Position, Position, Position

As our undercover IT support guy reports, the location of your computer equipment is important for the security, longevity and maintenance of your computer hardware.

I’m not talking real estate here, or sex! What I’m referring to is the physical location of your IT equipment - the computer hardware that is increasingly more important to the running of your practice.

It is a travesty that in many instances, the position of the vitals of your IT infrastructure is overlooked until the last minute when purchasing new hardware (or indeed during renovation or construction planning). Yet the location of your equipment can often have a bearing on its long term reliability, and in extremes on the very security and veracity of your data.


While the theft of any practice computer will cause inconvenience, the theft of your server will invariably cause widespread downtime and expose you to legal liability.

Jim the Junky may not have much interest in Harriet’s haemorrhoids, but this information is easily retrievable from a stolen server given the lacklustre security inherent in most clinical software. If your data falls into the wrong hands, patient anguish, extortion and legal trouble are all possible.

Where ever possible, your server needs to be kept behind a locked door “out the back”, or in the very least, locked down using a computer security cable. While I come across it on a weekly basis, having the server under the reception desk is perhaps the WORST place for a server due to its accessibility for a thief.


Heat is the enemy of computer components. This is well known and yet so often overlooked. I am sure in the last decade that I have been involved in medical IT systems I have seen many examples where excess heat has caused monitors, printers and internal computer components to fail, resulting in expensive downtime and unnecessary frustration.

As most people use desktop computers for their daily work, and don’t snuggle with them too often, many would be surprised by the heat they can generate. Try lying in bed with your favourite laptop (appropriately on your lap) surfing away for an hour or so. You will probably find that before long the computer is quite hot to the touch, and may actually shut itself down to prevent its internals from frying.

Without adequate space around the computer, the exhaust fans can’t do their job and the important internal components will slowly roast until failure.


As previously alluded to, the physical location of your hardware has a large bearing on how efficiently it can be maintained.

I have seen instances of rack mounted computers placed so high on a wall that you literally need a ladder to swap Ethernet cables in and out of ports. I don’t carry a ladder or climbing harness in my service vehicle, and rarely have I come across medical centres that have them on hand either!

Think about the position of your server. How easy can you or your IT person get to it if it goes down unexpectedly and needs attention?

On Site

I did a job at an inner city practice where space was admittedly at a premium. However in this practice the genius who put the whole catastrophe together decided to put the server to the rear of, and under one of the reception desks. I mean really underneath, to the point where you struggled to find the thing until it was pointed out to you. To make things worse, the monitor, keyboard and mouse were also nestled away in the gloom. It was just ridiculous.

I asked the staff to think about moving the server to a new location where I could access it more easily. That was not seen as a high priority so guess what? It didn’t happen. I asked the staff to spring for the cost of setting up remote access so at least the server could be ‘looked at’ from another machine. That wasn’t seen as a priority spend either. I asked the practice to buy a KVM switch so I could use the receptionist’s keyboard, monitor and mouse, again to no avail.

Now I try as hard as I can to not be a techno-fascist, so of course I continued to work on (and complain about) this server, and I kid you not it was giving me the irrits! So one day while I was working in this subterranean world, the practice principal came into reception and inadvertently (I presume) stood on my hand. That was about as much as I could take. I told the doctor enough was enough and I would no longer work on the server where it was and until it was located elsewhere, they were flying solo. The doctor was unimpressed and thought I was being extreme. Pushed to defence I told her I was going to go into her room and remove all the chairs and the next consult she did would be with her and the patient sitting on the floor! She told me this was ridiculous, but I patiently (no pun intended) pointed out that I saw myself as a professional also and NO PROFESSIONAL would work under these appalling conditions.

A couple of weeks later, I was called to the clinic to find a shiny new ventilated cupboard for the server with the monitor, mouse and keyboard setup neatly on the desk. Ahhhh Heaven!

Although this was quite an extreme example, there is a serious side to it. Imagine if I had really been injured by the stilettos. There is a responsibility in OH&S terms to the contactors who work in your practice. A crushed hand can obviously be a serious injury to an IT guy. A fall from a chair balanced on a fridge to reach a patch panel or server could be devastating to the injured worker and your insurance premiums. Or imagine if I had sent a female co-worker touting a mini skirt to service the clinic; would she be expected to get on the floor to work on a machine? Slater and Gordon might have a field day with that!

Posted in Australian eHealth

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