One of the first decisions you need to make after deciding to archive your Patient Health Information (PHI) is where you want the data archive stored. Some practices and medical facilities use their own onsite hosting servers and equipment for data storage. Others contract with a company to provide off-site hosting in a secure environment. There is not one right answer for all situations. It is important to consider options and determine which solution best meets your needs.
Here are five questions to answer when evaluating off-site hosted vs. on-premise EMR archiving:
1. Do we currently have the technology infrastructure required for an on-premise data archive? If you go the on-premise route, you must provide the equipment for the archive storage as well the location in your facility. For a single-doctor medical practice, that equipment might be as simple as a Windows XP Pro, Windows 7 or Windows Server 2003/2008 computer. The requirements certainly broaden from there for larger group practices, hospitals and health systems. If you already own equipment and the expertise to support it, then on-premise may be the best choice for you. Check with your archive or health data system consulting vendor to determine the equipment size and performance needed for on-premise hosting.
2. Does my IT staff have the expertise and time to set up and maintain the archive? If you use a hosting service, the hosting services handle all server support and issues and your staff is not responsible for setting up the servers and performing maintenance. For on-premise hosting, your IT staff must ensure that the technical infrastructure is maintained for the archive, that all users have access, and, they need to verify that network connectivity is available. It is also essential that your facility has a EMR backup and recovery strategy in place in case a restore is ever required. Smaller practices may backup to tape or remote drive while larger facilities may use a SAN or NAS. If considering a hosting service, ask questions regarding their backup procedures and methods. Medical practices and facilities with experienced IT staff may find that an on premise archive solution makes the most sense while health organizations with leaner staffing may find that a hosted archive is their best solution.
3. What is our current internet bandwidth and stability? Access to remotely hosted archives requires appropriate internet bandwidth for users to easily access records in a timely manner. It is also important to consider the number of users who will be using the internet connection at any one time. For smaller provider practices utilizing a lower bandwidth DSL connection for daily business needs, there may be slowness accessing archived data depending on the total number of simultaneous users. An on-premise archive may prove to be the best solution in that scenario so that response times when searching for archived patient data are quick. Facilities with high-speed internet connectivity can typically handle the demands of remote hosting and should evaluate it as a viable option.
4. Are our other solutions hosted or on-premise? It is important to determine your facility’s culture regarding hosting vs on-premise solutions. If you are already using hosting services for other software and data platforms that manage PHI, then a hosting service may be the best fit for your archive of health data.
5. What is the Total Cost of Ownership (TCO) for both options? Cost is an important consideration and should be weighed carefully. With on-premise hosting, facilities will likely have more upfront costs in regards to equipment and technology while those using a remote hosting service will ultimately take on higher recurring service fees. In some situations, the cost breakdown is roughly equal regardless of the path chosen while in others there is a significant difference. Compare all costs associated with both options over the length of your required retention requirements to determine if one route makes more financial sense than the other.
Which option did your facility choose? What factors went into making your decision? Are there other questions you wish you had considered?