Case Study: Bio-Reference | NETSCOUT

Case Study: Bio-Reference Gets Past the Blame Game and Safeguards 35,000 Daily Medical Samples with TruView and OptiView XG

At a Glance:


Bio-Reference Laboratories, Inc.



Healthcare Laboratory Testing



Elmwood Park, New Jersey



Bio-Reference Laboratories, Inc. provides clinical testing and laboratory services for physician offices with a focus on esoteric testing, molecular diagnostics, anatomical pathology, women’s health, and correctional health care. The company processes more than 35,000 medical specimens each night. To do this effectively, the company relies on a high-performance network that supports various hardware and software applications used in the laboratory sciences. A network delay of just five seconds can have a big impact on processing critical medical tests. And, any network issues or outages can cause serious concerns with test validity, compromising limited medical samples and short turnaround times for immediate diagnosis. Quickly identifying whether a network or application problem exists, and where it exists, is therefore vital to ensuring operational efficiency and testing accuracy at Bio-Reference.



Bio-Reference deployed TruView from NetScout and immediately saw a dramatic reduction in the amount of time required to identify network or application performance problems. By delivering real-time visibility into the network, staff can quickly respond to trouble tickets and resolve lingering issues. No more finger pointing, just quick problem isolation so teams can mobilize to solve the problem. And, with the addition of OptiView XG Network Analysis Tablet, IT’s network management capabilities are extended into wireless and remote access networks, presenting an ROI greater than the company expected and delivering true end-to-end network and application performance monitoring.



NetScout TruView™ and OptiView XG® Network Analysis Tablet


“Healthcare IT systems operate within very tight tolerances to ensure diagnostic equipment and results remain calibrated and accurate at all times. Network and application performance is critical, safeguarding against systemic failures. TruView provides immediate ROI with its integrated identification of network and application problems and eliminates the need for us to perform ad hoc audits with expensive outside consultants.” - Jeff Biss, director of information technology and infrastructure for Bio-Reference


Bio-Reference Laboratories, Inc. is the fourth-largest full-service laboratory in the United States and the largest independent regional laboratory in the Northeastern market. The company provides clinical testing and laboratory services for physician offices with a focus on esoteric testing, molecular diagnostics, anatomical pathology, women’s health, and correctional health care.

Bio-Reference strives to deliver the best service possible that is personalized to meet customer needs and preferences. Its main laboratory is located in Elmwood Park, New Jersey, with additional laboratories spread across the country. In total, the company employs more than 4,000 people across 10 offices along with numerous patient service centers providing convenient hours. Bio-Reference also operates in other specialized disciplines under subsidiary brands. It operates as a national oncology laboratory under the GenPath brand, one of the premier hematopathology laboratories in the country. GeneDX, a wholly owned subsidiary, is the Bio-Reference genetics laboratory recognized as the leading laboratory for testing rare genetic diseases.

“Bio-Reference is on the receiving end when doctors send patients to get blood and other samples drawn and tested,” said Jeff Biss, director of information technology and infrastructure for Bio-Reference. “IT systems and networks within healthcare laboratories operate within very tight tolerances, and network performance is critical to ensure medical diagnostics are performed on time with accurate results. We also need to ensure that sample tracking and logging is done without a hitch and that no sample is lost or incorrectly logged.”


Bio-Reference Laboratories operate like a well-oiled machine, processing more than 35,000 specimens each night to meet short turnaround times for physician diagnosis. An application delay of even five seconds can bring out systemic interruptions that add up to a lot of wasted time that could be better applied to processing critical medical tests to help diagnose and treat patients. More importantly, healthcare laboratory diagnostic systems and software are sophisticated and tremendously precise. Any network issues or outages can cause serious concerns with test validity, compromising limited medical samples and short turnaround times for immediate diagnosis.

“The laboratory instruments are extremely impressive, and it’s very important that everything remain calibrated and always right,” said Biss. “It’s a tough environment for IT staff with a lot of pressure to perform.”

The Bio-Reference network is ever-evolving to meet the company’s growth and reliability needs. Biss needed to grow the network with maximum security and minimal interruptions. He chose a flat, point-to-point network that mixes Layer 2 and Layer 3 pathways across the company’s office locations. More than 150 networking devices make up the network, which process a mix of Microsoft Office and complex homegrown applications.

Approximately 90 percent of Bio-Reference’s applications are created by in-house developers, designed to meet the company’s unique and intricate needs surrounding laboratory test procedures and sample tracking. These developers take great pride in their software. If something goes wrong, the network typically takes the initial blame until Biss and his team can prove otherwise.

“Troubleshooting and identifying the issue’s root cause takes us a lot of time, which is compounded if the network isn’t at fault since we have to get the application developers on the same page,” said Biss.

In the past, Bio-Reference would often bring in outside consultants to perform audits and analysis to validate network troubleshooting and performance testing. In addition, the company would undergo annual audits to ensure optimal network performance and security across the board. These consultants would also be brought in to arbitrate conflicting reports if the network engineers and application developers could not agree on root causes. All of this time and outside assistance adds up, costing Bio-Reference hundreds of thousands of dollars over the years. The constant disagreements also generated frustration and strained relations between network engineers and application developers.

Bio-Reference required real-time network diagnostics and reporting to match their evolving network, both today and into the future, all while delivering reliability and precision. Any effective system would also have to troubleshoot the network and provide easy, efficient visibility into the true root cause of performance problems.


Bio-Reference deployed TruView™ from NetScout to provide the flexibility, real-time network diagnostics, and application visibility they needed to manage network and application performance. TruView is the first truly unified, single-box network and application performance monitoring and troubleshooting solution. The system integrates network and application performance monitoring so that IT staff never have to waste time performing “swivel chair correlations” across multiple toolsets. To ensure these integrated functions operate without degrading performance,TruView has 250 percent more analytical processing power than competing solutions and a single, correlated dashboard that makes it easy for Biss and his team to drill down with granularity in just a few clicks.

At Bio-Reference, a core team led by Biss leverages the TruView system in an always-on configuration. Each team member monitors performance in real-time from a 42-inch display in their office, digging into any symptoms or issues as they arise. In just a few clicks, Biss and his team can identify what is causing the user’s slow performance and who owns that particular problem with breakdown views into where the delay originated (e.g., application, network, server). The team can see into device and interface availability as well as traffic analysis details across LAN, WAN, and cloud environments to uncover threatening traffic patterns that may be caused by rogue or other non-productive traffic.

“The TruView gives us a holistic view of the network, telling us if an issue exists and where it is coming from,” said Biss. “We often get clues even before a full-fledge issue arises, allowing us to proactively take care of the problem early instead of continually reacting with fingers crossed that downtime doesn’t get out of hand.”

Bio-Reference coupled its TruView system with an OptiView XG® Network Analysis Tablet to provide mobile network testing capabilities in a tablet form factor that supports both 1GbE and 10GbE along with full 802.11 a/b/g/n wireless LAN analysis.


Bio-Reference deployed NetScoutTruView and saw immediate results from the solution. The company was experiencing a frustrating, reoccurring network performance crash and could not get to the heart of the matter. Each night, some time between 11:00 PM and 2:00 AM, network performance would slow to a halt for just less than 10 minutes. Biss and his team could not catch the issue as it happened, nor could they solve the mystery based on logs.

“We just couldn’t catch it no matter what we tried,” explained Biss. “It was a big driver for us to push the TruView installation as soon as possible. We needed a better tool."

The morning of the TruView installation, Biss received a network backup audit request and set out to download the latest log files. The backup servers reported an issue, so Biss rebooted them and stepped out to work with NetScout while the servers came back online.

“It took less than five minutes,” chuckled Biss. “The backup servers came back online and everyone’s phones lit up to report a network performance issue. TruView pinpointed that corrupted data calls caused the backup servers to eat bandwidth and crash performance. NetScout helped us identify and resolve our evasive issue that morning.”

TruView also demonstrated how seriously Bio-Reference takes network security. After installing additional firewalls at a remote office, someone leaked the Wi-Fi password, allowing employees to connect personal devices to the network – a major offense at Bio-Reference. Biss noticed the connections and sent an email offering immunity if employees immediately stopped connecting to the network.

“Within 15 minutes of me sending the note, someone connected to the network changed their iPhone name to ‘Find Me,’” explained Biss. “I needed to show everyone how seriously we take network security and set off to prove a point.”

The TruView gave Biss a good start on finding who leaked the information, identifying the area and showing where the device was located in the office. He leveraged the OptiView XG Tablet’s Wi-Fi analysis capabilities to pinpoint the exact employee offender.

“We walked around as if it were a Geiger counter, honing in on our suspect with each step until I could let him know that we had indeed found him,” said Biss. “The TruView and OptiView combination worked extremely well, and took less than 30 minutes. Our staff now understands that we have cool tools to do whatever it takes to get the most out of our network systems.”

The NetScout TruView delivered bigger results for Bio-Reference and its IT department overall. Biss began bringing the TruView log reports to IT director meetings to provide regular network performance updates. The reports changed the way application developers interact with Biss and his staff.

“TruView got us past the blame game,” said Biss. “One report showed that a slow-performing application took two milliseconds to ping a server for data and 20 seconds to actually get it processed. You can’t argue that the network isn’t the issue in that scenario. That granularity changed our team’s interactions from ‘it’s the network’s fault’ to ‘hey Jeff, what do you see going on?’”

TruView delivered a return much greater than the Bio-Reference investment. It reduced staff and consultant resources needed for network testing while ensuring optimal efficiency in running medical tests. This ROI is pushing Biss to expand the TruView deployment.

“We are just starting to virtualize our environments,” said Biss. “I know what NetScout  can do. We’re very excited about leveraging these capabilities as we expand and virtualize our network because we know the results will be nothing but beneficial.”