External Web Monitoring for eHealth Applications

The Internet provides big contributions in health care. More and more applications move online. Web-based applications are less expensive and started to compete with traditional healthcare IT applications. The Single Web browser interface allows views or the ability to exchange information, and can also migrate to mobile/wireless platforms. Healthcare-related applications become complex. There are web sites that provide information (content) to consumers and physicians. Recent developments in Health 2.0 focus on communication, information sharing and community.

Using the internet for healthcare purposes increases end-user dependency and the need for external monitoring to keep 24/7 availability and high performance of the web-based healthcare applications.

Let's discuss a case how Monitis External and Internal Monitoring can be used to keep the healthcare applications available and improve customer satisfaction.

HealthCenter Maintains High Level of Care Giving

A HealthCenter Hospital upgraded its medical practice management and EMR system. Now they use web-based solutions for the internal care path management; care processes starting from patients' admission to release for inpatient and outpatient practices. All lab tests and referrals are managed through the same web interface. Also they started to provide service online to their patients and have a system which connects with other databases and family doctors’ applications.

It was now important to keep the application flawlessly running. Any downtime would jeopardize care giving process. HealthCenter was using monitoring products but mostly to monitor low level systems performance. They signup to Monitis service as an additional monitoring.

First, they activated simple ping and http tests from External Monitoring to monitor availabilty of web pages from external perspectives to verify connectivity. They started to receive real-time monitoring data on uptime and page load speed of their eHealth application from end user perspective. It was also important to undertstand how their application was performing for their users from multiple locations. This data provided them with better perspectives on performance and availability of the site from other geographic locations. Monitoring web applications from multiple physical locations showed if a problem is localized to specific networks or whether it affects all users.


The internet extends to multiple countries, networks and vendors. It is important to distinguish real outages from short accidents on the network. With Monitis they were able to compare monitoring results from other locations by running checks within short time intervals.

External monitoring revealed that the Health Center Hospital's web application was slow or even "timed-out" at certain times of the day. So hospital management wanted to know the real cause of the problem. They activated Monitis Internal Monitoring and understood that the problem comes from one the processes on the server, which consumes server CPU and slows application response time.
The Health Center's web applications was complex, and simple connectivity couldn't cover fully end-user experience to understand full page load and availability of the critical content. They activated the Content Matching feature to monitor full-page vs. html download. This way they allowed monitoring solutions to test and analyze content for errors and check for timeouts. The login fields availability was monitored by the POST function.

But the web page contained other elements, and dynamic processes, such as images, functional buttons and critical workflows, the operations of which would highly affect end user experience. Monitis had a solution to that problem as well. HealthCenter activated Transaction Monitoring features and started to check web application down to every page component and every transaction to ensure that the critical flow is up and running. TM simulated end users' actions with the system. Within certain intervals it was checking the response time and performance of each page and its components, as well as each transaction and provided summary on the whole transaction or information on each individual process. In case of failure, the TM detailed view showed which component or which transaction had failed to open. Monitis TM provided a snapshot of the page that failed to initiate. This monitoring allowed HealthCenter management to receive real information on user experience and within a timely manner prevent problems before they cause serious outages, and customer complaints.

Internet business consists of more then just a Web server. HealthCenter activated mail servers, FTP servers, VPN, networks and systmes monitoring. Comparing Internal and External monitoring provides the HealthCenter management the ability to analyze and quickly and accurately determine the source of the problem. Escalated alerts and notifications to their emails, IM or phones allowed them to be aware of their web application performance anywhere and any time.

HealthCenter can now check not only infrastructure and computers, but complete coverage to full e-business infrastructure performance and functionality and can notice system deficiencies in advance and keep high level of care giving.