Type of EMR Poll – SaaS, Web Based Client Server, or Client Server

I thought it would be interesting to see which type of EMR setup readers of EMR and HIPAA preferred. If you’re not sure what I mean by the various options, I put a short description of each EMR setup below. Also, feel free to leave a comment about why you made the choice you did.

Hosted Web Based EMR (SaaS/ASP) – This is where the EMR company (or some outside entity) hosts the EMR and provides you access to the EMR usually through your web browser. Data is stored in their location and requires an internet connection to access the EMR.
Client Server EMR (Web Based) – This is where you host the server for your EMR in your office, but you can access your EMR server using a standard web browser. Data is stored on the server in your office, but access to the server using a standard web browser can be available anywhere.
Client Server EMR (Client Install) – This is the traditional model of EMR where you have a server in your office and you install a client which you use to access your EMR. Data is stored on the server in your office and is only accessible from outside the office using some sort of remote desktop connection.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

12 Comments

  • I enjoy the idea of Hosted Web Based. With a well thought out agreement between the practices being hosted a lot of good data could be mined from the centralized hosting model. Its a little big brotherish, and encourages monopolies by the companies doing the hosting but the availability of crucial patient information could be quite a benefit.

  • There is a difference in ASP and SaaS model. In ASP, each practice’s data is locked inside their own private server and database.

    In SaaS (multi-tenant) architecture, there is an opportunity for sharing the server and data between practices.

    SaaS makes it easy to share patient records and data mining. As Matt commented, this is valuable. Make sure all right agreements are in-place to protect physician’s interests.

    ASP usually takes a client/server EMR or web-based EMR and puts the server on a remote hosting site.
    ASP eliminates the hassle of system maintenance.

    ASP may not allow for any data sharing across practices.

    Even though physicians may not like it, they need to be aware of all these differences.

  • Abhi,
    I considered separating the ASP and SaaS, but from a doctor’s perspective they are essentially the same. Since the main difference is the data sharing it wasn’t enough to split them into 2 choices. Plus, no one SaaS EMR company has gotten enough market share for the data sharing to be a really valuable feature. Once one does, I may be more apt to split them.

    With that said, thanks for describing the difference, because like you said it is good for physicians to be aware of all the differences in EMR companies.

  • I completely agree that practices must be fully aware of the differences & options out there. Each model has its strengths and weaknesses (accessibility, maintenance, hidden costs, etc).

    However, I also feel that to some degree, this is used as a marketing tool not unlike CCHIT. I believe a practice is being misguided if this is within the top 3 decision-based priorities.

    Functionality, intuitiveness, implementation, and support are more critical in my opinion.

  • I think that any of these 3 options is a viable alternative, but if that’s the case I’d think that more people would respond that it “Doesn’t really matter” However, I do have to say that this question can really narrow down the number of EHR you consider. I think that’s a good thing so that you can focus on a smaller pool of companies and compare apples to apples. Although, it’s always good to throw at least one orange into the mix as well to make sure you really do like the apples as much as you thought.

  • ‘I think that any of these 3 options is a viable alternative, but if that’s the case I’d think that more people would respond that it “Doesn’t really matter”’

    I agree and I think that touches on my point of it being used more as a marketing tool. The fact that the poll does not currently indicate more neutrality tells me that some practices (or vendors…) are limiting the scope of their search.

    I agree that you need an apples to apples comparison, but I don’t feel data hosting models should be the baseline. If I were a practice, I would only look at companies that could provide: single database EMR/PM, bidirectional interfacing, FAX MANAGEMENT, etc.

    Just so no one thinks I’m over looking one of our biggest buzzwords: Interoperability is too young, imo, to be used as criteria – every vendor with the aforementioned functionality has something already built into their system that they can point to the client and say, “Look! we have something to handle this” (CCR, CCD, etc)

    Perhaps that makes my scope too large, but if functionality doesn’t win out in this EMR “rat race” then the noble goal of lowering healthcare costs has no chance.

    Sorry a little off topic – great blog by the way.

  • The problem with your list of “single database EMR/PM, bidirectional interfacing, FAX MANAGEMENT, etc.” is that none of those really are differentiators for an EMR. Almost every EMR software has those things. You have to find other criteria that can help you narrow down your search or you’ll spend years demoing and get overwhelmed by it all.

    I’ll leave the other topics you bring up for other posts. Good ones, but far too much for the comment area.

    Thanks for the kind words about the blog. I appreciate you commenting. Some of the best info and discussion happens in the comments.

  • I think all options are viable and can address the HIPPA issue as well. However, if we are going to truly take HC to the next level and use EMR data for data mining, clinical decision tools, and research, we need a model where all data can be shared. I agree that it will feel “big brother” to many people, but the compilation of all data will be far more effective than a subset of the data.

  • Ann,
    My problem with many of the data sharing plans right now is they try to bite off EVERYTHING and basically end up doing nothing. I’d prefer a phased in approach which starts with a baseline (ie. meds and allergies). Then, we could add on things from there. I think it’s better to do something really well then trying to do it all and failing completely.

  • i’ll like to know everything about electronic medical record(emr). example, types, purpose, materials needed to build it and wireless emr.

  • pa comfort,
    I’m working on some e-books which I hope to put out this month. So, watch for those and you can learn a lot.

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