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More EMR Data Backups

Posted on April 9, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Many of you will remember my post making the case for in house EMR backups versus SaaS EMR backups. It was my first swing at my favorite part of blogging. I personally call it blog sparring. Basically, two (or more) bloggers discussing various viewpoints about a certain issue (I welcome other bloggers to join in).

Well, Lyndsey from Nuesoft brought the President and CEO, Massoud Aibakhsh, in on the fun in a post they called, “Continuing the Discussion…Data Backups: Leave it to the Experts.”

I appreciate Massoud’s response and he does make some interesting points about what is possible when a SaaS EMR vendor does the backups correctly. There’s no doubt that a SaaS EMR provider has more resources available to do a more robust backup, disaster recovery and business continuity plan than a small doctors office with a single server. His points about possible HIPAA breaches are also worthy of serious consideration. However, that kind of avoids a discussion of the points I made about relying on your SaaS EMR vendor to do the backup.

Nuesoft, why don’t you offer your end users a nice single click download of all their patient data which a doctors office could store in a nice HIPAA secured place in their office weekly/monthly or some other reasonable amount of time? Then, you’ll have the best of both worlds for a doctor’s office. They have your enterprise level backup, availability and load balancing and they’ll have a local copy of their data which helps them sleep better at night knowing it’s safely stored away in their office.

Of course, I’m not really trying to single out Nuesoft. I don’t know ANY SaaS EMR vendor that provides this service and that’s really unfortunate. Who’s going to be the first EMR software company to step up and provide this kind of support to the doctors?

If you’re really brave, you’ll even provide it in a format that they can extract the data themselves should they so desire (say if your company gets bought by someone else). I actually believe I heard of one EMR vendor that does this (client server though). They provide all of the data from their EMR in a nice exportable XML file which could easily be maninipulated.

I’m sure many in the room reading this will say, but what about vendor lock in? Why would I as an EMR vendor make it easy for my users to export their data out of my system? If I do that, they might *gasp* leave for another EMR vendor.

I of course asked the above mentioned EMR vendor about this problem. Their answer was a confident, “there are some that might leave because it’s easy to leave, but so far people have no reason to leave our EMR because they like it so much.” Kind of an interesting concept. Make an EMR that people love so much that they have no reason to change even though the door is open.

Granted, I’m not naive enough to think that some won’t leave. I’ve heard many a horror story of doctors leaving an EMR (for good reason or not) and then realizing that the grass wasn’t greener on the other EMR vendor side. Many of these doctors end up heading right back to their old EMR vendor.

One day a SaaS EMR vendor is going to revolutionize the backup process for their end users and start providing this level of data backup to their users. I know I’d be impressed with a SaaS EMR vendor that had that much faith in their product that they’ll give you a regular export (backup) of all the clinic’s data.

Now, back to some other comments from the Nuesoft post. In it, you asked me, “Do you seriously think banks use some of the services you mentioned to back up financial data?”

Well of course banks don’t use the services I mention to back up their financial data. Although, find me a bank that has 1 banker and 6 employees and I’ll show you a bank that uses the services I mention to backup their data.

At the end of the day. Let me liberally use a quote from the movie Shrek:

Shrek: Backups are like onions.
Donkey: They stink?
Shrek: Yes. no.
Donkey: Oh, they make you cry.
Shrek: No.
Donkey: Oh, you leave them out in the sun, they get all brown, start sproutin little white hairs.
Shrek: NO. Layers. Onions have layers.

Yep, backups are all about layers. The more layers of backup you have, the happier you’ll be. I know there’s been a number of times in my IT career that I’ve had to go to my 2nd, 3rd and 4th options to recover all the data from various backups I’d done. The more well designed layers of backup you have, the happier you’ll be if (when?) disaster hits.

EMR Backups

Posted on March 19, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

My favorite part of HIMSS is meeting all sorts of interesting people. One of those people I met was Lyndsey Coates from Nuesoft. I have a soft spot in my heart for Nuesoft since they were the company that trained me on my first EMR. I still remember the 3 day intense training in their office. Lyndsey and I had interacted a few times before the conference and so it was nice to meet her in person. It was just too bad that we didn’t get to spend more time together.

What does this have to do with EMR backups?

Well, Lyndsey and I didn’t have much time together at the conference, but she sent me a nice bloggers “love note” in the form of a blog post about offsite EMR backup systems after meeting me at the conference. She even sent me a friendly tweet to let me know about the post.

I was a little busy with HIMSS and all, but I’m always happy to share in a little blog sparring. So, Lyndsey, here we go.

I’m really glad to hear you respect my opinion, but I’m a little surprised that you didn’t like my post about offsite EMR backup services. I guess I could have imagined that a SaaS EMR vendor might have a different view. In fact, you make a nice case in your blog post about the challenges of backup with the client server model. Definitely a number of good points for doctors to consider when selecting their EMR.

However, somehow your post left out some of the problems related to backups with a SaaS EMR. No worries though, I’ll be happy to share;-)

First and foremost, I can’t believe you think that doctors will trust an EMR vendor to back up their EMR appropriately. I mean seriously, we’re talking about my whole clinical practice stored on your servers and trusting that your IT staff are doing my backups? I don’t think so. I barely trust my own staff to do backups, so why would I trust my EMR vendor’s staff to do something as important as the backups of my EMR?

No, I’m definitely not trusting you and your IT staff to backup my EMR. Maybe there are a lot of doctors that don’t do backups properly, but there are a lot of large vendors that don’t do backups properly either. Yes, even the all powerful Google lost some data because they didn’t have the right backups.

Plus, if you’re doing my backups that means that you establish the policy and time frame that the backups are done. If I do them in house, I get to schedule the backups, verify the backups and see the reports and logs about when backups are done. I get to choose when and how often those backups are done. With you, I just have to hope that you’re doing them.

Plus, there’s just something that doesn’t feel right about you having the backup of all my data. Maybe you don’t remember that the data stored in the EMR is my life. Not my literal life, but the life of my practice. Maybe you feel comfortable with my life being stored in your redundant data centers across redundant servers who mirror the data and all sorts of other cool backup processes. Personally, I feel comfortable knowing I have a backup of my life in my office with me. I can see it, touch it, pet it and know that it’s safe in my loving arms.

Finally, let’s not call out my previous post about Offsite Backup Service for EMR for “missing the mark a bit.” While SaaS EMR are doing very well, there’s still a VERY large number of people who will select a client server EMR. Better to help them get their client server backup services right than to just tell them that they should have bought a SaaS EMR.

Plus, maybe Nuesoft and other SaaS based EHR should consider partnering with one of these offsite backup solutions. I imagine a lot of doctors would love to have their SaaS EHR backed up to an offsite backup provider like the ones I mentioned in that post. Basically, a location that the doctor can access and control. Could be an interesting service to offer your clients.

Your turn Lyndsey!

P.S. I personally don’t care either way. I think that the client server or SaaS model are legitimate EMR solutions. Long term SaaS EMR are likely to win the day, but that’s still a long ways away. I do enjoy playing devil’s advocate though.