Advice Tips

Thinking About Cloud Computing? What questions should you be asking and why. – Part 10

Cloud Computing - What happens when the Internet goes outWhat Happens when the Internet Goes Out?

Cloud Practice Management Applications (PM Apps) rely on the Internet.  No Internet = No PM App.  This is the biggest worry of any Cloud user.

Ask yourself what the longest interruption in your Internet service has been?  5 minutes?  An hour?  A day or more?   Could you run your Practice without your PM App that long?  5 minutes?  Sure.  An hour? Maybe.   A Day or More?  No way!

It’s not a question of “If your Internet Connection will go out”, but rather just when and for how long.

Makes you cringe doesn’t it.  You need to prepare.

The good news is that Internet technologies continue to improve.  They are becoming faster and more reliable.   Additionally we have a greater number of options to choose from.  DSL, Cable, T1, 4G, Fiber and even WiFi.   In many cases now you have 2 or more options to choose from at your Practice.


This can vary greatly by area and provider, but my experience has generally group technologies something like this:

Very ReliableFiber

  • T1
  • Fiber


  • Cable

Less ReliableDSL

  • DSL
  • 4G
  • WiFi

I guess this really mirrors my order of preference, other than I would avoid T1 due to cost and speed limitations unless it was my ONLY option.

Mix and Match

One way to indemnify yourself from an Internet outage is to have two connections from independent carriers depending on your options available at your Practice.   Choose the best available solution for your primary connection and then the cheapest version of the next best option.  For example, get a great Fiber connection as your primary connection and back it up with the cheapest entry level Cable Modem.   Or get a great Cable connection and a cheap DSL.

Does the backup connection need to be as fast?  Ideally yes, but economics are a factor we can’t ignore.   Even a slow backup DSL connection is better than OFF.   You might suffer a bit, but you’ll only need to deal with it for a short period while your IT person deals with the problem with the primary connection and gets it fixed (sometimes all it takes is a restart of the ISP’s equipment)

Having two Internet connections is great, but you need an Internet Firewall/Router device that is smart enough to deal with them.  Most entry level routers don’t have ‘Dual WAN’ capability.  The router need to know it has two connections, which is Primary, and what to do when it fails.  Ideally you want it to quickly sense the Primary connection has failed and automatically switch over to the slower Secondary connection.  Once the Primary comes back online it needs to switch back automatically.  It should have some indication that it has failed over so you can tell “Why is the Internet so slow all of a sudden?” otherwise you might be completely unaware and not get your IT person on fixing the Primary connection.    One router we use routinely is made by Watchguard (model XTM25).  For as little as $400 it has everything you need.

4G to the Rescue

Can’t get two ideal Internet providers at your Prac4Gtice?  You still might be able to get the same solution with a Primary connection like a Cable modem and use a 4G Cellular service as the backup.  Again, the Firewall/Router you use needs to be able to deal with it.  The Watchguard I mentioned above has an option to work with a 4G mobile USB stick and will use that service as the backup.  Keep in mind there are probably greater costs and potentially some limit on data usage like any 4G plan.

Get Creative

Can’t get dual ISPs or don’t want the expense?   Could you get by with a laptop linked to a 4G hotspot from your cell phone?   Most 4G Smartphones can generate a local WiFi hotspot with decent Internet access speeds.  If you could link up a laptop or iPad maybe you could get by for a short period of time.  One system at reception so you know who’s walking in and one system in the clinic to use with treatment.   Not ideal, but far better than nothing.

‘No Tech’ Solution

Some Practices take a ‘just in case’ approach.  At the end of today, they print a copy of tomorrows schedule.   If they come in and the Internet is out, at least they will have a copy of who’s coming in when and have a clue as to what’s going on.  They take notes (on paper – gasp!) for the duration of the interruption and then catch up after the Internet is back on.

Numbers that Matter

Keep a cheat sheet with the important numbers handy during a moment of crisis.  Many Practices don’t know who to call if the Internet goes out.   Here’s what I suggest you have printed out on one sheet of paper and keep handy by the Internet Firewall/Router equipment:

  • Internet Provider – Company Name, Support Phone Number, and your Account Number.
  • IT Support Company – Company Name, Support phone numbers and account number if you need one.
  • Cloud PM App – Support Phone number and account number if needed.   There is always a slight chance that the problem is on their end, so you might want to call them if you can’t find anything wrong with your Internet connection.

Also you need to know where this equipment is.  Specifically the ISP’s device (usually called a modem) and your own Internet Firewall/Router that connects to the ISPs modem.   Label them so that your staff will know which is which.

Quick Fix Tip

What is the first thing I do when the Internet goes out?   Simple – Power cycle the ISP modem and your own Internet Firewall/Router.   This fixes the issue most of the time.   There is a right way to do this:

  1. Turn off the power to your Internet Firewall/Router
  2. Turn off the power to the ISP modem
  3. Wait 30 seconds
  4. Turn on the ISP modem and WAIT until it’s had time to fully restart.  Usually there is some status light that finally turns solid saying ‘Online’ or ‘Ready’.   If this status light doesn’t turn on, you know where you problem is.
  5. Turn on your Internet Firewall/Router last.  Give it a few minutes to get fully started up.
  6. Now go try accessing the Internet from one of your PCs.  Noticed I said access the Internet, not try using your Cloud PM app yet.   Just see if is working.  If it is move on to using your PM App.


No matter what your solution is you NEED to test it to know what to do when it happens for real.   Perhaps on a non-patient day run a firedrill with your staff and discuss what you’ll do.  Pull the plug on the Internet and see if things fail over as planned.  How usable is your temporary solution?  After the firedrill take a few minutes and discuss how it might be improved.

If you prepare properly, I think the risk and impact of an Internet outage can be minimized.

In this multi-part series I am trying to help educate you to the issues surrounding the issues of Cloud based solutions offered by Dental Practice Management software companies. By arming you with the questions to ask and the context behind them you should be empowered to better evaluate the products and how they would benefit your Practice. You can find a link to all the Parts of the Series back on the Index in Part 1.

Up Next in Part 11 of the Series I will be discussing “Is the Imaging Application any Good?”

MME TechnicianIf you need a little help with your Practice, this is what MME Consulting does. Just give us a call at 866-419-1102 or check us out online at

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By Steve McEvoy

Car Guy, Nerd, Canadian hiding in California