One of the lessons my client (Carolina Oncology Specialists... COS) learned with their previous foray into the EMR market was that it is important to have all records available at all locations. In some cases, patients went between locations on the same day, or even different days and the EMR product they had was not efficient at handling multiple sites.
So, in order to accomplish the goal of immediate clinic-wide access to up-to-date patient information we decided to implement our EMR system as a centralized 'web' server. I put web in quotation marks because, although it is serving data via http(s) requests, it is not on the public Internet. There are very large security concerns when operating outside of a more secure intranet.
This allows us not only to meet the requirements of the practice, but it also allows us many technical flexibilities because web servers are:
1. OS-independent
2. programming language-independent
3. easily replicable
4. able to benefit from Model, View, Controller (MVC) framework, providing even more flexibility
This decision also frees many restrictions on the client computers within the office. The client application is abstracted to a web browser, which is also platform-independent.
This could mean that you could implement your desktop and server architecture without paying a dime in Microsoft licensing! Go Linux! (You could even run this application on a Mac if you are an enthusiastic devotee.)
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Web based is great. I read an interesting article today about Joost's failure as they tried to create a client based application to watch TV online. I remember when Joost was the media darling. However, the lesson learned from Joost's failure was that the web based application won out.
ReplyDeleteI'm a little more cautious in this prediction when it comes to EMR. Mostly because EMR is more like an enterprise application than it is a consumer application. However, even there we're seeing movement to the web. It's just a matter of time.
John Lynn
http://www.emrandhipaa.com
John,
ReplyDeleteThanks for the comments. I agree that many enterprise 'solutions' these days are implemented as client applications, but one telling example of a movement to web-based enterprise applications is the rise of Microsoft Outlook Express. Many of my friends' companies (and my old client) use the web-based addition to MS Outlook. Say what you will about MS products, their mixed client/web-based model works very well. I don't forsee a client-based application for this project, but I am not a guy who says "never".