Cloud Computing and EMR Software

Watch as Software as a Service (SAAS) for EMR / EHR becomes Cloud Computing: And Cloud Computing becomes a Valid EMR Choice

By Sheldon Needle

A few years ago, the idea of SAAS computing services for the medical EMR / EHR industry was still on the vanguard, a little risky: a kind of out-there medical solution for medical groups who wanted a cheap, automated solution.

Today, many large Practice Management Vendors are offering cloud-based Practice management software alongside their client hosted EMR – and sometimes instead of client hosted EMR.

After all, if we do so much of our IT work on notebooks that don’t have much in the way of a hard drive, and are writing our personal papers on Google Docs that are out there in the ether world, why would we not consider similar solutions for our practice management software? Even client hosted software has its own mini-version of cloud computing when it offers physicians tablet-based drug prescription software (tied in to their own remote server) or patient portals that can be logged into remotely.

The difference between cloud-based EMR and client hosted EMR is really this: Who is doing the system maintenance? In the case of client hosted EMR, it is your own employees; in the case of cloud-based EMR, it is a contracted IT team. The question becomes one of reliability, and that is a hard question to answer.

If you are large enough to hire your own full time IT people to be available 24/7, well and good. It might make dollars and (good) sense to have your own client hosted server; if you are a smaller practice, or a large practice that doesn’t want to get involved in IT management, cloud computer based EMR / EHR begins to make more and more sense as medical software management application get more sophisticated.

Some of the risks associated with cloud computing for EMR need to be discussed and evaluated. Most are valid, but are equally applicable to client hosted systems as well:

1) Who controls the data?
If your secure data is in a cloud, it means that someone else has access to your data. But companies that offer software as a service are likelier to have more secure encryption and control of the data than you are in house with a personal server, because security is such a large part of their business. In-house ignorance of data control rules, even in data associated with patient billing, or lack of enforcement thereof, is just as likely to be part of the company culture. Benign neglect of rules because you trust your fellow employees makes a system even more vulnerable than leaving security issues to a third-party whose integrity and reputation will be based on careful security maintenance.

2) Poor training and associated data vulnerability:
Poor training in the use of patient-related data is a risk in any EMR environment. Ignorance of security procedures is a more likely culprit in confidentiality breakdowns than is deliberate security violations. Most providers of quality EMR software will provide enhanced training, either as part of their regular contract, or as an enhanced feature option available with your contract for a software package, whether it is SAAS or client hosted. Don’t skimp on training, because it can make the difference between a relatively easy migration to new software and a nightmare situation. IT can also make the difference between security slips due to ignorance and a safe and secure data situation.

3) Catastrophe and backup procedures:
Isn’t it wonderful to have someone else worry about backup procedures? This is something that must be part of any cloud computing contract. If it is not, you are not dealing with a provider who is aboveboard.

If you are managing your own backup and catastrophe procedures, be vigilant: no one wants to dream of the worst-case scenario, but as we have seen in the macrocosm, and in the microcosm, such things happen readily enough. Assign this critical catastrophe management and precaution role as an integral part of your daily workload, and assign it to one person or group; the buck must stop somewhere on security issues.

In summary, we are not preaching the virtues of cloud computing, but we are saying that cloud computing is a very valid and reliable choice for some practices today. Security and flexibility of design are issues in any system. Ultimately, someone is hosting your system, whether your server sits in your back office or half a world away. The real issue is responsibility for your data. Someone has to be in charge. And you had better know who that is.

Use our free medical EMR / EHR scorecard to help you evaluate different medical software packages for the functionality, security and stability needs of your practice.

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