K. Romero IT — Enterprise-grade IT for clinical practices

§ FINDINGS — THE PROBLEM

Does this sound like your office?

FINDING 01 · STRUCTURAL

Your office manager is the IT department. New employees wait a week for a working computer, and when it arrives, someone spends an afternoon setting it up by hand. Your break-fix vendor bills by the hour, fixes the symptom, and nothing ever actually improves.

FINDING 02 · RISK

Nobody is certain the backups work — someone set them up years ago. When the EMR is slow, the software vendor blames your network and your network guy blames the software, and you pay both while the problem stays. Every year the compliance questionnaires get longer: encryption, access controls, MFA, incident response. You're a healthcare organization being asked enterprise security questions, with no one whose job it is to answer them.

FINDING 03 · CONTEXT

None of this is anyone's fault. It's what happens when a practice grows past the point where "the computer person we call" is enough — and most do, somewhere around the second location or the twentieth employee.

§ REMEDIATION — THE TRANSFORMATION

From "the person we call" to an IT department

I don't sell hours. I sell an outcome: within a defined engagement, your practice runs on the same class of infrastructure a hospital system uses — scaled and priced for your size. Concretely:

Every device encrypted, managed, and monitored from a central console.
A new hire's laptop configured automatically in under half an hour, not half a day.
Multi-factor authentication and access controls that satisfy your compliance questionnaires instead of dreading them.
Backups that are tested, not assumed.
A network that was designed, not accumulated.
Documentation — so your practice owns its own systems instead of renting knowledge from a vendor.

And when it's built, you choose: I stay on as your fractional IT department, or I hand you a fully documented environment any competent provider can run.

§ QUALIFICATIONS — WHY ME

I've been on both sides of this

Built it from zero

For seven years I was the sole IT department for a Southern California clinical organization as it grew to 15+ therapy centers and 150+ staff. I ran the cabling, built the networks, deployed the devices, managed the accounts, and coordinated every ISP, vendor, and contractor for every new location. When a clinic opened, I was the reason its technology worked on day one.

Seen how the biggest do it

Today I work in enterprise endpoint engineering inside a Fortune 20 healthcare company — managing 1,500+ devices across 12+ clinical sites, serving as final escalation for the systems clinics depend on. I know what enterprise-grade actually means because I operate it daily: automated provisioning, security baselines, compliance policy, zero-downtime rollouts.

Most consultants have one of these backgrounds. The value is in having both: I know exactly what a small practice can skip, what it absolutely cannot, and how to get enterprise results without enterprise overhead.

COMFORTABLE IN CLINICAL ENVIRONMENTS — ARIA · MOSAIQ · MIM · ORCHARD HARVEST · PIONEERRX · DICOM/HL7 · PACS WORKFLOWS

§ SCOPE — HOW IT WORKS

A defined path, not an open-ended contract

PHASE 01

Assess

2 weeks · fixed fee

I inventory everything — devices, network, accounts, backups, security posture, vendor contracts — and deliver a written report: what's solid, what's fragile, what's dangerous, in priority order, with a fixed-price plan to fix it. You own the report either way.

PHASE 02

Stabilize

30–60 days

Close the dangerous gaps first: working, tested backups; encrypted devices; MFA on email and critical systems; removal of shared logins and ghost accounts; patching brought current.

PHASE 03

Build

60–120 days

Centralized device management, automated new-hire provisioning, security policies aligned to HIPAA expectations, network redesign where needed, documented onboarding/offboarding, vendor consolidation.

PHASE 04

Manage

Ongoing · optional

I stay on as your fractional IT department: monitoring, maintenance, security policy, vendor management, and a quarterly review with ownership on what's next. Fixed monthly fee, defined scope.

§ RESULTS — MEASURED WORK

The kind of work I do

130 → 28 minNew-device provisioning time, cut 78% across 1,500+ devices by diagnosing a deadlock at the Windows platform level — the kind of root-cause work that ends "it's always been slow."

1,500+Endpoints migrated to new remote-support tooling across 12+ clinical sites with zero support gap — staged, tested, invisible to clinicians.

10+ sitesNew clinical locations built end to end: cabling, switching, wireless, ISP and contractor coordination. Working on day one.

0 → 100%Centralized device management deployed org-wide across corporate and personal devices, from nothing.

Technical readers: I publish detailed writeups of this work → read the writing

§ FIT — WHO THIS IS FOR

Who this is for

Good fit

Medical, dental, therapy, and clinical offices in Southern California with roughly 10–150 staff — especially multi-site practices, practices about to open a new location, or anyone who's outgrown a break-fix vendor and knows it.

Not a good fit

If you need same-hour on-site response for daily helpdesk issues, you need a staffed MSP, and I'll tell you that on our first call — and can help you choose one.

Not a clinic? Most of what I do transfers — any organization that's outgrown "the person we call" has the same underlying problem. Clinical practices are where I go deepest, but if the description above sounds like your office, the call is still worth having.

§ NEXT STEP — GET STARTED

Start with a conversation

Twenty minutes, free. Tell me how your practice runs today; I'll tell you honestly whether I can help and what it would look like. No prep, no obligation, no slide deck.

Book an intro call