Can Software as a Service (SAAS) EMR Work for You?

If you have been studying EMR alternatives over the last year or two, you are aware that EMR is not a uniform glob of identical software services for physicians and health centers. Aside from issues of stimulus rebates and incentives, there are many differences among types of EMR services and products that are available today. All of them work, but one size EMR does not fit the needs of every practice or medical organization. This question goes beyond brand superiority, product training and support, and price. It really has more to do with the business model your medical practice management wants to follow.

There are two basic types of EMR software configurations available: Each software model has its upside and downside.

1. Client/server based software, which means that your practice (or your practice’s employees) houses and maintain your software on an in-house “server” or computer.
   
   Advantages: Most of the large, well known EMR software packages are client/server based. This means that you and the developer – whether you buy the package customized, or whether you provide customization in-house -- totally control the environment and it can be tailored exactly to your needs. Most of the specialized practice packages are client/server based. Many client/server EMR models are web-enabled, meaning users can connect to their EMR via the internet on a standard web browser from a remote location – but the software will still reside in-house. Web-enabled software packages sometimes offer the option of handling security issues “elsewhere” by offloading the maintenance issues to a third-party host . Perhaps this is the shape of things to come!
   
   The downside: These packages are expensive up front (although they may pay off royally in the not-too-long run for a large practice). They also depend upon you – or your IT person – to guarantee security, perform backups and restore operations, etc. In order to make the most of the major and full featured packages there is also a lot to learn: Staff has to commit to thorough training in order to make effective use of the system.
2. The SAAS, or “Software as a Service” web-based model, where the user logs onto a website and access medical practice software that is hosted by the software provider. Your software is thus reachable from any computer with internet connectivity.
   
   Advantages: If you are a small practice, you can log on to any computer anywhere and access your system. You do not need to have a dedicated IT person taking care of your computers. Security is taken care of, back-ups and updates are taken care of. Your up-front costs are usually much smaller than they would be for a client/server model since you don’t have to worry about hardware or network infrastructure.
   
   The downside: Because the software as a service is designed for use by many different types of practices, it may not be as “configurable” as EMR software you own for your application only. Though this will probably change over time, this is the current state of affairs. Another issue: your network connections must be fast and reliable, otherwise staff will be frustrated and eventually may even refuse to use it. And finally, the SAAS module allows the vendor to raise their fees for usage whenever your contract expires. You really have no control over pricing.

Take time, research the options for your medical practice: EMR is a big commitment. Read the reviews, and think it through!

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