Step Two — Learn Basic Details
Where Is Your Software Hosted?
Equipment Options
Confirm EHR Certification
WHERE IS YOUR SOFTWARE HOSTED?
There are two options for EHR systems: Client/Server and ASP.
The Client/Server model is a system installed in and managed by your office. Client/Server installations give you more control over your data and server. They require a number of components, based on practice size, including:
- File servers
- Workstations/tablets/laptop PCs
- Personal digital assistants (PDAs)
- Printers
- Fax machines
- Networking hardware (hubs, switches, routers, cabling, etc.)
This choice carries high upfront costs and requires ongoing support from IT contractors or in-house staff, but also offers depreciation savings.
An Application Service Provider (ASP) hosts software on a remote system and offers access as a subscription. That subscription – usually a monthly fee – provides you hardware and software. Because the system is offered on subscription, the ongoing costs are consistent and there are no high upfront expenses.
With an ASP, you do not host your system. Instead, the ASP supplies the EHR and its data from a secure hosting facility (which should include disaster recovery and backup). Ensure that any ASP agreement specifies who owns the data and how it can be accessed or moved.
ASPs protect data using firewalls and HIPAA-compliant encryption and maintain uptime using redundant systems. To use an ASP, you’ll need a high-speed internet connection in your office, as well as a computer network and other software.
EQUIPMENT OPTIONS
When considering your hardware options, use your workflow analysis to answer important questions about the best position of the equipment in exam rooms like:
- Where will patients sit?
- Do patients want to see the screen during their appointment?
- Do you prefer typing, using a tablet PC, or both?
The answers to these questions will help determine what hardware best meets your needs.
- Laptops
- Offer portability between rooms and locations
- Reduce costs — each provider needs just one PC
- Integrate keyboard and mouse
- May require backup batteries; most laptop batteries last 2-6 hours
- Tablet PCs
- Offer multiple configurations: laptop-style or pen-based
- May require backup batteries; most laptop batteries last 2-6 hours
- Desktops
- Are tied to one room
- Should be in exam rooms, common areas, and offices
- May provide faster network speeds
- Require patient-provider interaction considerations
CONFIRM EHR CERTIFICATION
The Commission for Healthcare Information Technology (CCHIT) developed a certification and inspection process for certifying EHRs and health information exchanges. It is expected that CCHIT’s initial three-year certification contract will be renewed. (Note: Your EHR must meet certification requirements to qualify for stimulus funds.)
Vendor certification. EHR vendors must have their products certified every three years. Standards have become more stringent since 2008 and CCHIT is now rejecting more companies.
EHRs with a recent CCHIT certification year are preferred.
Recently certified EHRs are more likely to have all the features required for a certified EHR." If you practice in a specialty, be sure to visit CCHIT to check for an EHR designed specifically for your specialty.