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H H S Department of Health and Human Services
U.S. Department of Health and Human Services
Health Information Technology

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Should I Purchase an In-House System or Contract Out for Services?

Your clinic or practice will have choices of on-site and off-site systems.  On-site systems are housed in your facility.  These systems require that you have access to a secure data center and network, as well as adequate computing power and storage capacity to handle all patient information and product software.  Alternatively, your health IT system and services can be contracted out to a vendor who houses most of the software and patient information at the vendor’s facility.  

Although you may be cautious about releasing data for a contractor to store on their system, many of the storage and maintenance needs of a small practice are more efficiently met by housing patient data in an off-site data warehouse or repository.  The main advantages of using an off-site consolidated data center are:

Scalability.  Your capacity to store ever increasing amounts of data will be needed, and an off-site consolidated data center may be better able to meet your growing data storage needs.  For example, if you need to keep records for a long period of time, or if your practice is interested in saving visual media files (such as digital X-ray images) as part of a medical record, the volume of storage you will require will increase dramatically.  

Sustainability includes account maintenance and troubleshooting.  Compared to a physician’s office or clinic, off-site consolidated data centers are more likely to have resources and staff on-call at all hours for rare events such as server crashes or security breaches and for routine matters such as back-ups and hardware upgrades.  

Physical plant requirements include the computers’ hardware and cooling systems.  These initial costs and necessary upgrades can be substantial.  Such upfront costs can be avoided by sharing these systems with others.  

Familiarity with data security requirements.  Data centers that specialize in health records are likely to already have familiarity with the data security requirements outlined in HIPAA, while health care providers may not.  Therefore, a consolidated data center may be better able to ensure the security of the data than providers who house their own data.

Regional Extension Centers funded by ARRA will provide you support during your decision-making process.  Their primary function is to provide information and technical assistance to small to medium sized provider practices to support meaningful use of EHRs and enable health information exchange.  There are now 62 Regional Extension Centers (RECs) throughout the country.  The Regional Extension Center that serves your geographical area will help you purchase, adopt, implement and work towards meaningful use of health IT.  Also, as you research your options, contact EHR vendors that focus on community clinics and Federally Qualified Health Centers (FQHCs); they may offer software, storage and maintenance systems themselves, or they may direct you to other service providers in your area.  

Related Resources:

How to Select an Electronic Health Record System go to exit disclaimer– This article discusses the EHR selection process, provides checklists and other tools to advise providers in the selection process.
Health IT Regional Extension Centers – The Office of the National Coordinator for Health Information Technology’s (ONC’s) Health IT Extension Program website provides a list of the 62 Regional Extension Centers, contact persons, websites and other resources.
Electronic Health Records and Meaningful Use – Overview of the benefits of EHRs to providers and patients, background on Meaningful Use legislation and regulations, and a link to Meaningful Use standards and certification criteria.  

Developed by the Health Resources and Services Administration as a resource for health centers and other safety net and ambulatory care providers who are seeking to implement health IT.
Health Information Technology Toolboxes help health centers, safety net providers, and ambulatory care providers with electronic and online resources and technical assistance to improve patient care.  More>
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