As I get my education game on in the world of EMRs, I consider myself lucky to be striking out in a solo private practice at such a great time in computer history. I’ve learned the two perhaps most important concepts that allow me to run a modern medical practice with electronic records: SaaS (software as a service), and cloud computing.
The first, SaaS, is really very important, as I found out after my practice manager and I tried to buy a system outright and own the software ourselves. This meant buying a server, which turned out to be the wrong one, and investing a lot of money into computer equipment and a local IT consultant company to help run the computer side of the office. If I was doing it all over again, I would have just gone with SaaS and let the experts do what they do best, manage the thing on their end. That includes all the software upgrades, having their own server or set of servers, and all the other wonderful accoutrements to make the process smooth and successful. We thought we’d be saving money in the long run by having our own system, but common sense would dictate that all these things run out of warranty, out of date, and eventually out of service. Who among any of us still has the first computer that they started out on? No one I know, since the technology gets updated so rapidly and repeatedly. After we switched to a SaaS-based company, life got much better and we have been much happier.
Now for cloud computing, I can’t say enough good things about it! Your memory doesn’t get taken up locally. The backup is guaranteed by someone else other than you and is usually redundant on multiple servers in multiple parts of the world. I’m thoroughly convinced that the cloud is the future of all computing. If you have a hard drive crash, there is zero liability for you when your data is web-based. You just get a new computer, log on to the web and login to your account. Google docs is a perfect example of this technology, and indeed I have been moving more and more of my own personal documents up to their cloud. Blue skies, coming my way…
Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009. He can be reached at doctorwestindc@gmail.com.
There’s no doubt that cloud services are great. You do have to make sure you’re relying on reliable vendor. Even Google has lost some data. So, it’s good to backup that data so that if something crazy happens, you still have your data.
I am a proponent of cloud services I use some myself. Just make sure you have covered your bases.
Can you trust YOUR personal, financial and patient data with your vendor.
If your SaaS provider becomes a victim of attack, are you still liable under HIPAA and HITECH? You may not like the answer to this question. Something to think about.
What happens when your cloud provider updates their software and it breaks functionality between multiple SaaS providers? Who is responsible for the fix?
How do you access your data without an Internet Connection?
As long as you have your HIPAA/HITECH mandated Disaster Recovery plan in place, SaaS provide great benefits at a low fixed monthly cost.
John and Brian, great points. Agree with all you’ve said.
Personally I live in the cloud and use cloud based services for nearly everything, but in the medical environment the 100% availability of your EHR system is a serious consideration. Treba a practice manager of 3 different practices with 3 different EHR’s commented at a HSRF (http://hsrf.blogspot.com/) focus group last month. “My practice with the SAAS product loves it, however it goes down 6 to 7 times a year with no warning. It stays down for anywhere from a few minutes to the rest of the day and they can’t tell you how long. You can’t see patients or get any information from the system when it’s down, all functionally is lost. If you call for support while it’s down frequently no one answers because all of their clients are calling at the same time. If you want control, don’t use a SAAS. With SAAS you don’t have any control over your data, or your system.”
Tripp,
I can only speak from my experience with Practice Fusion, but we had two brief outages in the past 15 months. The first was PF’s problem with an abnormal line of code that was fixed on their server and has never since then malfunctioned again. The second was during a massive Comcast outage throughout the Northeast that lasted an entire night. The beauty of that was when I switched to using Virgin Mobile’s MiFi service (http://www.virginmobileusa.com/mobile-broadband/mifi-2200.html) and I was able to bypass Comcast altogether to get on the web. Thus, Practice Fusion had one brief outage in 15 months. That’s a pretty good track record in my opinion.