Athena? Waiting room solutions? MedPlexus?
Would love to get thoughts from the experts on the advantages/disadvantages of web-based emr, and the above companies. many thanks!
I am with a web-based EHR company and used to be with a client server company. Keep in mind the following lists of reasons can a) often work both ways, b) is only as good as how well the vendors performs and c) has some "but's"
Advantages of ASP/SaaS:
* Accessibility - usually easier to get to your system and data from various locations, including anywhere you can use a cell phone
* Lower up front cost - no servers to buy
* May be lower ongoing costs - despite the ongoing monthly fees, an ASP EHR may actually be less expensive even in the long run because you don't have to pay someone to maintain your server(s), don't have to upgrade your server(s) or buy new ones, don't have to pay maintenance fees to a hardware company and your software vendor and upgrades are usually much easier on you.
* Data Security and Integrity - if the vendor uses a real data center and security protocol and contractually guarantees you rights to your data. With ASP there is no need to run back-ups, store tapes or disks offsite only to find out when the system crashes that your back-ups weren't really working and the person you assigned wasn't roatating tapes so you've lost 3 months of data.
* Easier and automatic upgrades - most ASP vendors provide upgrades routinely and at no extra charge. Upgrades are usually done over a weekend and when you next login, voila, its there and working.
* Usually includes all 3rd party data in the price and is automatically udpated - CPT, ICD-9, drug databases, ePrescribing, etc. This is the biggest area where I believe ASP is the wave of the future. EHRs are relying on so much external data that is being updated so frequently that ASP is much more able to keep up.
Client Server Advantages:
* You own the software. I list this but read the contract. In reality most of the time you don't, you just own the license to use it and that disappears if you don't pay the annual maintenance and keep your system within 1 or 2 releases of the current product.
* Maybe less expensive in the long run. Just make sure when you compare you include HW and software maintenance costs, someone to maintain your system and $ for future server upgrades and/or new servers.
* You maintain and have the data. This can be a pro or con - see ASP advantages. Also keep in mind that just because its sitting on a server in your office doesn't mean you can actually get to it and use it if the relationship with your vendor sours. Most vendors lock the database such that you can't get to the data without the software or their help.
* You decide when to upgrade (within reason). The vendor usually makes the upgrade available and you install it. Just keep in mind that you usually have to be within x versions of the vendor's current release for your maintenance contact to stay in force.
I personally believe the way of the future for all but the biggest practices is ASP. When looking at ASP also look at what I would call real ASP vs. what I would call hosted Client Server. "Real ASP" systems were designed to be ASP and therefore were designed for the relatively small band-width of the Internet and will frequently be faster than hosted Client Server. Hosted systems are the same systems the vendor sells as client server but the vendor just hosts the system for the practice. These systems may not have the same data security or speed as "real ASP" systems. They may even be housed in unsecure locations.
C Huddle VP, Market Development www.Sevocity.com