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EMR Educate - ASP Versus Local Installation

Important Considerations

There are many important considerations to take into account when deciding whether to choose an ASP ("hosted") EMR/PM system versus one locally installed at your premises. Most EMR/PM system vendors make both options available, but some offer only an ASP solution. You can learn more about each system type in the EMR Glossary of Terms.

Review the Quick Comparison Chart below for the basic decision points. Keep in mind, too, that the ratio of locally-installed EMR/PM systems to ASP systems is about 3 to 1. That is, there are three times more locally-installed systems systems presently deployed, driven mainly by the lower Total Cost of Ownership of locally-installed systems and the favorable control and data ownership elements associated with locally-installed systems.

EMR - ASP Versus Local Installation - Quick Comparison Chart

Comparison Criterion

ASP

 

Local Installation

Initial Cost

Less - Cost of client server eliminated; total first-year subscription fees less than first-year perpetual license fee for a local installation; 3rd party software fees usually included in subscription fees; software maintenance usually included in subscription fees.

 

More - Cost of client server (required); first year perpetual license fee more than first-year subscription fees; 3rd party software fees not included in license fee; software maintenance expense not included in license fee.

Total Cost of Ownership

More - Subscription fees continue forever; broadband Internet connection fees continue forever.

On average, an ASP system becomes MORE EXPENSIVE than its locally-installed counterpart after about 2.4 to 2.8 years.

 

Less - You own perpetual license forever once fully paid.

On average, a locally-installed system becomes LESS EXPENSIVE than its ASP counterpart after about 2.4 to 2.8 years.

Ease of Maintenance

Easier - All software upgrades and updates are performed automatically (behind the scenes) at your ASP host.

 

Slightly More Difficult - Software updates and upgrades must be installed in some fashion on your client server.  "Call home" feature, when available, makes upgrades and updates automatic (done for you behind the scenes).

Hardware

Less Required - No client server required; other hardware costs the same as a local installation (work stations, Tablet PCs, network).

 

More Required - Client server required; other hardware costs the same  as ASP (work stations, Tablet PCs, network).

Reliability

Less - You are entirely dependent upon your broadband Internet connection.  The best of connections will experience interruptions and "down time."

 

More - You have excellent control of "up time."

Remote Access

Easier - You can access your system from any location at which you can create a secure Internet connection.

 

Slightly More Difficult - You have to create (set up) secure remote access by configuring your client server.  After that you can access your system from any location at which you can create a secure Internet connection.

Ownership of Data

Poor - Your EMR/PM system vendor claims ownership of your and your patients' data and may charge you extra fees for "special" access to system data.  Often a problem when a physician leaves a practice or the practice want to switch to a new EMR/PM system vendor.

 

Good - You and your patients own system data, and all data resides at your physical location.

Control and Integration

Poor - You cannot control what you cannot access.  Most integration occurs at the client server level, and you won't have a client server.

 

Good - Your entire system resides at your physical location.

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