Cloud based EHRs – a response to PracticeFusion

In response to Dr Rowley’s posting

Note: I attempted to comment in the EHRBloggers blog but there were technical glitches with the “word” verification (used to prevent spamming) thus I am writing my comment here

Dr Rowley,
Thank you for your well crafted insight into the benefits of ‘cloud’ oriented EHRs, especially for solo practitioners who may not wish to invest in in-house hardware, software and associated maintenance.
Some responses:
1. Is a solo practitioner or very small medical practice, likely to have the high bandwidth internet connection required for SaaS based EHR?

2. Like any other SaaS solution, does the Dr’s practice grind to a halt because an Internet connection is down (due to the fault of the ISP or any other conditions beyond his control) and the physician cannot request an EMR for a patient?

3. The ‘care co-ordination’ you write about sounds wonderful, my question is what technical standards exist for medical practices to exchange EMR data ? Or is the ‘care co-ordination’ you write about restricted to medical practices that use the PracticeFusion cloud?

Looking forward to the ongoing conversation

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3 thoughts on “Cloud based EHRs – a response to PracticeFusion

  1. Thank you for your commentary (by the way, we’re looking into why you couldn’t respond on our blog, as some other comments have made it through). You raise good questions. Let me try to respond:
    1. Broadband bandwidth has become ubiquitous and inexpensive. One does not need extremely-high bandwidth to work with Practice Fusion, mainly because of the design of the user interface (it is written in a language that runs in a Flash player, so that small data exchanges occur with the server, once loaded and running, and the response time is very fast). A simple DSL line will suffice – it even works with cell-phone data cards (like Verizon or T-Mobile data card plug-ins to a laptop).
    2. Assurance of internet connectivity is the one residual potential points of failure for cloud-based systems. The points of failure of local server crashes, power outages, etc, which can happen with local installs is not present. We recommend solid connectivity with failovers to alternative connections – a DSL or cable-internet primary with a cell-phone-data device as backup, for example. We are currently working with a hardware and connectivity vendor to address these kinds of particulars, so that the doctor doesn’t have to “re-invent the wheel” each time.
    3. Care coordination – such as inter-practice messaging and chart sharing – are possible with practices using the Practice Fusion cloud. The issue of data exchange with other, legacy systems remains daunting – that is the purpose behind the whole effort to build an HIE infrastructure (regionally and nationally). These efforts are still preliminary, and no significant use of such interoperability has actually been seen in the “real world.” Once such exchanges are in place, functioning, and actually being used by practices with their legacy systems (1000 practices = 1000 points of integration), then Practice Fusion can connect with them as a single-point-of-integration. In the meantime, Practice Fusion will build its in-system HIE-like connectivity, since referral to non-Practice Fusion offices would simply mean a quick, five-minute sign-up (remember, that Practice Fusion is free) and then, voila, you’re connected (even side-by-side with your legacy system, if you want).

  2. Pingback: Medical Data in the Cloud | Bob on Medical Device Software

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