EMR & EHR Blog for Physicians

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Web-based EMRs have been touted as a nice way to implement EMR solution with low initial investment. Web-based and client/server EMR systems have unique advantages and disadvantages. Which model you should choose for your practice will depend on your special requirements.

Despite the obvious advantages of web-based EMR (access from anywhere, remote hosting, etc.), there are some important points you should consider when deciding whether to implement a web-based system:

1. Don't imagine that a "high-speed" Internet connection is all you need to run a Web-based EMR. It's important to find out if you'll actually have the bandwidth required to send, receive, and exchange data efficiently. Consult the EMR vendor about its requirements, and talk to your Internet service provider about its available bandwidth options.

How much bandwidth you need will depend on the number of users and the volume of data flowing between your practice and the hosted Web- based EMR. If the data increases, you may need additional bandwidth, and you'll need to be prepared. Carefully review the EMR vendor's recommendations before you sign up for a bandwidth plan.

2. How reliable is your Internet connection? This is critical - and also, your upload and download speeds may vary depending on the time of day and how much bandwidth is being used by nearby businesses. You'll want to plan for extra bandwidth to avoid slow-downs in charting your patient encounters.

If you share an Internet pipe with other businesses in the same complex, your data transfer speeds may fluctuate dramatically, depending on how the others businesses are using the connection. We recommend asking your Internet service provider for documented evidence of the uptime you can expect. Depending on the answers, you may want to consider getting a dedicated pipe for your clinic. Work with the EMR provider to develop a backup system for charting on paper if the system goes down, and develop your office processes accordingly

3. What if your EMR vendor folds its tent? Will you be able to retrieve your data from the vendor's servers? Will the data be in a format that you can use/convert/transfer?

After deciding on a web-based EMR vendor, treat the vendor as your partner. You should be able to discuss every possible scenario with the vendor's sales reps. Better yet, work with an experienced EMR consulting company who'll help you communicate with the EMR vendor. Consider asking the vendor to provide data-backup files on a regular schedule.

4. Unlike a client/server environment, where you have local control over the server and EMR software, a web-based EMR makes you dependent on the vendor's customer support. Will your vendor reliably and promptly support you and your staff by phone, IM, email, or chat? Will the vendor be available to quickly help you solve urgent or critical issues? Talk to the vendor about its support structure, especially outside normal working hours.

5. What will happen if you someday decide to move from a web-based to a server-based EMR? Does your vendor offer that flexibility? If so, how seamless will the migration be? How much will it cost? Even if you don't believe it will ever happen, it's in your best interest to discuss it with the vendor today, and get an in-depth understanding of the process.

We've seen many successful web-based EMR systems. They do work well for most physicians. By understanding the handful of caveats we've outlined above, and preparing accordingly, you'll stand a better chance of implementing a successful web-based EMR system for your practice.

Learn about the top 10 EMR Software features that you should be looking for. Download our free article on Top 10 Electronic Medical Records features for every physician.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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I was reading an interview with the CEO of a company which offers EMR Software on SaaS (Software as Service) basis. The CEO of that EMR vendor company mentioned that theirs was the only real SaaS EMR, others who claim to be SaaS are really only ASP EMRs. I have seen this term used interchangeably in the past and therefore thought that it would probably help to clear the air a little bit.

In a hosted solution (whether ASP or SaaS), the customer does not have to buy the software or the server infrastructure. The EMR vendor hosts the application on a server that is securely hosted in a data center that is accessed over the internet by the users. These are low-cost ways for businesses to obtain rights to use software as needed. Also known as 'on-demand' licensing, the customer does not have to deal with the associated complexity and potential high initial cost of licensing the application, installing it on expensive hardware and paying for annual maintenance.

We have known many EMR Software solutions that have been offered on a hosted basis for many years.

So what excatly is the difference between ASP and SaaS offerings?

SaaS applications differ from ASP applications in that SaaS solutions are developed specifically to leverage web technologies such as the browser, thereby making them web-native. The database design and architecture of SaaS applications are specifically built with 'multi-tenancy' in mind, thereby enabling multiple tenants (customers or users) to access a shared data model.

An ASP application on the other hand in most cases is a typical Client-Server application (meant for a single client) that is accessed over the internet and therefore includes an independent instance of Database that is specifically meant for your medical office.

So, as a physician, does it really matter to you if the solution is offered as an ASP or as SaaS? Really not. As an end customer, it has no impact on how you interact with the EMR application. It does not matter to you that from EMR vendor's perspective, it is expensive to create multi-tenancy based SaaS solutions but at the time more cost-effective to host and support them.

However as a customer of hosted EMR solution, you need to unambiguously understand as to who owns the data and whether the vendor of the hosted EMR software has the right to sell the patient and physician data (howsoever anonymized it may be) to third parties like data mining vendors. Also, if and when you decide to move on to an alternative EMR solution, how easy it is for you to get access to 'your' data (including all master data) in a format that can be imported into the new EMR database.

Do you disagree with these thoughts? We'd love to hear it in your comments. If you like reading these thoughts and articles, please subscribe to our blog using RSS feed or email.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.