Dental group slashes downtime by 99% with Meraki SD-WAN

When Dan Mirksy first arrived at Sage Dental -- a dental practice based in Boca Raton, Fla., with 60 locations across Georgia and Florida -- he made an unsettling discovery: Chronic network outages were costing the business tens of thousands of dollars a month in lost revenue.

Mirksy, the new vice president of IT, moved aggressively to deploy Cisco Meraki software-defined WAN (SD-WAN) technology, which he had trialed in a previous position at The Lasik Vision Institute. Within four months, he had led the replacement of Sage Dental's entire WAN infrastructure to immediate and remarkable effect. Practice offices, which had been experiencing 30 to 40 hours of downtime a month, suddenly had none.

In this Meraki SD-WAN Q&A, SearchNetworking spoke with Mirsky to find out how Sage Dental's WAN went from sabotaging the business to supporting it.

Editor's note: This interview has been lightly edited for length and clarity.

What was Sage Dental's WAN like before you deployed Cisco Meraki SD-WAN?

Dan Mirsky: I came in shortly after our new CEO started, who really embraces technology. At the time, they were doing a good job of keeping everything running, considering how old the infrastructure was. But, honestly, I don't think they realized how much it was interrupting the business.

A circuit would go down at 2 o'clock in the afternoon, and we'd have to send the staff home. That equates to a lot of lost revenue.

Our key applications were unresponsive, the user experience was atrocious and we lacked visibility into what was really going on in the network. I had practices that were using their personal cell phones at work rather than trying to use their Avaya VoIP phones. We use these dental sensors that take X-rays and upload them to the data center, where the practice management system can consume them. Well, our key applications were running over remote desktop protocol [RDP], and then we're sending these large images back and forth. It was just a nightmare. I walked into that and said, 'OK, we have a lot to contend with here.'

During my first month, I did an assessment that showed we were experiencing 30 to 40 hours of downtime per month due to network outages. A circuit would go down at 2 o'clock in the afternoon, and we'd have to send the staff home because they couldn't see patients. That equates to a lot of lost revenue. But, at the time, it was commonplace and accepted.

How did you get from there to your Meraki SD-WAN deployment?

Mirsky: I started building some IT governance policies and initiated a root cause analysis process to create awareness around the biggest problems and generate insight into how we could resolve them. We kept coming to the same conclusion that SD-WAN was going to solve our immediate issues. We were bleeding revenue, so I immediately started getting broadband dropped to our office locations and engaged one of my longtime [consulting] partners, R2, to help build out the Meraki network. We worked with the Cisco guys to fast-track everything, and within four months, we had replaced the entire network infrastructure.

It's scary to forklift your entire infrastructure, and we did it while the practices were fully operating. We would rip out the legacy network infrastructure at lunchtime and then come up on Meraki SD-WAN after lunch. It was a perfect example of changing an airplane's engines at 20,000 feet and never missing a beat.

Now, all my key applications are running, my VoIP traffic is prioritized and we have zero downtime. We're even offering a guest Wi-Fi experience, with patients able to stream Netflix in the lobby. We went from one end of the spectrum to the other in just four months, just from implementing Meraki SD-WAN. It's a great shift.

Can you give an example of Cisco Meraki SD-WAN technology in action on the ground?

Mirsky: In August 2019, there was a Comcast outage that took down links at 17 of my practice locations, but none of those offices missed a beat. The broadband went down, but the employees didn't even know there was a problem because the Meraki automatically switched over to the other link. The failure would have affected guest Wi-Fi, but it never touched the core business because the SD-WAN prioritized the traffic correctly -- VoIP traffic first, then RDP sessions and business-critical applications -- and pushed it all through without any degradation.

If that had happened a year ago, we would have been calling patients to cancel appointments, and the downtime would have equated to about $120,000 in lost revenue that day alone. I'd have been in my CEO's office trying to explain why one Comcast outage is taking down our business. It's nice to have peace of mind knowing I have that redundancy in place.

Another example: Sage Dental uses a business intelligence analytics platform called Dental Intel, which gives field operators across our practices a 360-degree view of what needs to happen on any given day -- open treatments, appointments, no-shows, etc. Before our Meraki SD-WAN deployment, it was practically unusable. People would click on the app, go get their coffee, come back and see if it had opened yet. With SD-WAN connectivity, it actually works, and we now use Dental Intel's [Morning Huddle] feature in most of our practices every morning.

I also loaded Dental Intel into my Meraki Insight portal, so if someone calls the service desk with a problem using the app, we can go right to the portal and pull up an [SD-WAN analytics] graph showing whether it's a local, WAN, server or provider issue. That makes the troubleshooting process more efficient. It's also awesome to see the whole network in front of you on a single dashboard and be able to pinpoint bottlenecks and flag potential problems.

Do you still use MPLS?

Mirsky: Yes, we have an existing MPLS contract with AT&T; that's our primary link. When that ends, I'll probably move to carrier-grade internet for our primary link and keep using broadband for our secondary link.