02/21/2014    Raymond F Posa, MBA

EHR Back-UP of a Cloud System (Michael DeVito, DPM)

Dr. DeVito brings up a very important issue that
many are facing today. Many EMRs are moving toward
a cloud-based model. The cloud model offers many
advantages such as lower infrastructure cost (no
server to purchase and maintain), the EMR company
can handle all of the updates and patches and does
your backup for you. So for many the ease of
ownership is appealing.

One very important item that gets overlooked when
entering into a cloud EMR is the exit plan. When
we buy a new software program we only think about
the good it will do for use and we look forward to
a rosey future together, similar to a marriage.
The problem come when things don’t work out. A
little more than half of all marriages don’t work
out and the numbers for those who leave their EMR
are similarly high. If you have been through a
divorce or know someone that has, you know what a
stressful and traumatic event this can be. When it
comes time to leave your EMR, things can get
equally nasty if you have not prepared ahead.

One of the most important things to negotiate in
an EMR software contract for cloud-based service
is the exit plan. This needs to be clearly spelled
out in the contract. You want exact details as to
how you get your data upon conclusion of the
contract and what format they will provide it in.
If they just dump a proprietary database onto a
disk for you and hand it to you, that is worthless
because you will not be able to see any of your
data.

In Dr. DeVito’s situation, the company is at least
offering to sell him a stand-alone version of the
software so he can see his data locally. Yes, all
cloud companies are going to stick it to you on
the way out, that is just how it is. The question
becomes how bad are they going to stick it to you.
This is something that needs to be negotiated in
the very beginning when you are making the
purchase.

If you use cloud-based EMR you need to keep in
mind, that if you every decide to switch software,
you need to make sure you have access to your old
data for at least 6 years. During an audit you may
have to produce specific reports and if you do not
have a running copy of your software you could
have a huge problem.

If you are already in a cloud EMR setting or are
planning to buy into one, make sure of the exit
terms in your contract. Make sure they are spelled
out in great detail, have you IT company review it
and make sure that what you get at the end of the
contract will be usable. One of the features that
all cloud users should insist upon is the ability
to work “off-line”. Basically, this is a local
copy of the software so if you were to lose your
internet connection, you would still have some
access to your data. This feature can also be a
life saver in the event you want to leave your EMR
company.

Raymond F Posa, MBA, Farmingdale, NJ,
rposa@themantagroup.com

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