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Web based EMR - ASP vs. SaaS? Should you really care?

Posted by Alok Prasad
  
  
  
  
  
  
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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 ASP SaaS EMRa 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. provides best value comprehensive solutions to medical practices. Our solutions include affordable Electronic Medical Records Software (a.k.a. EMR or EHR Software), Patient Portal, and Practice Management or Medical Billing software and revenue cycle services including medical billing, medical coding, coding audits and account receivables management services. 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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COMMENTS

Whether you call a software delivery model ASP or SaaS may come down to a question of semantics, but the difference in the technology of the two models you describe is far from persnickety. One important reason that SaaS solutions are superior to client-server applications that have been modified to be quasi-ASP using terminal services is because rather than running on a remote server and then reproducing the screen pixel by pixel for each user, SaaS solutions group the elements used to create each screen and save them locally. This means they load once on your desktop and then don’t take up precious bandwidth loading over and over again. There are also often important security and cost implications to using quasi-ASP solutions, depending upon the particular application and its implementation. 
Additionally, your explanation that SaaS solutions “are developed specifically to leverage web technologies such as the browser, thereby making them web-native” is not exactly true. The most advanced models are Java-based and don’t rely on a Web browser. Advantages of Java-based applications include that they will run on a PC or Mac and are not limited to being compatible with one type of browser on one operating system. They are also more secure, because they don’t route data across the public forum of the Web A more detailed explanation of the differences between the four most common types of technologies used by EMR/medical practice management software vendors can be found here. But ultimately, to answer the question posed in your post, if security, cost and speed are important to you, then yes, you should care very much about the difference. 

posted @ Tuesday, October 20, 2009 4:43 PM by Jennifer McDuffee

I would like to add few more points on this topic.  
 
 
 
Generally, SaaS Model can handle catering of different modules and functionalities to different clients, thus client has more freedom to choose modules and functionalities from a pool of modules and functionalities that are provided by that software service as a whole, hence more cost effective for clients. Where as ASP model generally provides the same modules and functionalities to each client if it is supporting more then one client.  
 
 
 
On Technical side, SaaS requires more architectural soundness on middle tier and database tier to handle securely and authentically different client simultaneously. Even maintenance and administrating keeping all different clients isolated often becomes a big challenge. In short, while developing SaaS model, need of system analysis, architectural soundness, time and cost is quite high in comparison to developing an ASP model.  
 

posted @ Wednesday, November 11, 2009 2:16 AM by Parth Ghosh

Very informative post! However it is for technical people to really understand the points made herein. On the other hand, I am interested in knowing your experience with the end user (physicians. Are they comfortable with either (ASP or SAAS) model? Are they not intimidated by the fact that the data is not in their building and therefore less secure? Physicians in general already fear HIPAA regulations and I would think that ASP and/or SaaS model would increase their fear! Please share your thought on the points I just made.

posted @ Wednesday, May 05, 2010 10:41 AM by Souza

‘Security of Data’ is an aspect that is always a matter of concern for the end user; if data storage is done in Client’s premises under clients control then Client gets more confidence on the system. But just ‘Data’ being in client’s Machine/ Premises would not do much about the ‘Security of Data’.  
 
 
 
A robust architecture has to be followed for Data Security, irrespective of where the data is laying. Client’s Data is legally owned by Client, and any vendor/ agency does not have ownership of it until any specific arrangement is there through some agreement.  
 
 
 
Vendor and Clients partnership must be strong enough and it’s vendor’s responsibility to take the client in confidence that their data is secured and under strict access control. They can explain and make it a point in contract document and if needed can elaborate the technical aspect of ‘data security’ in the contract document.  
 
 
 
Data Security can be achieved through a well-defined, managed scalable architecture and broadly by using Technologies of Network Security, Encryption, Access Rights along with Loose Coupling of Data and Application etc. etc. It depend upon vendor’s technical strength and capabilities 
 
 
 
If client is much concerned about Data Storage and Security and particular about it to be at their premises and arrangement. Then, better draw an architecture that will segregate Data Storage tier and Application tier in two different networks but linked to each other by secured network connection. Data Storage can be at Client’s Network, Application at Vender’s Network, (but in this case Maintenance of Data would be a separate issue though can be done by vendor remotely) This Arrangement can be done for both ASP and SaaS Models. 
 
 
 
By experience, I found almost 75% to 80% of Client–Users shows concerned about data security, but a little percentage is there who are really very clear when they say ‘Data Security’. Both these two type of Clients can be convinced through discussion and showing them how their concern are taken care about under the proposed Architecture. In fact there is a little need of educating the market and take the client in confidence.  
 

posted @ Monday, May 10, 2010 2:13 AM by Parth Ghosh

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