When I was looking for a EHR system, I was originally looking at SAAS systems. That’s Software As A Service. Basically you log in to a website, managed by the company, and you use the software and all your data is there. When the company has a new version, it automatically gets upgraded on everyone’s account, so the next time you log in everything is suddenly on the next version. It’s completely hands off, so you can focus on practicing medicine, and not dealing with your EHR software.
I didn’t find an EHR that matched all my criteria as well as available in the SAAS model.
We found NextGen and found we could have it hosted off site by a third party that was familiar with and regularly manages updates etc.
Having the software hosted off site allowed us to avoid dealing with hardware completely. We also knew that it would be easier to configure a connection from each of our five locations to this third party hosting site. (We are using a mesh network via AT&T – MPLS)
But let me tell you what I really wanted to do with NextGen. I wanted to run it in the cloud.
Most people think of the cloud as anything that is available via the Internet, but actually there is another definition of cloud computing. Cloud computing means that the software runs on a virtual server. Most applications that run via the Internet are loaded on real servers in some server farm somewhere. You purchase/lease three (how ever many you need) servers, configure them, load your web software, and then allow access from the outside world. If all of a sudden you get massive growth, your servers get overloaded, and they crash. You then have to get more servers, and configure those to handle the additional load. Everything is done manually. Disk space is also managed in the same manner.
A virtual server isn’t a physical box limited by it’s internal guts. A virtual server is setup in a manner that allows the server to contract and expand based on the need. Everything is done automatically. It never gets overloaded and slow, or crashes. Additionally, you only pay for the current state of use. You can also get virtual storage, that does the same thing.
I setup a conference call with NextGen engineers to explain my plan. I was going to use Amazon EC2, and Amazon S3 (Microsoft was just announcing their release of Azure). Several issues were brought up by NextGen. First, they didn’t think NextGen could be installed to a server in this manner. (I still don’t see why not, but maybe I’m missing something). Second, there were concerns of HIPAA security compliance. (? I don’t know).
If anyone is successful at getting NextGen running in this environment, let me know, because I would consider moving it over given the many advantages.