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Why is it not web-based?

There has been a lot of hype in recent years towards web-based EMR programs (so-called "Software-as-a-Service" in the broader sense or SaaS).  Adoption for SaaS overall in the business industry has not been as widespread as web service vendors would like to think, for several reasons.  Here is a good article on this topic, and roughly the same arguments can be translated into EMR systems.

Here are my comments regarding web-based/SaaS EMR systems:

The speed of the office internet connection becomes the bottleneck as every user on the system has to depend on the internet to send and retrieve data from the web server.  Text is usually fine, but his can slow down as you start flipping through pages of scanned documents, if that's even an option.  A locally installed database will always have the edge in speed.

Some would argue that office-based EMRs are less secure.  A good firewall and secure wireless access should keep you protected from external threats.  Even if you have  a web-based EMR, you should still protect your network and hire a third party IT professional if needed.  Doxio works with Windows Domain as well as Workgroup networks.  As far as backup is concerned, Doxio writes its data to an external drive and updates it by the hour.  If your server goes down, you can rebuild the database in a matter of minutes, either on the same machine or another computer on the network.  Drive and folder encryption provides HIPAA-compliant data protection and can be easily implemented using Microsoft Windows (professional and ultimate editions) or using free third party software like Truecrypt.  We recommend rotating backup drives daily, with one drive stored in a location outside the office, such as a safety deposit box or taken home by an administrator or the practice owner.  What if the web service provider decides to close shop?  Will you still have access to your data?  I find it hard to imagine entrusting my entire clinic database to a third party that I do not know.  With Doxio, your data (and the means to access it) will always be with you.

The biggest benefit of a web-based EMR is the ability to access your records from anywhere.  With a locally-installed system like Doxio, you can still do it with third party remote-access vendors like LogMeIn or thru VPN.