Sorting out the Options
Health Data Management Magazine, July 1, 2009
Talking to executives at companies that offer hosted electronic health records about how they differentiate their products and services is enough to make your head spin.
Many companies, including Allscripts, eClinicalWorks Inc. and NextGen Healthcare Information Systems Inc., offer both remotely hosted systems as well as conventional client/server systems that are installed on a practice's server. Some added new options in recent months as practices geared up to go after incentive payments under the economic stimulus package. Other vendors only offer hosted systems bundled with related services. Athenahealth Inc., for example, offers outsourced billing services as well as clinical transactions supported by hosted practice management and EHR software.
Advertisement
While "software-as-a-service" now is the hot marketing term in this arena, athenahealth says "software-enabled service" fits its model better. That's because the firm offers such services as transmitting and tracking lab test orders and offers clinical decision support, says Jonathan Bush, CEO at the Watertown, Mass.-based company. Bush likens the model to the retail sales site amazon.com, which is fueled by software.
Other vendors and some analysts, however, say that it's difficult to distinguish the differences between SaaS and SES offerings. But they acknowledge that remotely hosted EHRs can differ greatly in their infrastructure.
For example, some longstanding client/server EHR vendors, like NextGen and Allscripts, offer remote hosting using application delivery technology from Citrix Systems Inc., Fort Lauderdale, Fla.
Some competitors, including eClinicalWorks, claim that their model, which is purely Web browser based, is more practical. "Trying to put a legacy application in a hosted model using Citrix does not give you benefits in terms of easy connectivity that you get with a Web-based application," says Girish Kumar Navani, CEO at Westborough, Mass.-based eClinicalworks.
On the other hand, some practices perceive that using Citrix technology offers far better security than a browser interface, says Glen Tullman, CEO at Chicago-based Allscripts. "From our customers' perspective, what they want is an electronic health record that's available when they need it and is easy to use and cost-effective," Tullman says. "Most of our customers can't tell the difference in what model is used [Citrix vs. Web browser] nor do they care."
Scott Decker, senior vice president at Horsham, Pa.-based NextGen, says it eventually will offer its clients a Web browser-based hosted EHR in addition to its current Citrix offering.
Decker predicts more practices may select a remotely-hosted EHR over the next 24 months as they scramble to hit deadlines for Medicare and Medicaid financial incentives. NextGen recently changed its pricing model for its remotely hosted approach, offering monthly subscription fees rather than a large upfront payment.
Meanwhile, Allscripts now is offering a subscription model for its hosted as well as its client/server EHRs as a result of the stimulus program, Tullman says. "A lot of practices who talk about the hosted model are really just asking for different payment terms," he notes. "A lot of smaller practices lack upfront capital, so they really want a monthly fee and they don't care about the model."
Nevertheless, Tullman predicts perhaps as much as 40% of its new clients with 10 or fewer physicians will opt for the remotely hosted model so they can speedily adopt electronic records.
One major advantage of working with a vendor that hosts an EHR and provides related services, says athenahealth's Bush, is that the model makes it easier for practices to update their systems. "The day the federal government defines 'meaningful use' of EHRs, we'll reshape our workflows to make sure that data that demonstrates meaningful use will be readily available," he says.
(c) 2009 Health Data Management and SourceMedia, Inc. All Rights Reserved.
http://www.healthdatamanagment.com/ http://www.sourcemedia.com/
