The Challenge
A family medicine practice had grown from one location to three over five years. Each location had been set up somewhat independently, and the technical environment reflected that.
What they were dealing with:
- Three separate IT vendors — one per location, none of whom talked to each other
- Patient communication emails going to spam at an unacceptable rate
- The patient portal working correctly at locations one and two, and intermittently failing at location three for reasons nobody had been able to diagnose
- HIPAA compliance review coming up with no documentation of their systems or access controls
- The practice administrator spending an estimated 6–8 hours per month on IT coordination that produced no resolution
The owner's summary: "We have three vendors, none of them know what the other is doing, and every time something breaks I spend a week emailing people who blame each other."
The Solution
We started with a two-week technical audit covering all three locations: network configuration, email setup, DNS records, patient portal configuration, access credentials, software inventory, and vendor contracts.
What we found and fixed:
- Email deliverability: SPF record was configured for location one's sending infrastructure only. Locations two and three were sending from IPs not covered by the record. Added all three sending sources, implemented DKIM, and set DMARC to monitoring mode.
- Patient portal failure at location three: A DNS entry had been misconfigured during setup and never corrected. Portal subdomain was resolving to the wrong IP intermittently due to a TTL misconfiguration interacting with a CDN rule.
- Vendor consolidation: Negotiated termination of the three-vendor arrangement and consolidated IT support under a single managed services provider with cross-location visibility.
- Documentation: Produced a full systems inventory, network diagram, access credential register, and vendor contact sheet for each location.
We also produced an 18-month technology roadmap covering: HIPAA documentation requirements, planned EHR integration, anticipated staff growth and licensing needs, and a recommended upgrade cycle for aging workstations at location two.
The Result
Patient portal issues at location three were resolved in 47 days from engagement start.
Email deliverability climbed from an estimated 71% inbox rate to 96.3% within two billing cycles.
The practice now has a single IT contact across all three locations, a documented environment, and a roadmap the owner can actually use to plan ahead rather than react to the next failure.
The compliance review passed without findings related to IT documentation — the first time they had been able to say that.