Multi-site rural provider experienced
frequent downtime and problematic


  • NextGen Hosting
  • Application Support
  • Security Awareness Training


  • Reduced downtime
  • Smoother upgrades
  • Stronger data security
  • Fast, reliable support

Presbyterian Medical Services Background
Established in 1969, Presbyterian Medical Services (PMS) is one of the largest health, early childhood education and human services providers in New Mexico. Its services include primary care, dental, behavioral health, childhood education and senior programs. To make the greatest impact possible, PMS focuses on meeting the needs of underserved areas of New Mexico.

PMS operates 120 sites around the state. About half of the sites use NextGen solutions including Electronic Practice Manager (EPM), Electronic Health Records (EHR) and Document Manager. All the NextGen sites are in rural areas of New Mexico. The other sites are Head Start centers that serve children. Laura Martinez is a Senior Application Support Analyst at PMS and is the main point of contact for NextGen across the sites that use it.

Better Stability in the Cloud
PMS started out self-hosting its NextGen applications but struggled with system instability that caused frequent downtime. Every time the system went down, it affected providers and staff across all NextGen sites. They had to wait for an internal network team to identify the issue, fix it and bring the system back up. This impacted the front desk’s ability to schedule appointments, led to patient care delays and created extra work for staff.

Laura recalls “We had a disaster recovery plan in place so the providers could continue seeing patients, but everything had to be documented by hand on paper which slowed down appointments. And when the system came back online, they’d have to go back and re-enter the notes in the EHR. They were frustrated by the double work and how often it was happening.”

In 2017, PMS decided to partner with a NextGen hosting provider. Its goals were:
• Better system stability
• Continuous uptime
• Faster support

PMS selected ITelagen based upon the breadth and cost of its services. “ITelagen’s proposal was exactly what we were looking for and the cost was better than other vendors we evaluated,” says Laura. “The move to ITelagen went smoothly. They created a transition plan and ran a pilot first, to make sure everything worked properly with NextGen. Then we switched over during the weekend and were up and running on Monday.”

PMS has experienced no downtime since ITelagen started hosting its NextGen applications. If there is even a possibility that an interruption may occur – for example, due to bad weather – ITelagen sends an advance notification to alert PMS. The staff appreciates the stability that ITelagen hosting brings to their daily operations. “We’ve had zero downtime with ITelagen,” says Laura. “It keeps things going here. The front desk can continue to make appointments and our providers can continue to see patients.”

Dependable Support Team
Laura enters and tracks NextGen-related support tickets for 1,000 NextGen users across 60 locations. She works with both ITelagen and NextGen to resolve tickets, depending on the scope of the issue. The customer service she receives from ITelagen is reliable and fast, allowing PMS to avoid the downtime and delays it had previously.

“I always get a quick response from ITelagen. When I put in a ticket it goes to one person who will work the entire ticket through to the very end,” she notes. “I never get passed around or have to go back and forth with them asking for more information before they will fix the problem. Everyone there is great to work with and they provide the full support I need on the first try.”

Worry-free Upgrades
PMS used to have one internal person doing onsite system upgrades, and often ran into issues. For example, one time a staff member forgot to turn on an important service after the upgrade happened. Today, PMS is on an annual upgrade cycle managed by the ITelagen support team through the cloud. “Upgrades run more smoothly with ITelagen. We have a schedule planned out in advance, so we know when upgrades are happening. We don’t have to worry about missing a step or doing something wrong that will impact our ability to open the next day.”

ITelagen recently led PMS through an upgrade to NextGen 5.9.3/8.4.3. A key goal for the upgrade was to enable providers to access Population Health and Prescription Drug Monitoring data directly in the EHR. “Our providers used to have to go outside of NextGen to access
this data through another web link. Since the upgrade, they can now access it within the EHR, which takes fewer clicks and saves valuable time,” Laura notes.

Strong planning resulted in a flawless upgrade with seamless handoffs between the ITelagen and PMS teams over a weekend. The system was taken down at 7pm on Friday and the upgrade was completed by Sunday at 11am. Patient appointments continued as normal beginning at 7am Monday morning without any issues.

“The communication couldn’t have been any better between ITelagen and our teams,” says Laura. “We knew exactly who was working on what at all times, with clear instructions on how the handoff would work to get us to the next step. It was planned out so well that we didn’t run into any issues during or after the upgrade. Our NextGen rep even asked me if we had actually done an upgrade, because he hadn’t seen any tickets opened.”

Stronger Data Security and Staff Awareness
Stronger data security is another benefit of ITelagen’s hosting model. “When we started working with ITelagen, our main goal was to improve system stability, but data security is always a concern,” says Laura. “When I evaluated different hosting options, I saw that ITelagen’s cloud was fully HIPAA compliant with strong security built into it. With 60 sites’ worth of patient data, we need this level of protection.” PMS knows that a cyberaware staff is essential to reduce the risk of a breach and is using ITelagen to provide Security Awareness Training for its staff. The multi-pronged program includes mandatory training modules, simulated phishing emails, and follow-up training for staff who click on suspicious links. “Since we started this program, we’ve seen improvements in the staff’s ability to spot and avoid potential cyberattacks. It’s a great complement to the data security we have with ITelagen’s cloud hosting.”

Keys to Success
PMS provides care in rural areas of New Mexico, which can lead to unique challenges. Laura appreciates that ITelagen has taken the time to understand PMS’ model and what it needs to be successful. “From the beginning, the ITelagen team has worked to really understand our workflows and how our sites are setup,” she notes. “They know that patients are our priority, and they’ve made it their priority to ensure we’re always able to provide care at every one of our NextGen sites.”