When buying Electronic Medical Record (EMR) Software which is better ASP or Client/Server? Unfortunately there is no right answer. You’ll need to decide what’s important to your practice and what’s not. In this article we’ll explore the advantages and disadvantages of each model so you’ll be able to make an educated decision when the time comes to purchase an EMR software solution.

ASP is a remotely hosted software system accessed via an internet web browser, similar to the model used in online banking. This remotely hosted system is accessed by paying a rental or service fee. The server is secure and HIPAA compliant and is not located in your office. All technical aspects of the server are managed by a professional IT company, and you pay a monthly access fee (or per occurrence fee) for the services of this IT company. The cost of an ASP-based system is relatively low in the beginning, however because the fees never stop the cost over the long term adds up and is usually ends up being more expensive than using a Client/Server-based system.

One of the other benefits of the ASP based system is that almost all computing is done on the remote server, thereby reducing the minimum computer hardware requirements on the clients/workstations. ASP allows you to access all of your information at any time, from any place with internet access. Like all comparisons with advantages come disadvantages. Loss of customize-ability; the host server is being accessed by many different users.

Although your data is secure, your individual customized needs are not met as readily as you may desire. One of the other disadvantages is that an ASP system does not move as quickly as a Client/Server system. This is and important factor to consider with point n’ click intensive Electronic Medical Record software as vital time may be lost by waiting for data to transfer over the internet; these seconds can quickly add up to minutes and hours of a couple weeks time. Accountability issues are a deep consideration to ASP. Company service degradation is felt more acutely and such things as vendor bankruptcy could have a more drastic impact on the practice as a whole. Periodically check the stability of the EMR software vendor, and ask for a backup copy of your data for your own records.

Client/Server models allow for quicker response times in the application as the data from the server to the client is transmitted much faster (usually 100 Mbits/second). The newer client/server products developed in Java and Microsoft .Net are capable of offering the “best of both worlds” as they have the speed of a local system plus the accessibility from a remote location. Where traditional client/server products required practices to use MS Terminal Services or Citrix technology to access their data from remote locations, these newer systems can be accessed from any internet browser. Client/Server also boasts the benefits of practice having the control over there data. However with this control comes responsibility; the responsibility of being responsible for your data as you are now open to the risk of theft, fire, hard-drive failure and data corruption.

Many IT futurists consider ASP based systems to be the future however many offices find they don’t have the need for remote access and don’t want to put their data in the hands of another company making client/server systems still a popular option. In most cases, if an office has multiple locations an ASP system should always be considered but if an office requires high-performance and doesn’t have multiple locations the client/server system may be the better option. Speak with your IT consultant and the software vendor to get all the facts you need to make an educated decision.

Employers increasingly are realizing the value that worksite wellness programs deliver as an effective tool to improve employee health, increase productivity, reduce absenteeism and lower health care costs.

A 2003 report published by the U.S. Department of Health and Human Services (HHS) highlighted how important it is for employers to incorporate health promotion as part of their business strategy. The report asserts that preventable diseases place a heavy toll on business, including lower productivity and higher health insurance costs.

The HHS estimates that $1.66 trillion was spent on health care in 2003. and it attributes a majority of those costs to chronic diseases and conditions such as heart disease, diabetes, obesity and asthma. Sadly, the money allocated for preventing or controlling these conditions is negligible.

In a recent article, American Cancer Society CEO John Seffrin reported twothirds of cancer deaths in the United States could be prevented through lifestyle changes in diet, exercise, cancer screening and “especially” tobacco use. A well-designed worksite wellness program, provided by your health benefits company, serves the best interests of both employer and employee.

Bottom line return on investment
Ron Goetzel, a nationally recognized expert in the field of health management, data analysis and applied research, said in a recent interview that with an investment of $100 to $150 per employee per year in health promotion, an employer can expect an average return on investment of approximately $3 for every $1 invested ($300 to $450 savings per employee per year). Goetzel says, however, that these returns are not typically realized until two to three years into the wellness program.

Legislative incentives
Sen. Tom Harkin (D-Iowa) has been an outspoken proponent in seeking legislative solutions for a strained health care system. “As a nation, we have a ‘sick care’ system that is focused on helping people after they get sick, rather than a ‘health care’ system which focuses on keeping healthy people healthy,” he says. Harkin introduced the Healthy Lifestyle and Prevention (HeLP) America Act of 2004. One of the initiatives under Title II – Healthier Communities and Workplaces, provides tax credits to businesses that offer comprehensive programs to promote employee health and grants for small business.

Worksite wellness, getting started
Implementing a worksite wellness program with your health insurance carrier can be accomplished with simple, lowcost strategies.

Offer incentives for participation.
Create a wellness campaign.
Schedule seminars on nutrition, diabetes and cholesterol.
Establish programs such as fitness, sleep diary, smoking cessation and injury prevention.
Offer chair massages or simple stretching exercises to do at the desk.
Change vending machine options to offer healthier, low-fat snacks and drinks.
Work with a health insurance carrier that can implement, manage and maintain your program. Actively promote employee participation.

A successful worksite wellness program can boost company morale, enhance productivity, reduce organizational conflict, attract superior workers and lower the rate of employee turnover.

The case for establishing a worksite wellness program is well worth the effort.

The cost of providing employees with health insurance coverage continues to increase at a double-digit rate. We’ve read a lot about cost drivers in health care – exorbitant hospital charges, rising prescription drug costs, expenses associated with developing new technologies and treatments, an aging population and litigation. Nurturing these factors is an environment in which the demand for health care seems to be increasing.

For the most part, there is little employers can do to control what is driving health care costs out of their reach. Health benefits companies can and do negotiate discounts, and while those help, the underlying costs continue to skyrocket. The increases created by these cost drivers flow through the health benefits companies and eventually trickle down to employers in the form of higher health insurance premiums.

In this soft economy, declining revenue is putting a squeeze on company expenses. It is likely that you will experience a 15 percent to 20 percent increase in your group health insurance when a renewal form lands on your desk.

Can you raise the cost of your company’s product or service as quickly as your health insurance premiums are increasing?
Probably not. However, there are steps you can take to gain some control over your health care costs.

Finding a solution

Employers can exercise some control over their costs by finding a health benefits company that provides the “best” value for their company’s premium dollars. The way in which you “shop” a health plan can impact the price. I’ll use an analogy. Your travel agent has a great deal for you – air, car, hotel and meals included. You tell your agent to book it.

Coincidently, your neighbors just booked that same trip for $1,000 less through their travel agent. One agent shopped for the best price, the other agent arranged the trip through his or her vendor of choice. Whether it’s a family vacation, buying a car or choosing a health benefits plan, how you shop can impact your cost. Make sure your insurance agent doesn’t “arrange” your health plan for you. How many providers are enough? The more participating providers a health plan has, the more you’re likely to pay in premiums. If you are considering a health plan that doesn’t include a few desired physicians, request that the carrier add them to its network.

Physicians participate in many different health plans and are usually willing to participate in one more. Don’t get caught in the trap of paying 10 percent to 15 percent more for your health insurance premiums because one or two doctors are notparticipating in the plan. It’s reasonable that an employee can find another physician out of the thousands on the plan.

The power of marketing

Living in the United States affords us exceptional opportunities and choices. Along with that privilege comes a barrage of communications designed to influence our decision-making. What we read in the papers, see on television, hear on the radio, see flashed across a billboard, get stuffed in our mailboxes or pops up on the Internet is designed to predispose us to a company or its product.

Marketing can be an effective tool, and depending on how much is spent, can be quite influential. What marketing cannot do, however, no matter how much is spent, is replace what it takes to come up with an affordable health benefits solution that works for you. Be sure to look for a health benefits company that is flexible, listens and is willing to roll up its sleeves to provide you with a package of health benefits that you can afford.