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6 responses to "Conflicting Indications of the Move to SaaS Based EHR"

1. # John Brewer commented on November 29th, 2011:

   SaaS EHR Pros:
   - Reduced IT costs

   SaaS EHR Cons:
   - Speed
   - “I want my data in my office”
   - Speed

   It seems like a web based EHR makes a lot of sense.
   It seems like, if Facebook & Yahoo can serve up huge amounts of info instantly, then a web based EHR can to. Is the amount of data stored by an EHR really that different than the amount of data stored by Facebook?

   I haven’t met a SaaS based EHR that doesn’t drive the office nuts a month down the road in poor speed.

   There will always be folks who don’t want their data in the cloud – heck I created my own cloud in my office so I don’t have to store it somewhere else.

   BUT – as Facebook serves up loads of data almost instantly, using Google Docs drives me crazy. It is slow and clunky…compared to Office.

   This may be part of the issue.

   Either way, SaaS EHRs make a lot of sense for small offices…beyond that it gets fuzzy.

2. # John commented on November 29th, 2011:

   A really simplistic look at the pros and cons of SaaS vs. client server EHR software. Lots of them missing from your list. However, it’s very true that many offices will continue to use client server EHR software. Particularly in rural areas where internet speeds are terrible.

   Personally I’ve seen the issue of slowness with client server EHR as much as cloud based EHR. Yes, that probably does say something about many of the client server EHR software out there.

3. # Chip Hart commented on November 30th, 2011:

   I think the lower IT costs of a SaaS solution are more mythical than reality.

   First, the practices still have to maintain a local network and that, often, is the biggest long-term problem and expense. You still have local clients, you still have viruses, you still have printers. Worse, the practices will be paying a lot more to their local telephone/Internet solution than they otherwise would. Sometimes, a LOT more…I have plenty of non-urban clients for whom reasonable commercial bandwidth is more expensive than the software.

   Second, server costs aren’t at all what they used to be. Every vendor I’ve spoken to simply amortizes their server costs and pushes it back onto the practice somehow. It’s not like a vendor is going to voluntarily take less money or even a loss.

   Third, every SaaS solution I’ve ever seen effectively guarantees a greater amount of downtime. Period. Whether it’s the vendor or the local Internet connection, you will not have access to your data and tools more often. What’s the cost?

   Years ago, there used to be an “ASP EHR vendor” mailing list. We were considering the jump to ASP/SaaS at the time and I asked the vendors on the list who among them actually passed their savings – because they can be considerable for a vendor – back to the customers. I even publicly shared our potential agreements for feedback.

   I got radio silence.

   In the end, the balance of the SaaS advantage is in the vendors’ favor.

4. # Writer Fox commented on November 30th, 2011:

   What is lost in any discussion is the ultimate cost to the patient. Keeping up compliance with HIPAA, for instance, requires systems costs, software costs and increased paperwork (or should we say ‘computer work’) for office staff, not to mention legal advice. Sometimes what is initially seen as an enhancement to the practice of medicine is actually in impediment.

5. # loinc commented on November 30th, 2011:

   According to a paper from Carnegie Mellon University, compliance with the HIPPA requirements for 2003 cost $10,000 for a small medical practice to $14 million for larger organizations. It will be interesting to see the financials for compliance with the 2013 directives.

6. # John Brewer commented on December 2nd, 2011:

   @ John: overly simplistic, sure, but reality.
   We tech nerds have to remember that non-techies don’t give a damn about a computer.
   This morning I installed a new graphics card on my wife’s computer so she could go dual monitor…I find that fun…many others don’t.

   @Chip: I agree. As I help offices to meaningful use risk assessments, those on a SaaS don’t really have any less costs. Some less pain-in-the-behind, but in the big picture, no huge savings.

   @loinc: hmm, is that cost per year, over the lifetime? I get small practices HIPAA compliant daily. To go from zero to fully compliant is not $10,000.