Server-based EHRs lend themselves to in-house management. But technology expertise for the employee with that responsibility is key, say experts.
The most common way practices have managed EHRs is keeping that responsibility in-house, meaning that the role is “owned” by an internal employee, according to Derek Kosiorek, principal consultant with the Medical Group Management Association’s Healthcare Consulting Group.
EHR software was built to support his model, he adds, as the practice typically purchases a server onto which the software is loaded, and the server is located in a room at the practice. Physicians then access the EHR on a per-user basis on their computers.
While there’s been a move by some EHR vendors to move physician practices to a cloud-based version of their software, Kosiorek describes the industry’s overall move as “slow” in this regard.
If a practice hasn’t switched to a cloud-based EHR, it’s generally going to be a better fit to hire a new employee who can take responsibility for managing the EHR at the practice, says Kosiorek.
Practices should be aware that this model entails higher upfront costs, including software licenses, hardware, and paying the vendor for installation. The upside is lower annual maintenance costs, and much of the EHR maintenance is done by the practice’s staff member.
That staff member will be responsible for managing the server at the practice and updating the EHR software when the vendor releases new versions, notes Kosiorek, who highlights that the practice employee must be knowledgeable about data security.
This is important, he insists, because the data has to be protected and the practice needs someone who understands the associated risks and how to mitigate them. Some of those risks include poor passwords, ransomware, and unsecured mobile devices.
Rod Piechowski, senior director of health information systems at the Healthcare Information and Management Systems Society, says one benefit of having an employee responsible for managing the practice’s EHR is “ultimate control and responsibility over the functionality and performance of your system.” In addition, it’s valuable to have a person on-site to troubleshoot any technical issues associated with the EHR, he says.
Still, it’s important to have a staff member who has technology as a core competency, adds Piechowski. That person may already have some core technology skills, which they can then develop with more experience managing the EHR.
Employee turnover is one issue to keep in mind when considering whether to keep this responsibility in-house, says Piechowski. That’s why the practice must develop a contingency plan for when this employee leaves; that plan should include a deep understanding of the requirements to manage the EHR and any risks associated with this plan, he adds.