Features get the attention during a sales cycle, but support and uptime determine your day-to-day experience for years afterward. A system you cannot rely on, or a vendor you cannot reach when the schedule is full, becomes a liability quickly. Here is how to evaluate both before signing.
Read the service level agreement carefully
The SLA defines what the vendor actually commits to. Look past the headline uptime percentage and check the details.
- How is uptime measured, and what is excluded (scheduled maintenance, third-party outages)?
- What are the response and resolution targets by severity?
- What remedies apply if the vendor misses targets, and are they meaningful?
- How is planned maintenance scheduled and communicated?
Support channels and hours
Confirm how you reach support and when. A clinic that runs evening or weekend hours needs coverage that matches. Map out the channels (phone, portal, chat), the hours of live support, and what happens after hours for an urgent issue.
Escalation that works
Every vendor has a happy-path support story. Ask how a stuck ticket gets escalated, who owns it, and how long that takes. Reference calls are invaluable here: ask existing customers about a time something went seriously wrong and how the vendor responded.
Downtime and recovery
No system has perfect uptime, so the question is how gracefully it handles failure. A mature vendor will have documented downtime procedures and a tested recovery plan. For your part, you need read-only access to critical data during an outage and a paper or backup workflow so care can continue.
| Question | What a good answer looks like |
|---|---|
| What is your disaster recovery plan? | Documented RPO/RTO targets, tested regularly |
| How are backups handled? | Encrypted, geographically separated, restore-tested |
| What do we see during an outage? | Read-only or cached access to recent records |
Updates and version management
Ask how updates are delivered, whether you control timing, and how the vendor communicates changes. Cloud systems often update automatically, which is convenient but means you must verify that workflows still function after each release. Confirm there is a test or preview environment.
Putting it together
Support and uptime are hard to assess from a demo, so lean on documents and references. Read the SLA, request historical uptime and incident reports, and talk to current customers about real failures. A vendor that is transparent about its weaknesses is usually a better long-term partner than one that promises perfection.
Reference calls that actually tell you something
Vendors provide references they expect to say nice things, so the value comes from the questions you ask. Skip "are you happy?" and ask for specifics: how long does a typical support ticket take to resolve, when was the last significant outage and how was it communicated, how did the vendor handle the most recent upgrade. Ask whether they would choose the same system again knowing what they know now. The texture in those answers reveals far more than any satisfaction score.
Your half of reliability
Even a flawless vendor cannot guarantee uptime if your own infrastructure is fragile. For cloud systems especially, your internet connection becomes part of the reliability equation. Consider a backup connection, confirm your local network and devices are sound, and write down a downtime procedure your staff can follow when the system is unreachable, including how to deliver care on paper and how to catch up afterward. Reliability is a shared responsibility, and the part you control deserves as much attention as the part you are buying.