9 Ways to lose your wallet on an EMR

Ever feel like you're getting milked dry?  Here's a look at 9 expected and unexpected costs of implementing an EMR


1. Software Licenses:

Many providers charge for a software license per users.  It is important to note the cost and renewal periods of the license. 

Key questions:

  • Is the license a one-time/lifetime cost?
  • Does it require an annual subscription/renewal cost?
  • How about upgrades? 
  • What if a new version of the software is released?  Is there an additional cost to upgrade?


2. Database License and Management

A big question is where your data will be stored.  In order to avoid HIPAA violations there needs to be a logical and physical separation of data.  This risk applies to on-premise installs as well as  cloud- or web-based providers.  In order to securely store your patient records, you'll need a secure database. 

Key questions:

  • Are there additional costs associated with database licensing?
  • Do I pay for upgrades?
  • Who is monitoring the database?
  • What if the database becomes corrupt?  Do I have a backup?
  • What if there is an on-premise breach?  Who is responsible?  Your IT consultant or you?
  • What if I run out of room on the database server?  (In the cloud, scalability and flexibility issues are near non-existent.)
  • Ask if an on-premise install can scale up quickly and how much it will cost
  • How about performance -- what if our database slows down our productivity?  Does it cost to improve performance?


3. Windows Server Software

Many EMR providers run on Windows Server 2003 or Windows Server 2008 regardless of whether they're physical machines or virtual machines. The licensing costs for these servers can be extraordinary and Windows servers typically have more issues and data breaches than their secure counterpart, Linux. 

Ask you provider if they are running on Windows and what costs are involved in licensing and upgrades. 


4. Virus Protection and Backup

EMR platforms need to be secure. To that end, you'll need virus protection and back-up products specifically geared towards protecting your patient data.  A number of third-party suppliers provide virus protection and backup products. The prices for these products vary. They can be user- or server-based or both.


5. Disaster Recovery

Perhaps the most important consideration of an EMR is backup recovery. 

Key questions:

  • Do you have a backup of your patient data? 
  • Is it backed up every night?
  • Is your backup environment HIPAA compliant?
  • Is it stored off-site or on-premise?
  • What if there is a disaster at your office or even on your street?  
  • How long will it take to restore your backup?


6. Hardware and Infrastructure

The hardware required to run an EMR environment can be complicated.  You'll need to look not only at your servers, but also your PCs, laptops, etc…

Does your EMR require an install on each PC?  If so, this can add high maintenance and require that each PC have certain specs?  Performance, virus issues and maintenance may require a monthly review from an IT consultant.


7. Audits

For an EMR and storage of patient records, you'll need to be confident that your infrastructure and software could survive an audit.  HIPAA violations and security violations can be companies out of business or damage their reputation.  You'll need to get a pre-screen audit from a consultant to ensure your ability to stand up to an outside set of eyes reviewing your environment.   Be sure to understand the costs of a pre-screen and/or an audit before implementing any EMR or medical software.


8. Long-term contracts

What if your on-premise install or web-based software doesn't work for your company?  It could be that it's slow, it just doesn't meet your needs, or that it doesn't work as advertised.  Be sure to know the terms and conditions of your contract. 

Key questions:

  • Is my contract set to auto-renew?
  • How much notice to I need to give before an auto-renewal of my contract?
  • Are there penalties for leaving early? 
  • Will I be able to get a copy of my data if I leave?
  • Are there any costs for getting a copy/export of my data?
  • Are there any annual fees in the contract?


9. Data Storage

One hidden charge with any software provider, on-premise or cloud-based, is storage costs.  Most providers allow you to store data up to a certain amount.  After that charges start to incur. This makes perfect sense.  Storage is not free, but it's something not often considers.

The real misunderstood cost is the backup storage costs.  If you want a backup of your data for 30 days, your storage needs just increased exponentially.  For instance, let's say you have 100 GB of data.  You want to keep 30 copies of that data, even if it's just a "daily differential," which means you only want to backup what has changed from one day to the next vs. a complete backup of everything every day. 

Still, your costs can go through the roof.  To store 100 GB of data for 30 days, you may be looking at storing 500 GB or up to 1 TB of data. As mentioned above, you'll want this backup copy to be accessible, easily restored, compliant and secure. 


Depressed Yet?  Don’t be.  There is good news!

As the leading EMR in the industry and a cloud provider, WebPT understand security, ease of use, HIPAA compliance, the needs of small business and the latest technology.   We’ve got you covered.  Here’s how WebPT addresses the 9 costs mentioned above, in order:


  1. Software Licenses: There is no software license. No software to download, upgrade, maintain or renew.
  2. Database license and management – Again, there is no license to purchase, download or renew.  We manage your data in a secure, maximum-security, SAS 70, fully redundant facility.  Your patient data is as secure, or more secure, than most banks or financial institutions. We also monitor your database performance, storage, scalability and security.  It’s all taken care of.
  3. Windows Server Software – No offense to Bill Gates and half the corporate world, but Windows software has had more issues than there are people in China.  Security loopholes, poor performance and constant patching and upgrades plaque Windows environments.  We run on the latest and most advanced Linux servers in the world.
  4. Virus Protection – No need for you to worry about hackers or viruses.  Being cloud-based, all of the software resides on our servers, not your PCs.  We protect your data against any vulnerability.
  5. Disaster Recovery – Unlike an on-premise install, your data lives in two places with WebPT.  Getting data back online or having a backup copy restored takes minutes vs. days.  The cloud enables providers to store data in geographically disperse locations vs. relying on a server in a back-office closet.
  6. Hardware and Infrastructure – Again, as a cloud provider, no hardware or servers are needed at your company.  Provide every PT with an iPad, tablet or laptop and you have everything you need to run your clinic. It’s that simple.
  7. Audits – As your EMR in the cloud, we handle audits and protect against HIPAA violations in our data center.  Of course, most HIPAA violations occur outside of the digital world.  Most are the result of printing documents and leaving the m in plain sight.  WebPT cannot protect against his, but we can assure you that your patient data is safely stored in the cloud. 
  8. Long-term contracts – There are no long-term contracts, no annual fees and no hidden costs.  We do all of this and still maintain and 99.1% customer retention rate.
    Also, your data is your data.  Take it anytime you want for free.  We will provide a backup to you at no cost if for some reason WebPT is not the right fit for you.
  9. Storage – We store your data at no additional costs to you.  It’s that simple. 
The PT’s Guide to Software Implementation and Training - Regular BannerThe PT’s Guide to Software Implementation and Training - Small Banner
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