While reading a post on EMRandHIPAA today, I was reminded about an issues that I had thoroughly thought about two years ago when I was looking for a more capable EHR vendor to partner with for our medical practice clients.
A practice’s data (their patient charts) is not only what their business runs on, it’s proper maintenance is required by law and by a basic trust with their patients. Many EHR vendors seem to take advantage of this by holding their client’s EHR data hostage when they want to move to another product or even interface an ancillary service into their EHR.
What should be a simple database connection from a automated patient reminder service can turn into months of waiting and thousands of dollars of interface development fees from the EHR vendor. A much worse scenario is a vendor going out of business and your practice being unable to migrate to another EHR because there is no direct database access or published database schema.
With that being said, who’s data is it anyway? Most EHR Vendor’s contracts read that the data belongs to the practice. But what does that mean if you can’t move it, or interface with it without the aid and permission of the vendor?
Let me give you two examples of what we’ve run into over the years. The first was not a clinical setting, but the scenario still applies.
- A law office client of mine had been running a legal PM application for a number of years when suddenly on December 1 1999 the system popped up a message that said your license expires in 31 days. Each day the countdown continued. They called me and I called the number on file for the vendor, a recording answered in a sexy female voice “Are you ready to have a good time?” The vendor was gone completely, they scrambled and bought a new system and manually transferred their information before the end of the month. Imagine that happening to your practice! There is no way to properly move to a new system in a clinical environment in 30 days!
Another example is what is currently happening with one of our medical practice clients.
- They purchased a system a long time ago, and that system’s vendor has been sold a number of times over the years. The current vendor is one of the big guys and had changed their policy so that even systems purchased outright in the past require a maintenance contract to allow the system to function. So even though the own the software, as soon as they stop paying for support, the system stops working. So who’s data is it?
We partnered with Glostream in 2009 because they promised to be partner only, they use a Microsoft SQL database and we can control access to the database. We stopped partnering with them when they dismantled their partner program and went direct only, however if our clients want to interface or move the data they can without paying the vendor anything. If they stop paying the annual maintenance, they stop getting support and new releases, but the application does not time bomb because the practice actually owns the software and data!
No matter which EHR vendor you choose vendor you choose, make sure that you own the data!
Leo Bletnitsky, HIPAA & Technology Expert