Behavioral Health EHRs: A Walk in the Cloud

As advocates for agencies who manage valuable patient information we are asked daily which EHR a behavioral health provider should choose.  Buzz words are often thrown around such as “cloud-based” and “web-access”, which for many still are intangible terms when it comes to record security and applicability.

Cloud Computing

More than a decade ago, engineers figured out ways for data and software to be distributed efficiently across several machines and their power pooled for collective use. In the simplest of terms, cloud computing means storing and accessing data and programs over the Internet instead of a computer’s hard drive.  A cloud computing platform refers to the efficient management of systems and networks of data storage over the Internet.  The term itself is an airy metaphor for systems of intelligently orchestrated global networks of millions of computers, harnessing, using, and then renting huge amounts of computing power.  It no longer matters which servers are running a job or from where; it is just inside this “cloud” of machines. 

When you store data on or run programs from a hard drive – called local storage and computing – everything you need is physically close to you, and data is accessible only on a local network.  This working from the hard drive is how many workplaces have functioned for decades.

Why Choose a Behavioral Health EHR in the cloud?

In a world where the workplace in no longer as localized as it once was, the introduction of cloud computing has seen immediate performance gains.  Stand-alone servers typically use only a fraction of their capacity in case of a surge in demand.  By linking the machines together into a larger “virtual” system, the surge problem has been eased and room for increased computation has been freed.  Also, the ability to pool tremendous processing power is leading to innovations thought impossible just a few years ago; work and research can be done anywhere, anytime, and the information and analysis completed and shared almost immediately.  Since its inception, further innovations have added hundreds of capabilities and features, such as data analysis tools. 

Perhaps most notably is the effect of cloud computing on cutting prices while making available more efficient ways to run systems. Individual providers and organizations are uniquely empowered by the cloud.  Without the cloud it would have been almost inconceivable to fund a start-up like Pinterest, which now loads 60 million photos a day onto AWS but employs only 300 people.

Besides making it much cheaper to experiment, do research, and start new organizations, the cloud has a huge hand in enabling the technological evolution which is shaping the performance of connected objects.  And as companies learn how to further cut costs and increase performance themselves, they pass along at least part of that gain and costs go down for everyone.  

Trust in the Cloud

By making massive storage and data management available to anyone able to pay the rent has made and remade thousands of organizations by lowering individual costs.  At the same time, the ways in which we are presently managing the cloud grants a huge amount of power, control, and influence to a handful of powerful companies. Much as it is with electricity – it’s likely that fewer than a dozen companies really understand and control much of how this technology will grow, work, and be shared.

An Impending Storm?

Our clients aren’t using cloud computing to store excess pictures or iTunes files, so we understand that they are all about cloud security.  It’s important to serious practices to have an EHR that is safe, private, and HIPAA compliant.  Questions arise that we feel are important to answer when choosing a Behavioral Health EHR that uses a cloud computing platform.  Is patient data sitting on one or two dusty servers somewhere being backed up to a less than secure source?  Who has access to this patient data?  How often are passwords changed and updated on these servers? Are these servers all in the same location or spread around the country?

At everythingEHR we spend a lot of time debunking marketing agendas so providers get the facts about EHR technology.  Beware the EHR vendor that tells you that a cloud computing platform is not as secure as their installed, web-based product.  In fact, it can be just as safe or unsafe as installed software on local machines and vice versa.  And there are cloud platforms available that fully meet with HIPAA encryption standards as laid out by the National Institute of Standards and Technology (NIST).  We want the behavioral health community to know that advanced, secure technology is available to them – so that they may focus on patient care rather than EHR headaches.  

We also understand the demand from the practices we work with for a stable and financially secure behavioral health EHR vendor.  Any cloud computing platform vendor we would recommend would have these three traits:

1. A vendor who offers a system hosted on multiple servers in multiple states
2. A vendor who guarantees back-up to secure sources and a clearly outlined back-up plan (so that if your EHR goes down you are up and running immediately with minimal to zero data loss)
3. A vendor who ensures an appropriate support team – including people who are familiar with cloud computing (These are MEDICAL records being hosted.  Your behavioral health EHR vendor should have no less than 10 dedicated support staff with varying credentials such as in Information and Technology, Software Programming, Licensed Mental Health counselors, Certified coders and billers)

Is it expensive for an EHR company to have this kind of infrastructure?

Absolutely, which is why it is important for providers of mental healthcare services to choose a Behavioral Health EHR vendor that is large enough and has the financial stability to safeguard your patient data.  

Cloud ‘Good’, Installed Software ‘Bad’?

No, but EHR software that must be installed does add limits to your practice.  To a large extent this is because you can only use the software on machines where it has been installed.  Using installed software also could mean being limited to the type of computer (Windows or MAC) that can run the software effectively. And by ‘effective’ this shouldn’t mean having to buy additional software in order to use it on a different computer.  Many EHR vendors are attempting to “convert” their Windows based EHRs to being accessible in the cloud.  This transition is difficult and costs providers additional fees.  The EHR was not designed with large buttons for easy use with your index finger on iPads, Tablets, etc.  The software tends to run even more slowly.  In a world of Smartphones, iPads, Windows Tablets, MACs, PCs, and other technology that can all communicate with one another you don’t have to pay extra for this kind of access.  There are behavioral health EHRs on the market that include all of this with their product.

The cloud has upended one of the biggest businesses in the tech world.  Software companies used to selling software in packages frequently loaded onto computers with costly service contracts now compete with companies that are instead renting data storage and software via the cloud.  By now, many consumers know they no longer have to buy that expensive desktop software.  Instead, they can find good alternatives that work in the cloud.

Regardless of preference, at everythingEHR we look for Behavioral Health EHR vendors that stick to facts and stay away from marketing tricks.  It’s a competitive market out there and this is not a bad thing, but we don’t want the speedy innovations of technology to aid any tricksters in their racket.  The more information about developing technology providers have available to them, the better EHR they use, and the better patient care they can provide.

As always, we are here to help. An EHR is a tool to help mental health providers focus on their clients’ mental wellness.  This is why we support Behavioral Health EHR vendors that meet certain criteria.  If you would like an advocate during your EHR search or simply want to ask some questions, feel free to reach out!