Illinois Bone and Joint Institute Client Story

Illinois Orthopaedic Practice Reaps Benefits of Cloud Partnership

Illinois Bone and Joint Institute (IBJI) is a specialty orthopaedic practice with over 20 locations in Chicago and the surrounding suburbs. IBJI’s 110 providers are some of the most accomplished and respected orthopaedists in the country.

As technology became an integral element of patient-care, IBJI found themselves struggling to keep up with the rate of change and their ability to adequately support the increasingly complex IT environment and its users.

IBJI’s Executive Team decided to evaluate alternative options, including Netgain’s private cloud environment.



Though IBJI was a partial owner in a technology division at the time, called TechnologyMD, that provided all their infrastructure and network services, they felt they were not maximizing the value of technology within their practice. Further, they were facing challenges that were negatively affecting user satisfaction and potentially, patient care.

  • Unreliable performance

    An unstable network meant IBJI’s users were experiencing unexpected downtime, system slowness and an overall performance level that was not acceptable for a practice of their prominence. Users were struggling to be consistently productive, which affected patient care as well as overall practice morale.
  • Pending capital refresh

    The technology infrastructure that TechnologyMD had in place for IBJI was aging and would need to be replaced within one or two years to sustain optimal performance. In addition to the server infrastructure upgrade, the data center also needed a back-up generator, additional physical security elements and upgraded network equipment. The upgrades carried a massive capital expenditure price tag and there was no guarantee that it would offer the complete solution that IBJI needed.
  • Growing storage needs

    As electronic health records were growing in popularity, IBJI faced a shortage of data storage space in their existing environment. Additional storage, at a level that prepared them for the impending requirement of EHR technology, would mean a significant investment into a Storage Area Network and a specialist to build and operationalize their storage strategy.
  • Staffing Challenge – Depth and Breadth

    TechnologyMD, the service provider owned in-part by IBJI, struggled to provide the broad field of knowledge and depth of coverage a larger, more scaled provider like Netgain might offer. Though fielding extremely talented staff, the team sometimes struggled as “masters of none” when it came to modernizing the approach to IT delivery. In this environment, keeping up with the shifting sands of clinical IT for IBJI was nearly impossible for this small-but-hard- working team. The service provider and clinic jointly embarked on an evaluation of Netgain as infrastructure and delivery partner.



After Netgain acquired IBJI’s in-house solution (TechnologyMD), IBJI’s Executive Team evaluated Netgain’s solutions as well as another cloud provider’s. IBJI’s Executive Team chose Netgain’s healthcare IT expertise, and began to implement a multi-phase migration to Netgain’s private cloud environment.

“Netgain created a milestone-driven strategic roadmap for IBJI that stabilized their existing environment, maximized their budget by using existing components and positioned them for future stability and growth,” said Matt Riley, Netgain’s VP of Healthcare Strategy who led the partnership with IBJI.

  • Phase I – Data Center Partnership

The first step in the roadmap was a data center partnership between IBJI, TechnologyMD and Netgain. Netgain evaluated IBJI’s current infrastructure elements and, using some of the elements already in place, built a stable environment that would allow IBJI to maximize the infrastructure to its potential lifespan and maximize IBJI’s budget.

“There was a team of us heavily involved in the IBJI roadmap. Our first initiative was to install a new storage plan, stabilize their existing assets, and add new compute resources. We identified these initiatives as having the quickest effect on performance and user productivity,” Riley says.

After implementing the initial initiatives, Netgain was able to extract nine months of use out of the existing infrastructure while they prepared to migrate IBJI to the new environment. This saved IBJI from a significant capital investment.

  • Phase II – Private Cloud Environment

After the data center project, Netgain migrated IBJI to their private-cloud environment, which offered IBJI dedicated resources to further improve performance, optimize resources and enable users. The move from IBJI’s Tier 2 data center in a Chicago-suburb to Netgain’s Tier 4 data center in Chicago happened smoothly, with minimal disruption to IBJI’s users.

Netgain then worked with IBJI’s software vendors to migrate their entire software stack and data to a fully hosted environment. Netgain migrated patient-care-critical applications like their SRS EHR, Allscripts PM, and PACS solutions in a single private-cloud environment. By allowing these disparate applications to coexist in the same interconnected cloud environment, Netgain was able to maximize the security, speed and performance of the entire system, as well as improve the overall user experience, in a way that is otherwise not possible when hosting single applications with individual software vendors.

  • Phase III – Ongoing Projects and Roadmapping

Matt Fletcher, IBJI’s Director of Systems Integrations and Development, oversees the IT roadmap and develops plans for how the systems are utilized. Fletcher serves as the primary point-person for Netgain’s ongoing relationship with IBJI. Fletcher works with IBJI’s Executive Team to gain insight into how technology can be used more efficiently and as a competitive advantage in their practice.

“Last year, we upgraded our Allscripts Practice Management software, which we wouldn’t have been able to do on our old system because of infrastructure limitations,” Fletcher says. “Netgain’s knowledge of Allscripts was—and continues to be—invaluable. We wouldn’t have found that expertise in another hosting provider.”

In the last couple of years, IBJI has upgraded their PM system, implemented web-based surgery scheduling and numerous other technology initiatives, with Netgain playing a critical role. “Netgain has been involved in evaluating vendors, determining how new technology will affect our environment and which technologies we should be planning for in the future, based on what they’re seeing in the industry. This sort of partnership is incredibly valuable to us,” Fletcher says.”



  • Performance

    With the move to a cloud-based environment, IBJI experiences uptime that is incomparable to their environment before Netgain.
  • Security

    After moving to the cloud, IBJI finds themselves feeling more comfortable and confident in their security processes. Fletcher says he can focus on the security practices of IBJI’s staff because Netgain
    provides a secure hosted environment for the applications and services.
  • Flexibility

    Fletcher appreciates the flexibility Netgain’s cloud has intrinsically installed in IBJI’s IT environment. “We’re able to use Netgain the way we want and need to,” Matt says. “We want Netgain focusing on the most critical aspects of our IT environment like our PM, EHR and providing top-tier support. For less-critical applications like email, we’re able to host and support that ourselves.”
  • Bench Strength

    IBJI now has access to teams of technologists who specialize in areas like clinical IT, security and compliance, networking, storage, infrastructure, support and virtualization. This depth and breadth of expertise could not have been matched with an internal team.Further, Netgain’s Innovation Team is constantly reviewing industry shifts and trends that may affect how IBJI treats patients, consumes technology or manages the practice.
  • Strategic Partnership

    “Netgain’s greatest value is their familiarity with our organization, users and how we utilize the environment,” Fletcher says.According to Fletcher, there are very few IBJI projects where Netgain is not involved. “Technology touches almost every piece of our business, and Netgain understands how each of those pieces interact with each other. The impact that one, seemingly small, change will have a ripple effect on other areas of the business,” he says.

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Quote “Technology touches almost every piece of our business, and Netgain understands how each of those pieces interact with each other. The impact that one, seemingly
small, change will have a ripple effect on other areas of the business.”

-Matt Fletcher, Director of Systems Integrations and Development