What electronic health record system should I select?
There is no more common question among physicians and managers in small-group practices today. And lately, another vexing quandary has emerged: whether to purchase or lease EHR software and install it on servers in your office, or subscribe to an Internet-based system maintained in “the cloud.”
What is the Cloud?
When EHR vendors began offering their products via the cloud, many physician practices may have been puzzled. Some think the cloud is simply technology parlance for the Internet. In fact, it refers to a method of computing whereby the critical applications are hosted remotely and accessed by end users via the Internet.
Practices have long been accustomed to hosting critical software applications on servers in their offices. After all, that is how they have accessed their practice management systems — the IT backbone of medical practices — for 20 years.
But a cloud-based EHR, where all the practice’s data is hosted remotely, raises questions about data access and security. To understand how a cloud-based EHR works, consider how much you are already doing in the cloud.
Many people conduct much of their banking via secure websites that allow them to access all of their private financial information, transfer funds, check investment accounts and pay bills. Millions have used web-based e-mail systems like Gmail for all manner of personal and professional correspondence for years.
These services are offered up in the cloud. You do not have any software loaded and running on your computer to use these tools.
The cloud is really just a giant client-server model: a distributed application structure that partitions tasks between the providers of a service (called servers) and the clients. A client (a user workstation or PC) initiates communication sessions with the server by requesting a service function.
In the cloud, the server providing the service — for example, EHR service — is hosted remotely. Your Web browser is the client.
Why is the cloud gaining popularity?
Cloud computing is a paradigm shift in IT management. The cloud makes it possible for you to grow and expand rapidly by generating efficiencies and cost savings, paying as you go for the services you use.
Cloud-based EHR services are typically offered as complete software packages provided over the Internet, eliminating the need to install and run an application on your own computers and simplifying maintenance and support. Sometimes this is referred to as “software as a service,” or SaaS.
For many practices the cloud-based solution is a common choice for several reasons:
• Generally, there are no retained earnings in medical practice, so any new investments must be financed externally or the physicians take a hit against their current earnings. Low up-front costs are more palatable and less complicated.
• IT expertise and resources may be nonexistent or retained on a project-by-project basis. The cloud model does not require sophisticated technology infrastructure that must be built and maintained by an expert, costly IT staff.
• A cloud-based EHR does not require a special facility or environmental considerations because on-site servers are unnecessary. Backup and disaster recovery services are central and inclusive in the cloud model.
Fear of losing control over critical data is often a stumbling block in cloud adoption. Cloud computing can give you even more control over your data than you get with a client-server EHR.
Cloud providers offer a plethora of options for protecting the data entrusted to them — often more than your in-house IT staff or budget could make possible. In all situations, however, data sovereignty should belong to you.
An encrypted high-speed Internet connection provides your practice with access to data and applications without having to manage software changes or invest in server hardware. Updates are automatic and managed by the vendor so you won’t need staff to work over a weekend to install software, migrate files, or test data conversions.
And you’ll always be on the most current version, without requiring additional infrastructure investment.
Although there are start-up costs, there is no up-front software license to purchase or lease with the SaaS cloud model. While you won’t be paying a software maintenance or upgrade fee, you will be paying a monthly subscription or service fee.
For organizations that have the wherewithal and staff to maintain a data center (multiple servers, perform regular data backups, manage software upgrades, and attend to the details of technical troubleshooting) a client-server model is a viable choice, but may still be cost-prohibitive. Practices that find start-up investment in a data center daunting, or do not have adequate IT support, will find clarity in the cloud.
Cloud computing sounds complicated, but in reality, your practice can profit significantly from more connectivity. And that’s what Rosemarie Nelson, renowned MGMA consultant, aims to uncover on January 22nd with Cashing in on the Cloud: How You Profit from a More Connected Practice.
MGMA consultant Rosemarie Nelson, MS, has significant expertise in effective system implementation. Key to her qualifications and success is the business analysis method for evaluating processes and needs and applying solutions to information systems applications.
Do you know what you need when setting up a new medical practice?
