Should doctors' offices go SaaS?

The recent Misys-Allscripts deal highlights how many medical offices are starting to see the advantages of going SaaS. (Illustration from Eric Berto's blog at Etolos, an open source software vendor.)

Software as a Service (SaaS) means that you really only need simple PCs in your office, with perhaps a hard drive as back-up for files stored remotely.

SaaS means you have visibility for your IT costs. You pay for your medical software as you do your rent, and when new software comes out you're automatically upgraded.

SaaS also means that, over time, you can think about the form factor of your client devices. Those Tablet PCs are cool, and if you aren't burdened with the capital cost of a server-based system maybe you can afford one.

But there remain risks with a SaaS strategy:

1. Compatibility with whatever the hospital you're linked to buys. Sure your vendor may claim "system integration is our specialty," but it's your professional life on the line.
2. Privacy for your data. Sure your vendor may claim 10 levels of security, but data breaches happen, and you don't want them happening to your patients.
3. Disaster recovery. Sure you may be able to maintain a file back-up in your office closet, but how much capability might you lose if your vendor's system has an outage?
4. Loss of control. Having your patient's data, as well as your IT infrastructure, outside your office makes many doctors nervous, especially when you realize there will come a day when you might want to switch vendors.

Some of these concerns are overblown, in my view. It's clear that many software vendors see big benefits in SaaS, and are re-organizing to fit that business model. But is it right for you? Ask yourself some questions:

1. Is your practice growing, or is it stable? Not just in terms of physicians, but in terms of equipment? If you're in love with the latest geewhiz diagnostic gear, your SaaS vendor must be flexible enough to handle those files.
2. If you're going SaaS for medical records, will they integrate with your payments vendor? And vice versa?
3. What happens when you decide to leave, as you undoubtedly will eventually? What guarantees do you have that data will come back to you in a timely manner, in a usable form? Get it in writing.

Given any conventional cost-benefit analysis, the pressure to automate records and uncertainty about the future , SaaS seems to be a great option.

Just make sure you get those termination terms in writing.