPA's help desk only provide vague information about the issue, with users complaining, "The system is slow." or "I'm being booted out of my PC." Without a comprehensive view of the entire network, the team was left using remote desktop tools, which could only identify the symptoms of the issue rather than provide insight into the error's root cause.

"These practices exist to deliver healthcare to their patients, so any delays or network issues lead to lost productivity," said Jerry Boudreau, IT Manager at MACIPA."Without a way to see what was wrong or find the best permanent fix, end-users and support technicians were understandably frustrated."


Without any jurisdiction over the PCs or networks used by their member clinics, the MACIPA IT team realized it needed a better way to ensure consistent delivery of their services and a high-quality end-user experience.The team also knew it needed a solution that could specifically handle cloud-based and third-party applications.With this in mind, MACIPA selected TruView Live for a pilot program with 27 of its member clinics.

MACIPA found TruView Live to be incredibly easy to deploy.Installing the lightweight TruView Live agent (called Pulses) on each clinic's local PCs was quick and straightforward.As each TruView Live Pulse runs in the background, it continually collects essential network and application performance data without causing additional slowdowns.With TruView Live in place, MACIPA was quickly able to establish a benchmark for application performance, based on test responses to Google, MIT, and Citrix environments.

Most importantly, TruView Live has brought immediate benefits.

"Having instant access to a clinic's network performance data is definitely reassuring,” continued Boudreau.“With TruView Live, we can efficiently pinpoint the cause of malfunctions with confidence and can instantly see the impact of any enhancements we make.Being able to share that information with our clients has helped us work collaboratively and build their support."

With TruView Live now gaining traction among its customers, MACIPA is establishing performance benchmarks and measuring end-user experience to get a better understanding of how well its EMR platform is being delivered.By using TruView Live Pulses, MACIPA can easily measure network performance at individual clinics.

Within the first few months of deployment, MACIPA encountered several situations where TruView Live provided the critical insight to help identify the root cause of a performance issue.Since TruView Live measures performance through the DNS, Client, Network, SSL, Server, and Applications it can pinpoint where a delay is occurring.Users at a hospital recently reported being booted out of the system.Using TruView Live, MACIPA determined the users weren't actually being disconnected from the EMR system as originally thought, but that latency of roughly 1.5 seconds was causing the problem in the network.MACIPA determined the outage was the result of poorly running VPN tunnels, which were unreliable and needing re-initiation.

In another example, an independent heart specialist had been complaining of general slowness and issues with the EMR platform.A TruView Live Virtual Pulse installed on the office's computers showed there were five subnets inside the 600 square-foot space competing for bandwidth, which meant the issue had nothing to do with the EMR platform itself.This was particularly helpful because the analysis revealed the clinic's devices weren't necessarily connected to the same infrastructure, as initially thought.

Based on the successes that MACIPA and its customers have had with TruView Live so far, the IT team is expanding the solution to more clinics.For the IT team at MACIPA, TruView Live's ease of deployment, scalability, and instant results have already made it an invaluable and economical solution.

"TruView Live's pricing model shows that it is one of the most affordable tools available," said Boudreau."It provides absolute measurement and visibility into network performance from the origination point all the way to the application in a very cost-effective way."

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