Charts can be slow, and bandwidth may be one of the issues, but it is hardly ever the sole issue. Adequate bandwidth, low latency, low packet loss, and intelligent traffic management are the actual targets required to keep your EHR/EMR responsive in all locations.
Latency vs. Bandwidth: Why Your EHR Charts Are Slow
Once a clinician clicks into a chart, the system tends to fetch a great many little things (patient demographics, meds, labs, notes, allergies, previous visits) instead of a single gigantic file. Such traffic is as sensitive to latency (delay) and packet loss as it is to raw Mbps; thus, a link may report a speed of “200 Mbps” and still be slow due to instability or poor routing.
Bandwidth Needs by EHR Architecture: Cloud, On-Prem, and Hybrid
Chart loading speed also depends on the location of your system:
- Cloud-based EHR/EMR: Your web connection is your lifeline.
- On-prem in headquarters and outlets over VPN: The lifeline is the quality of the network between the branches and headquarters.
- Hybrid (part cloud, part HQ): Connectivity in both directions must be solid.
Minimum Broadband Speed Requirements for Medical Practices
The FCC minimum broadband guidelines, summarized by HealthIT.gov, offer a good starting point: single physician practices at 4 Mbps, small practices (2-4 physicians) at 10 Mbps, clinics/large practices (5-25 physicians) at 25 Mbps, hospitals at 100 Mbps, and large academic Centers at 1,000 Mbps.
Those figures are useful as a floor, but multi-location clinics can quickly outgrow the minimum due to the following factors:
- Both sites have concurrent users.
- Additional applications are web-based (eRx, imaging viewers, patient messaging, cloud phones, device integrations).
- Data is transferred across locations (or to the cloud) on a daily basis.
The following are typical bandwidth-consuming activities in a multi-site clinic—specifically, activities that spike during peak times.
EHR Workflows: Impact of Real-Time Integrations and Shift Changes
Plain charting is not normally the highest bandwidth hog per user, but it requires consistency. The trouble begins when you add:
- Numerous users during shift changes.
- Labs, eRx, and eligibility checks (real-time integrations).
- Remote desktops/VDI sessions.
- In-built tools in browser tabs (dictation, e-fax, analytics).
If the clinic operates a richer platform—think Enterprise EMR software with a variety of modules, integrations, and multi-site workflows—then planning for headroom matters even more than reaching a minimum Mbps number.
Telehealth Bandwidth Requirements for Video Visits
Video processing is essentially heavy mathematics, and the bandwidth usage adds up quickly.
Healthdirect advises on their Video Call platform that 350 Kbps up/down is required to sustain a 2-endpoint call, and that 350 Kbps up/down should be budgeted per additional participant in peer-to-peer calling.
To achieve Full HD quality, Healthdirect estimates 2.5 Mbps up/down. They suggest 2.5–3.5 Mbps up/down for a steady connection, and adding another 2.5 Mbps download bandwidth to support an extra Full HD participant.
Bandwidth usage is similar in Zoom-like meetings: one guide mentions 1080p video requires about 3.8 Mbps up / 3.0 Mbps down.
Lessons learned: If every site utilizes telehealth (or even frequent insurer/provider video calls), consider supporting many parallel HD streams at the site, rather than planning for just “one video call per organization.”
Medical Imaging Bandwidth: PACS and Radiology Transfer Speeds
In imaging, file sizes that were manageable yesterday may break workflows today as resolutions increase and clinicians become accustomed to accessing everything in seconds.
According to one article on the imaging industry, it is possible to use a 5- or 10-megabit pipe to read a 250-slice study in about 30 seconds (which they cite as acceptable to most physicians). However, when you are pushing studies to a different site, rapidly pulling priors, or 3D-rendering, bandwidth and stability are mission-critical.
Managing Background Data: Backups and System Updates
Endpoint upgrades, cloud backups, file syncs, security tools, and OS/app patches silently consume bandwidth. This usually happens during work hours unless scheduled otherwise. These processes not only consume Mbps but also create contention that causes chart clicks to appear sluggish.
How to Calculate Bandwidth Per Location (Step-by-Step)
To make this manageable, size bandwidth at the site level and include an organization-wide safety margin.
Step 1: Scope peak concurrent activity.
Estimate peak simultaneous usage for each location:
- Active chart users (providers + clinical staff charting simultaneously).
- Simultaneous video calls (telehealth + provider/admin meetings).
- Imaging users dragging studies (unless hosted locally).
- Background loads (backup/sync/updates—should be on a schedule, but be realistic).
Step 2: Workload-based budgeting.
An empirical method of planning is to reserve bandwidth buckets:
- Interactive apps (EHR/EMR): Consider stability/latency, create consistent headroom, and ensure that peaks do not strangle sessions.
- Real-time (telehealth/voice): Assign bandwidth per stream (starting with the numbers above for telehealth/video).
- Burst (imaging downloads/uploads): Plan for occasional spikes; for imaging centers, consider this a first-class requirement.
- Bulk (backups/patching): Throttle or schedule these tasks.
Step 3: Add headroom (do not run at the limit).
Although the math may say that 40 Mbps is enough, shoot higher so that you do not run at 80-90 percent capacity during peak times. Clinics run smoothest with an average utilization that is comfortably less than the cap, leaving room for bursts and retransmits.
Optimizing Network Performance Without Buying More Bandwidth
Increased bandwidth works—until it doesn’t. If the actual problem is latency, jitter, or congestion, smart tuning can generate a larger effect than upgrading from 200 to 500 Mbps.
Consider:
- QoS/traffic shaping: Access to EHR, VoIP, and telehealth should be prioritized; access to guest Wi-Fi and bulk sync should be de-prioritized.
- Separate networks/VLANs: Isolate clinical systems from non-clinical systems, as well as from guest and IoT chatter.
- DNS and routing sanity: Slow DNS lookups will cause EHR slowness to resemble a bandwidth problem.
- Local caching where feasible: Minimizes common resource repetitions.
- Browser/device cleanliness: Outdated PCs and overloaded endpoints can simulate network slowness.
ISP Checklist for Healthcare Facilities
Clinics complaining about slow chart loads may not actually need more bandwidth, but rather high availability and consistent upload rates.
When discussing the purchase of high-performance internet, request:
- Equal speeds where available (upload is important in cloud applications, telehealth, scanning, and transfer of imaging).
- Business SLA (uptime and repair time).
- Low-latency routing to your data center or cloud.
- Actual backup (a second circuit, LTE/5G backup, or two providers).
- A router/firewall capable of handling your throughput with security options enabled (not all hardware can).
Conclusion: Ensuring Consistent Speed During Peak Hours
For multi-location clinics, an ideal bandwidth plan is constructed based on maximum concurrency and peaking workloads—particularly telehealth and imaging—and safeguarded by QoS and redundancy. When starting with minimum guidelines, allow headroom to ensure charts remain snappy even when all locations are busy.