Things to Know About Switching to a Cloud-based EHR

The first question a practice administrator needs to ask himself about switching to a cloud-based EHR is this: Whose security is better? Yours, as a small- to medium-sized practice, or a company whose business is securing the software they sell? To Lee Kim, director of privacy and security at the Health Information and Management Systems Society (HIMSS), the answer is obvious: The software vendor wins out every time.

"Most physician practices shuffle their feet when it's time to do the [HIPAA-required] yearly risk assessment - and this is the case even though security is a top concern for doctors. [Doctors] want someone else to worry about the EHR, in terms of problems and bugs. That's because there are so many administrative things that practices have to do. I highly doubt that they want to spend a lot of time dealing with their EHR system," she said.

Still, practices need to do due diligence when considering vendors for a cloud-based EHR. Lee recommends that practices focus on these types of questions:

• How long has the vendor been in business and is it a standalone company or a subsidiary of a much larger company? (This is an important question to ask because it speaks to its financial stability, said Lee.)

• Will the vendor rely on a third-party to host the EHR?

• What's an appropriate service level to expect? For example, should I expect a response to an issue in a day or a week?

• How often is the software updated and is there a charge for updates?

• What happens if you decide to go with another EHR vendor in the future? How will you access all of your patient records?

Kim Zimmermann's practice had been working with their current cloud-based EHR vendor for billing for many years, so the relationship and trust was already built. The deciding factor for Amita Health Medical Group, a Chicago area-based practice where Zimmermann serves as chief operating officer, was the fact that it wasn't scalable for her IT team to manage an on-site server to host the EHR.

Instead of needing to hire a team to maintain the servers on-site and perform updates, testing, customization, and programming, her practice can rely on the EHR vendor. All she needs to hire are people who are expert in the software and can train physicians on using it.

Zimmermann also touts the benefit of her practice's clinicians being able to log into the EHR anywhere they have internet access without the need to worry about security issues.

She cautions practices to push vendors to come clean on what they show in demonstrations of their cloud-based EHR. You need to make sure that the price you're paying includes everything you're seeing in the demonstration, she said.