Electronic Medical Billing Software: Client-Server Versus Application Service Provider (ASP)
Electronic medical records (EMR) and digital billing systems offer significant clinical care, financial, practice workflow, and compliance benefits for physicians, insurance companies, and patients. But half of the medical practices that buy EMR software don’t implement it successfully.
Rapid development is a prominent feature of this technology market: eighteen news items published by providers of electronic medical record technology and billing systems were listed in BillingWiki/Technology in May 2006 alone. The eighteen news stories are split from seven to eleven between web-based application service provider (ASP) solutions and client server (CS) based technologies. After briefly reviewing the key factors that define each technology, we compare them based on two criteria, namely the likelihood of implementation success and costs.
Architecture Client Server
The CS model has existed since the early eighties of the 20th century. Its architecture includes a central server deployed in the medical office and multiple client stations to allow users to interact with the application. The central server typically runs the database and some of the application logic, while client stations do much of the processing locally.
Such a distributed processing architecture facilitates relatively high application performance by minimizing waiting time. The downside of the CS architecture is that it requires the practice owner to set up the necessary infrastructure in advance and continuously manage it in the future. The infrastructure includes a central server, client terminals, and a local network that connects the computers. Management tasks include installation, configuration, backups, restores, and regular updates.
Thus, a typical CS charge model involves an initial infrastructure and application license investment and subsequent monthly support costs, as well as significant time spent completing required tasks and maintaining the level of knowledge required for successful operation. of hardware and software.
To justify an investment, CS solution providers offer a traditional five-year return on investment (ROI) analysis. Such an analysis compares the EMR benefits of reduced office workload, clerical and clinical errors, improved coding, and faster cash flow, against the costs of ownership of the infrastructure.
The pitfall of this approach is that it ignores the technical and financial aspects of aging technology. Technically, Moore’s law of development of digital technology tells us that chip density doubles every 18 months. Therefore, computer hardware and the technology built on it become obsolete every 36 months. Can you justify an investment using a five-year horizon on a technology that could be obsolete in three years?
Financially, investments make sense in assets that appreciate in value. Otherwise, renting business-necessary equipment or software often offers the dual benefits of freeing up cash flow and tax-deductible business expenses.
Application service provider architecture
The ASP model was introduced just before the turn of the century. It is based on the use of the Internet. The ASP architecture places the database server at the provider’s site instead of the doctor’s office and assigns most of the application logic to the server, which reduces the amount of code required to run the client. This approach allows users to interact with the application directly through the Internet browser, completely eliminating the need for local office infrastructure and management. The provider manages all technology centrally and for all offices, including compliance, disaster recovery, installation, upgrades, backups, and restores.
The ability to set up systems and train and support staff without even visiting practice sites provides one of the most cost effective EMR solutions. Deployed remotely over the Internet, the ASP methodology avoids time-consuming on-site outages. Online training allows physicians and staff to schedule at their convenience, further minimizing practice disruption.
Obviously, the ASP model creates significant economies of scale that eliminate the need for local IT staff. The typical charging model for modern solutions similar to Vericle is monthly access fees and avoids investment and ownership of the associated infrastructure.