Figuring out the real pricing of EMR is like a game of catch 20. The thing is you do not know you are playing the game when buying an EMR. I will share with you the right questions to ask and win the game.
Database License and Limits
Most desktop solutions come with database limits. Once your total database size hits that mark, you will be faced with a very, very stiff bill. A limit is usually a large number (4 Gigabytes for SQL Server 2005 Express), but what is a large number for a clinic with 2 users may not be so large for a Clinic with 10+ users. DICOM Imaging, Videos, before and after High-resolution images, geospatial data, and aggregation from multiple devices into a single data store are rapid advancements in technology that are hurtling your clinics closer to such limits. As technology progresses so do such caps on the database size, however, the point of concern is the lack of transparency. Most vendors do not mention such limits in their product literature, and Doctors are left in the dark. Next time when presented with a quote, specifically, ask
- Which database do you use?
- Is it a free one?
- What is the database size limit?
- How much does it cost to upgrade to the next edition?
Sometimes after the purchase of a desktop EMR solution, you find the performance to be sluggish. Upon contacting the Vendor you are told that the hardware needs an upgrade. It can usually be fixed by adding more RAM to your computer. But sometimes the requirements of the EMR software are so high that you need to buy a new computer. Often you will find that the desktop EMR software cannot run on netbooks – the lower edition of laptops. Hardware can become an add-on cost. You can avoid this by asking the vendor to provide the minimum recommended configuration upfront, or better get the vendor to assess the hardware of the clinic. Ask these questions to figure out hardware costs
- What is the minimum hardware configuration required
- Does it run on netbooks
- What is the recommended RAM
- Does it run on a 64-bit operating system (lets you know if you need to buy your operating system license)
“Desktop EMRs” are not well known for being flexible to change. That is a term you are more likely to associate with Web-based or Cloud-based EMRs. Customization is usually not possible or comes with heavy customization charges. You must insist on a 1-week trial edition so that you can install it, use it and have a list of all the changes that are required. Otherwise, you would either be unable to use the software due to a lack of support for your workflows and lose your investment OR, be faced with a high customization bill from the vendor. Find out
- What is the cost per man-day of development for customizations
- What is the AMC per year
- Does AMC include minor customizations