Colon and Rectal Surgery Associates Client Story

Positioned for Growth and Success

Colon and Rectal Surgery Associates is a 25-provider practice that achieved their IT goals of lowering costs, improving network reliability, and aligning IT goals with overall practice initiatives by moving to a hybrid cloud environment.

The 100-user practice has five locations and a Pelvic Floor Center with its own set of business initiatives and goals. Sue Wilkus serves as the Director of Information Systems and Business Office Operations at Colon and Rectal Surgery Associates (CRSAL).

Prior to working with Netgain, CRSAL employed two IT employees who were in charge of day-to-day operations and management of the IT environment. In addition to the seemingly constant investment in infrastructure, Sue recognized the vulnerability and risk of having their entire IT system rest in the hands of two individuals.


Sue and her physician partners began evaluating outsourced IT management options. As part of their evaluation process, they established objectives to use as a measuring stick for project success.

Objective: Reduce capital expenses, gain control and predictability of IT costs, management and support. Also, provide a cost-effective way to scale the IT infrastructure as needed as the practice grows.

CRSAL was facing large, capital expenses that come with IT hardware refresh cycles. During those refresh cycles, CRSAL frequently encountered unexpected upgrade expenses, maintenance costs and other emergent needs. In addition, they were trying to scale the practice, but the infrastructure in place hindered their growth.

Objective: Access a broader team of professionals with specialized skills and healthcare technology experience who can be leveraged.

CRSAL recognized that the majority of their IT knowledge resided with two individuals. The extent of IT support and maintenance was dependent on the IT staff’s knowledge, skills, and ability.

In addition, the CRSAL leadership team felt there were IT support tasks that could be streamlined and automated. They desired the ability to measure and manage service tickets as well as automate frequent or repeated IT tasks to reduce cost and increase quality.

Objective: Build a network that is fault-tolerant and secure.

The leadership team did not feel confident in the availability or security of their existing network.

CRSAL users were experiencing network slowness and “gaps” in availability that rendered them unproductive.

They also recognized network security requirements would continue to increase as security regulations tightened, reliability demands, legislative pressures, and core function needs.

Objective: Partner with a vendor who could implement a disaster recovery plan.

CRSAL had several business-critical systems like their EHR and practice management applications that had very low downtime tolerances. They needed are more comprehensive business continuity or disaster recovery plan, to reduce vulnerability to network outages.

Objective: Partner with IT professionals who could help them be more strategic about their IT environment and needs.

CRSAL had been lacking in their ability to strategically plan around IT needs. Sue recalls that the practice was much more reactive than proactive to IT problems. They required a three-year plan that aligned with business objectives and offered timely, on-budget execution.

Objective: Standardize all desktops so they were always running on the latest software and technology.

CRSAL employees were running Operating Systems that were out-of-date on hardware that was past its recommended refresh stage. They had a mix of newer and older servers and software in various stages of needing upgrade or replacement. They were running older software that was not regularly upgraded. They had difficulty keeping up with the recommended support, upgrading and maintenance.

CRSAL searched for a partner who could provide a solution to help them achieve all their project objectives. The providers simply wanted their systems to work, consistently.

After evaluating costs against the alternatives, calling references and evaluating multiple IT providers, CRSAL felt confident in their decision to migrate their IT needs to Netgain.

“Netgain helped us understand where we were and how we were going to get where we wanted to go,” Sue said. “They were very patient in answering our questions, gathering data, and presenting it back to us as options we could evaluate. We did a lot of due diligence in making this decision, and Netgain made us comfortable the whole way through.”


CRSAL migrated their entire IT environment to Netgain’s private cloud environment. The migration included their EHR as well as other business applications. Netgain provided an environment that was more stable and performant than their former environment.

As part of their strategic IT roadmap, Netgain has since partnered with CRSAL in many additional projects that improve the IT environment for CRSAL users.

New NextGen EHR Migration

Netgain worked with CRSAL to migrate from Allscripts to NextGen. This involved strategically powering up and powering down servers at specific times as to not lose data or interrupt user productivity. “Netgain was one of the key reasons we were successful at earning the money available from the Meaningful Use legislation. They did this by helping us through several necessary upgrades to our EHR,” Sue said.

Pelvic Floor Center Solution

CRSAL’s Pelvic Floor Center (PFC) was not initially migrated to Netgain’s cloud environment because of the amount of imaging performed at the PFC. This meant that CRSAL was still managing outdated servers, complex storage and IT resources on-site for the PFC. Netgain did an assessment, understood the high-availability needs, and designed an on-site solution that could be managed by Netgain’s team remotely. This Infrastructure-as-a-Service solution stabilized the IT environment and improved patient care for PFC.

Managed Services

CRSAL wanted to clean up their local workstations and upgrade outdated hardware and software. Netgain provided a Managed Services solution where they took complete control of all local hardware and made a plan to get it all upgraded. Over time, Netgain was able to make order from chaos. “Netgain inventoried everything and advised us with a multi-year process. Our whole on-site environment has been cleaned up from workstations and printers to wireless access points and routers,” Sue said. “We’re finally confident in the performance and viability of our on-site hardware.”

Cloud Backup Solution

Storage seems to be a growing concern for practices after the required move to EHR. CRSAL’s PFC requires an incredible number of images, which calls for an even more incredible amount of storage. Netgain worked with CRSAL to determine a cloud-based back-up solution. The solution helped CRSAL store and recall images at an optimized speed while also managing the growing costs of storage.


“Overall, all of our objectives were met,” Sue said. “If not at first, we’ve reviewed each of them and addressed them over the years in our relationship with Netgain.”

Cost Control And Predictability

CRSAL has been able to stabilize their costs into a predictable monthly fee that only varies with resource usage or user changes.

“Initially, our costs went up, but that was because we were under-provisioned before and that represented a security risk,” Sue said. “Now, we know our costs, and we can make informed decisions knowing what the cost differences will be.”

Access To Extensive Knowledge

“Netgain really is our outsourced IT team,” Sue says. “We couldn’t hire the internal knowledge that Netgain has on-staff, and we wouldn’t want to.”

Netgain has grown familiar with CRSAL’s environment, applications, and users. Like with all clients, Netgain provides a dedicated client support team that fields all CRSAL issues and is familiar with the intricacies of the environment.

Reliable And Performant Network

CRSAL no longer experiences user disconnects or gaps in availability like they did before working with Netgain. Netgain helped stabilize their network so users and providers can optimize their productivity.

Full Disaster Recovery Plan

CRSAL recognized their vulnerability in needing a comprehensive Disaster Recovery plan when they came to Netgain. Now, Sue says, she knows Netgain has a comprehensive disaster recovery plan that is tested routinely and has helped CRSAL develop disaster recovery processes for their on-site environment.

Strategic Partner

Netgain is very embedded in CRSAL’s environment. “Netgain understands that changing one thing will have repercussions in other areas, and they help us see that. We’ve gone through so many projects with Netgain and have accomplished so many of our IT and overall business initiatives with their help,” Sue said. “They truly are a strategic partner, not just another vendor.”

Updated And Stable Hardware

Netgain has relieved CRSAL’s worries about outdated hardware, software patches and obsolete equipment. “They’ve really helped us clean up our environment and make sure that all of our equipment is where it needs to be from a performance and security standpoint.”

Going Above and Beyond

“Netgain even helped CRSAL in areas where we didn’t know we needed help,” Sue says. “After our HIPAA-mandated security risk analysis, Netgain reviewed the results with us and helped us solve the addressable issues.”

Overall, Netgain has helped position CRSAL for growth and success by eliminating the worry of IT. “We have regular communication with Netgain to discuss updates on ongoing IT initiatives and projects,” Sue says. “They’re an extension of our team and a true IT partner.”

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