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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.

For most companies, open enrollment is a 30-day period in which employees have the opportunity to select their benefits for the next year.

Making an informed decision about which health plan to select is critical for employees, but it can be a little overwhelming, especially if there are several plans to choose from. To assist employees in their decision-making process, it may be helpful to hold a series of on-site open enrollment meetings. These meetings provide a forum for employees to meet with a representative from the health insurance carrier to discuss details about each available plan and ask questions.

The key to planning a successful open enrollment campaign is preparation, preparation, preparation. If you plan ahead and enlist assistance from your health benefits company, you can offer employees an educational campaign that will equip them with the information they need to select the best health plan for them.

So many choices

The first step is to determine the health benefits options that will be available. The plans that you offer to employees may change from year to year.

Prior to open enrollment, many employers revisit their health plan package to make sure they are getting the most for their company’s health benefits dollars.

Whether you select a new health insurance carrier or renew with your existing one, be sure to find a plan that packages core medical benefits with additional services designed to improve health and reduce costs. For instance, ask your health benefits company if it has a disease management program to help employees with chronic conditions such as diabetes.

Typically these programs provide employees with tools and instructions to help them monitor their health status and manage their disease to a point where health risks are as minimal as possible. Participation in disease management programs can also help employees avoid costly hospital admissions and reduce your bottom line.

Set the agenda

Once you have determined the health benefits plans that will be available to your employees, it is time to develop an agenda for open enrollment. An effective open enrollment campaign should do more than simply inform employees of their health benefits options; it should also educate them on how to get the most from their health benefits plan.

Open enrollment is a great time to inform employees about cost-effective options that are built into their health plan. These options can significantly reduce an employee’s out-of-pocket expenses, but often employees don’t know they exist. For instance, with many plans, receiving services from an urgent care center for a nonlife-threatening illness or injury (such as a minor cut, cold or insect bite) may be cheaper than receiving the same services at a hospital.

Open enrollment is also a good time to educate employees on the importance of a healthy lifestyle and make them aware of any worksite wellness programs. If the available health benefits plans feature discounts on fitness club memberships or complementary and alternative medicine therapies, be sure that this information is made available to employees.

Promotion, promotion, promotion

The final step to a successful campaign is to communicate the schedule of open enrollment meetings to your employees and encourage their participation. If your company has a newsletter, include the meeting schedule in it. E-mail is a good communication tool; you may also want to consider posting signs.

Open enrollment does not have to be a stressful time for you or your employees. With the proper planning and assistance from your health benefits company, you can conduct a successful campaign that educates employees so that they select a health plan that makes sense for their health care needs and budget.