In today’s healthcare landscape, healthcare delivery organizations (HDOs) are faced with an abundance of choice. For example, deciding which vendor best suits the needs of your providers and your patients? Once selected, there are seeming infinite ways to customize or modify the EMR application to tailor it to your organization’s configuration and deployment. As technology has improved and the utilization of EMRs has become ubiquitous, yet another decision has come up for many healthcare organizations today – should we contract with our EMR vendor to host our environment or maintain our own server infrastructure locally?
It goes without saying that there are many benefits in choosing to remote host your EMR platform. HIPAA security requirements need seemingly constant maintenance and attention when it comes to the digital deployment of EMRs, and that can put a large burden on the IT staff at a smaller clinic or critical access hospital. Going remote hosted with an EMR vendor can offer the HDO the ability to place the responsibility of security in the hands of the vendor. Additionally, the vendor takes on accountability for backup and disaster recovery requirements, which can allow organizations without a full-blown IT staff the ability to focus primarily on patient care, and leveraging their EMR as a tool for that purpose, without all the overhead that self-ownership can require. Recently, we’ve also witnessed a boom in the growth of cloud-based storage and solutions, which can offer even greater flexibility to hosted medical practices in terms of access and usability of their data.
On the other side of the coin, however, there are upsides to maintaining ownership of one’s own server infrastructure. Many larger medical groups do have the advantage of a full IT staff deployed to manage and maintain the system, and when those people work for the same organization they support, it allows a level of control and decision making that can sometimes be skewed by the addition of a third party. There is also the convenience of access and ability to customize or modify things like interfaces or SQL reporting scripts on the fly, based on the needs of an individual’s organization, without the burden of third party change control processes. Furthermore, most EMR vendors who provide remote hosting services do not allow full back-end visibility and administrative control, which can inhibit an IT team’s ability to self-diagnose and address issues.
As the healthcare IT landscape has developed, many organizations started out with their EMR deployment in-house, and have built processes around that level of ownership, sometimes extending so far as to have staff based solely for management of their internal infrastructure. This requires many organizations to weigh the cost benefit of staffing their own IT teams versus the costs related to both implement and maintain a remote hosted infrastructure with an outside vendor. There is also need for consideration of home-grown or third-party built jobs and processes that the organization may use for reporting or maintenance internally. Will your remote hosted vendor allow you continued management of those items, or will they allow them to exist at all?
While there are many points for consideration, one thing is for certain – the remote hosted EMR landscape is here to stay. When weighing the options for your unique organization, here are some helpful points of consideration to begin a dialogue around this critical decision:
- What is the cost associated with our current IT staff? How would the costs change based on the ownership shift to a remote hosted EMR?
- What challenges do our IT staff currently face in terms of infrastructure maintenance and end-user support?
- How much (if any) custom development have we invested in to make this product/system work for us? Can this custom development be maintained/continued if we move to a remote hosted environment?
- What level of access/change control limitation are we willing to accept, and what limitations does our potential hosting vendor require?
- What is the one-time deployment cost for a remote hosted solution? Monthly maintenance/subscription costs?
- What will our contractual obligations to the EMR vendor be if we move to a hosted environment?
- What third-party integrations do we use today, and how would a move to a remote hosted solution impact their usability and support?
This is only the tip of the iceberg, but should be a good place to begin considering whether a remote hosted infrastructure could benefit your healthcare organization. Please comment below with any other questions, or provide a testimonial of your experience with the decision to go remote hosted.