Scaling Healthcare IT From 80 to 300 Users Without Losing the Personal Service Behind the Growth
Apex Dermatology needed technology operations that could grow as quickly as the practice—without the impersonal service, rising costs and unreliable phone experience it had outgrown. Knowtion helped build a more scalable operating model across users, locations, devices, voice, licensing and support.
Engagement metrics reflect Knowtion’s April 2021–August 2024 support period.
A fast-growing dermatology practice built around same-day access and a high-touch patient experience.
Apex Dermatology is a Northeast Ohio dermatology organization focused on accessible, high-quality patient care. During Knowtion’s engagement, the practice expanded rapidly across Ohio—creating new demands around user support, voice reliability, device management, licensing, office moves and day-to-day technology operations.
Apex had outgrown both the economics and the operating model of its existing MSP.
The problem was not simply support tickets. Apex was scaling quickly and needed technology to feel more personal, more reliable and easier to operate across every location.
Costs were rising sharply
The incumbent MSP was increasing pricing while Apex felt service was becoming less personalized. The environment also contained many shared or dormant PCs used by rotating surgery teams, making a simple per-device billing model a poor fit for how the practice actually operated.
Voice architecture had become a bottleneck
VoIP traffic was routed through a central location that also shared bandwidth with user internet traffic. Dropped calls and robotic-sounding audio created an operational and patient-experience problem.
Growth was accelerating
Apex was adding locations, users and devices rapidly. IT needed to scale without forcing leadership to manage more vendors, more exceptions and more complexity.
Technology needed a human service model
Apex wanted fast, friendly, accountable support that understood the practice—not a generic MSP experience optimized only around ticket volume.
A referral based on healthcare experience—and an operating style that matched Apex.
Knowtion was referred to Apex by Lake Health hospital systems based on prior work and a reputation for friendly, fast, quality IT support and strategic technology operations. Apex needed a team that could solve day-to-day problems while also thinking ahead about growth, vendors and architecture.
Modernize the core services, standardize the fleet and stay close to the users.
Rebuilt the voice model around the cloud PBX
Knowtion helped Apex move to a cloud-based VoIP provider so each location could connect directly to the cloud PBX instead of routing phone traffic through one shared central bottleneck.
Designed for bandwidth, QoS and failover
Each site’s primary connection—and failover connectivity—could support phones with appropriate bandwidth management and Quality of Service rather than competing blindly with general user traffic.
Deployed 300 managed iPads
Knowtion deployed roughly 300 iPads with laser-etched identification and mobile-device management, creating a more controlled and supportable device fleet.
Delivered 24/7 end-user support
Users received around-the-clock help desk support alongside endpoint patching, updates, antivirus protection and day-to-day troubleshooting.
Right-sized Microsoft and Adobe licensing
Knowtion reviewed user requirements and optimized Microsoft and Adobe licensing so Apex was not paying for more licensing than its users actually needed.
Removed legacy infrastructure
An on-premises fax server was retired, reducing another piece of local infrastructure that had to be maintained and supported.
Moved three offices overnight
Knowtion migrated three Apex offices into new locations overnight without operational issues, allowing staff to resume work without a prolonged technology transition.
Prepared 120+ PCs for Windows 11
Before Windows 10 end of life, Knowtion assessed more than 120 machines, upgrading SSDs and RAM where appropriate and identifying systems that should be replaced rather than over-invested in.
Price support around people—and make every location feel like the same environment.
Apex had roughly 300 PCs under management, but not every machine represented another active employee. Many systems were shared, dormant or staged to support surgery teams that rotated between locations. Knowtion charged Apex based on supported users rather than charging a separate managed-services fee for every PC, aligning cost more closely with the way the practice actually consumed IT support.
Knowtion also standardized Apex locations on Ubiquiti access points and switches. A consistent SSID and Wi-Fi credential experience across clinics reduced one-off network differences, simplified support and made it easier for staff moving between locations to connect and work.
Stop sending every phone call through the same pipe.
The previous design routed calls through a central location where voice traffic shared bandwidth with user internet activity. Knowtion helped move Apex to a cloud PBX model where each clinic had a direct path to the voice platform and failover connectivity could continue supporting phones.
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IT scaled with the practice instead of becoming the constraint.
Across more than three years, Knowtion supported Apex through growth, office changes, device expansion and modernization while giving leadership a more cost-conscious and operationally focused technology partner.
“Knowtion took over IT and made it more cost effective, operationally excellent and improved our operations. They are also fun to work with!”
Ray HannaCFO · Apex Dermatology
Three-plus years of supporting a rapidly changing healthcare environment.
Knowtion began supporting Apex in April 2021 and remained engaged through August 2024. The work evolved with the organization—from taking over day-to-day IT to supporting expansion, moving offices, modernizing voice, managing devices and preparing the endpoint fleet for Windows 11.
Questions growing healthcare organizations ask when IT has to scale with the practice.
Can Knowtion take over IT from another healthcare MSP?
Yes. Knowtion can inventory the existing environment, vendors, users, devices, licensing, voice and open issues, then transition support with continuity as the first priority. Apex moved to Knowtion after outgrowing its incumbent MSP’s pricing and service model.
Can managed IT scale with a healthcare organization that is adding locations quickly?
Yes. The operating model should standardize devices, access, support, networking, licensing and vendor ownership so each new location does not become a one-off environment. During Knowtion’s engagement, Apex grew from 8 to 13 Ohio locations and from roughly 80 to 300 users.
Can Knowtion support healthcare users 24/7?
Yes. Knowtion can provide around-the-clock help desk coverage with escalation for endpoint, application, identity, network and other technology issues.
Can you manage iPads and other mobile devices for healthcare staff?
Yes. Mobile-device management can standardize configuration, security and lifecycle operations. Knowtion deployed roughly 300 iPads for Apex with laser-etched identification and MDM.
Does Knowtion charge managed IT by user or by device?
Knowtion can structure managed IT around the operating model rather than automatically charging for every endpoint. Apex had roughly 300 PCs, including shared and dormant machines used by surgery teams rotating between locations. Knowtion charged based on supported users instead of treating every PC as a separate billable user.
Can you standardize networking across multiple healthcare locations?
Yes. Knowtion standardized Apex locations on Ubiquiti access points and switches with a consistent SSID and Wi-Fi credential standard. This simplified administration, troubleshooting and the experience for staff moving between clinics.
Can Knowtion modernize an unreliable healthcare phone system?
Yes. Voice design should account for site connectivity, Quality of Service, bandwidth and failover. For Apex, Knowtion helped move from centrally routed VoIP to direct cloud PBX connectivity at each location.
Can you optimize Microsoft and Adobe licensing?
Yes. Knowtion can review which users need which licenses and reduce unnecessary licensing where the business requirement allows. This was part of the Apex engagement.
Can you support healthcare office relocations without extended downtime?
With proper planning, yes. Knowtion supported three Apex office moves into new locations overnight without operational issues.
Can Knowtion prepare older computers for Windows 11?
Yes. Knowtion can evaluate whether a system should be upgraded or replaced, then perform hardware improvements such as SSD or RAM upgrades where economically sensible. More than 120 Apex machines were assessed and prepared ahead of Windows 10 end of life.
Does Knowtion provide strategic IT guidance in addition to help desk support?
Yes. Managed IT can include vendor review, licensing optimization, lifecycle planning, architecture decisions and guidance on which technologies to simplify, modernize or replace.
What should a growing medical practice look for in an MSP?
Look for responsive support, clear escalation, scalable device and identity standards, reliable voice and networking, licensing discipline, vendor accountability, documented operations and a provider that understands how technology affects clinical and patient-facing workflows.
Build support around the business you are becoming.
Tell us what is changing—users, locations, devices, voice, vendors or costs—and we will start with the operating model rather than another generic MSP package.