The hospital Brad Huerta leads simply didn’t have enough money to pay for a traditional electronic health record system.

It couldn’t afford the software.

And it couldn’t afford hiring a single information technology employee, not to mention a complete staff.

So Huerta, CEO of Lost Rivers Medical Center in Arco, Idaho, decided to put the 14-bed critical-access hospital’s records and billing systems in the cloud. There, they’d be overseen and maintained by a software vendor, not by an internal employee that the hospital couldn’t afford to pay anyway.

More and more, hospitals such as Huerta’s are following in the footsteps of physician groups and looking to the metaphorical sky for their EHR needs. Though Epic Systems Corp. and Cerner Corp. still dominate the hospital market with solutions that are mostly client-server based, cloud-based EHR vendor Athenahealth more than doubled the number of hospitals it has contracts with last year, and 90% of provider organizations surveyed by KLAS Research are either currently hosting or considering hosting their data off-premises, according to preliminary research.

“Inside and outside of healthcare, cloud is becoming the dominant paradigm,” said Christine Parent, associate vice president of marketing for EHR vendor Meditech. “I think that most institutions will be heading in this direction in the next five years.”

Cloud-based EHR vendors say their solutions are cheaper upfront, faster to deploy, and safer than their counterparts that are hosted in-house. That’s because of where the EHRs reside: in the cloud—which means on servers somewhere else, rather than on servers inside the hospital or doctor’s office. In other words, cloud-based EHRs are web-based.

The difference isn’t just technological—it’s financial too. Whereas traditional EHRs tend to include heavy installation costs, cloud-based EHRs sometimes have no such outlays, with vendors charging monthly fees or a portion of providers’ collections.

This move toward paying the variable costs of a service and excluding fixed costs mirrors what’s happened in other industries, such as Uber is doing in transportation, said Kyle Armbrester, Athenahealth’s chief product officer. The trend, he said, “is not owning all the infrastructure but getting a service delivered to you.”

That makes implementing an EHR system easier for hospitals that can’t afford huge upfront costs but must adopt modern technology to meet meaningful-use requirements. “This push for ambulatory providers and hospitals to adopt EHRs came at a time when we had a lot of new cloud vendors emerging,” said Nancy Fabozzi , a healthcare analyst with Frost and Sullivan. “Cloud-based EHRs give them a nice avenue to get into an EHR without spending a lot of money.”

The move toward cloud-based EHRs signals a time is coming when server rooms in hospitals will be rare and when all providers can access their patients’ information on any device, not just on a computer in the exam room. It signals a time when it’s not magical that an EHR installation takes just a few months—it’s expected.

But first, cloud-based vendors and their fans will have to convince hospital and health system chief information officers that all of this is possible, worth it and beneficial.

Ready for a change

When Huerta first started looking into the cloud, it was because he wanted to bring the hospital’s medical records into the 21st century from 1993, the year its EHR was first installed. Lost Rivers’ revenue cycle was molasses-slow—as was the technology itself, which depended on the copper wires the hospital still used for telecommunications.

As the hospital began taking bids for a new EHR, 
Huerta said, “One of the things that became apparent was that the only thing harder for me to recruit than a doctor was a full-time IT guy.” The hospital is about 70 miles from the nearest metropolitan statistical area, and “finding anybody that could really manage a server farm or do day-to-day operational pieces you need for non-cloud-based EHRs was almost impossible,” he said.

Huerta was looking at alternatives to client-server systems for reasons beyond hiring IT staff, though. He also wanted a vendor that could meet meaningful-use deadlines and one that was, overall, cheap.

To the cloud he went.

“It was witchcraft,” he said of how others saw the decision to get a cloud-based solution, “particularly in Idaho.”

Eventually, he settled on an EHR from RazorInsights, which was soon after acquired by Athenahealth, a company that had 1.6% of the acute-care hospital market in the U.S. in 2016 (See chart above). Lost Rivers was one of the first if not the first hospital in Idaho to be completely cloud-based, Huerta said.

Now, everything is integrated into Athenahealth’s platforms, from billing to the clinic to the emergency room, helping to stabilize the hospital’s once-dire financial situation. Lost Rivers is charged by Athenahealth based on the amount of collections.

“The cloud gives you all kinds of advantages related to staffing and backup and security,” said healthcare analyst David Muntz.

Source and Full Story: Modern Healthcare