So What's It Going to Run Me?

Moving up to the latest and greatest in EMR software and the hardware needed to run it is not going to be cheap! If you’re lucky, you already have a number of office computers on a network and all the computers will have been purchased in the last 2 years or so. This will save you some cash.

Software

In terms of software costs, there are two fundamental license types to consider. One is an outright or “purchase” of the software. The upfront costs are generally higher, anywhere from $1000 to $10000 per provider, but no annual software fees. However you will likely to be required or highly encouraged to pay an annual tech support/maintenance fee of anywhere from $300 to $3000. The other model is an ASP model where you don’t “own” the software, but basically rent the use of the software on a monthly basis. Costs are in the $200-$700/month range per provider, and typically include the service/support portion built in.

The Pros to using the ASP model include the lower startup costs, maintenance and upgrades usually performed remotely via your EMR company, usually no need to purchase a server ($3000-$10,000 depending on hardware/software configuration).

Downsides to using the ASP model include, lack of in-house access to the server, more difficult to perform on site backup, long term costs likely higher than outright purchase.

Pros to buying the EMR software and running your own server: ability to upgrade the local server whenever you want, lower long term costs, if Internet access is down from your ISP provider, you’re still up and running (assuming your in office network is ok).

Cons to buying your own EMR software, running your server: you may have to do all the software upgrades yourself, you’ll be responsible for keeping your server in good health, applying upgrades, patches, and general computer upkeep (backups, battery backup), may have to hire outside IT professional to help with network/server issues.

Service and Support

Other associated costs include service charges. You’re certainly going to need service and support for your installation (beyond the initial training that will be required to use your EMR. Training can run several thousand dollars and the EMR company may require you to be on site at their offices for this.) Service contracts should include phone and email support and possibly in person support requests.

If you purchase the software outright, the service contract may include the cost of any software upgrades (as well as the cost of the actual installation), but this should be checked before you sign up.

Hardware costs

Hardware costs will vary by platform, desktop computer or laptop/tablet price. Expect to spend anywhere from $500-$1000 per desktop, $800-$2500 per laptop or tablet pc, and $3000-$10000 for the server. The server costs vary widely depending on which OS your EMR requires (Linux, MacOS X, or Windows Server.) Windows Server (including database software) may cost you several times the cost of the hardware just for software licensing costs!

Add into your long term calculations the need to refresh or upgrade your computers every 2-3 years. When deciding on hardware, focus on cost/performance, and less on actual upgradability, since in the future you’re much more likely to replace your hardware than to add more to the computer to upgrade it (with the exception of more RAM memory.)