With the Medicare and Medicaid Electronic Health Records Incentive Program now in full effect, many medical professionals nationwide are switching to electronic health records (EHR). And while such incentives may make switching to EHR very compelling, there are still EHR implementation decisions that must be made. One of the very earliest decisions to be made is to choose how you your medical practice will deploy an EHR solution – traditional client-server fashion, or in the cloud.
Reputable cloud based solutions come built-in with many benefits, such as redundant data and application servers, as well as automated backup and recovery mechanisms. Access to the application for most users is provisioned through a web browser which means that there is no configuration of client software on user desktops. Therefore, all that is generally required for using a cloud based system is a computer and a reliable and trusted Internet connection. However, in a client-server system setup, the servers providing the database and application functionality are, to a significant extent, the responsibility of the client. Traditional on-premise client-server systems require a medical practice to have the correct server hardware and software installed to support the given EHR solution, and thus the office staff must be augmented with competent and trained IT personnel. Alternative deployment scenarios for EHR client-server implementation include off-site hosting and application service providers (ASP), but there is still a significant technical cost of ownership on the medical practice. While client-server systems have generally been the status-quo for enterprise technology for the past few decades, in recent years more and more practices are switching to cloud-based systems for the following reasons:
1. Advancing Technology. The pace at which technology is advancing is astounding. Investing in a client-server infrastructure for your medical informatics can expose you to some risk of your investment becoming obsolete in a year or two. Cloud based providers are constantly upgrading their technology infrastructure in a rotating fashion, and the costs of maintaining and upgrading this infrastructure are spread across all of the clients that use the cloud based infrastructure.
2. Fewer Points of Failure. When dealing with a client-server system, you risk encountering technical problems and potential loss of data or application access at each level of the client-server architecture. Database corruption, application server faults, and client code incompatibilities could all lead to potential downtime with your EHR system. Cloud based systems take care of much of the “plumbing” with an enterprise system architecture – including provisioning of redundant database and application servers. With most cloud based end user application functionality provided through a web browser, there is for all intents and purposes a “zero-configuration” environment for provisioning the application within the office to users.
3. Increased Flexibility. A client-server system uses a predetermined amount of data storage on a database server to store its data, and an application server has a limited amount of memory for handling end user sessions and application logic. By design, cloud based systems utilize server farms, and are scalable so your application or database server needs can grow without any concern for outgrowing the physical limitations of any one server in the farm.
4. Saves Money. When considering a client-server EHR system, paying for the high priced and necessary hardware and software licenses is just the tip of the iceberg. In fact, with a client-server system it’s common to find oneself paying for installation fees, licensing fees, maintenance fees, update fees and much more. With a cloud-based system, however, there is no hardware or software installation involved, just a simple and steady monthly payment. Ultimately, this makes your overall EHR investment a regular and predictable operating expense.
5. Data Protection and HIPAA. A significant consideration for any medical practice implementing an EHR solution is the degree to which a system affords protection of confidential patient data and restricts access to the application and patient data. Cloud-based systems are designed and built with secure data and access management in mind, and use industrial grade encryption to protect stored data and data in transmission. They also incorporate advanced authentication and authorization schemes to ensure that only properly authorized users are able to access the system and relevant patient data. Thus, using a reputable cloud-based EHR system that complies with the Health Insurance Portability and Accountability Act (HIPAA) can be considered secure, and the burden of ensuring HIPAA compliance falls, in large part, to the cloud based solution provider. With a client-server system, a medical practice must protect the system at the network, server, and application level in order to reduce the risk of hacking or unauthorized access to confidential data. Moreover, as the custodian of the client-server EHR system, the medical practice assumes the burden of ensuring that the system is HIPAA compliant.
6. Increased Patient Engagement. With a cloud-based system, a patient’s health and medical records can be easily accessed at a moment’s notice. And with today’s new medical technology, such as the Informacio Workstation, accessing a patient’s medical information and then verbally and visually sharing it with the patient is easier than ever before. Together, a cloud-based system with the Informacio Workstation is a way to increase communication in a way that is both engaging and simple to understand.
With the Medicare and Medicaid EHR Incentive Program, many medical practices are making the switch to electronic health records. And while both a cloud-based system and client-server system are two viable options, the benefits of a cloud-based electronic health records system seem to span far beyond just incentive payments.