Physician practices are slowly starting to use ASPs (Application Service Providers) because of the familiarity of web-based systems, the ease of getting data and lower and more predictable costs. Rather than spend money on buying record software, the necessary server, and spending money to deal with upgrades and maintenance, physicians are paying monthly subscriptions to have ASPs host data and software on their servers and offer physicians remote access via the Internet to personal computers or hand-held wireless devices. ASPs are also incorporating the Health Insurance Portability and Accountability Act of 1996 rules dealing with data privacy and security requirements into their software, which is an added incentive.
ASPs in the work place
Small practices have been more inclined to start using ASPs, but there has been an effort for larger practices to get involved. The 15,000 member Ohio State Medical Association recently endorsed practice management software and billing services from an ASP in Massachusetts.
On a smaller scale, Molly A. Katz, M.D., of Katz, Kade and Hewitt Inc., a four-physician obstetrics and gynecology practice in Cincinnati, says that using an ASP has saved her time and increased patient satisfaction.
"On a Sunday afternoon, when a patient calls me with a problem, I am able to get on the Internet from home and say, 'There's a spot open at 10:15 a.m. tomorrow' instead of 'Call the office tomorrow at 9 o'clock and Michelle will find a spot for you.' Not only can I pick a spot for the patient, but I can leave a message for whatever staff is appropriate, to say, 'Mrs. X is coming in for this reason and I need these supplies and I need this personnel available to help me.' And at 7:30, when our staff arrives, they are getting that message as a high priority. Plus, the patient knows what to expect."
The practice plans to add hand-held prescription applications when they become available. Katz estimates that she spent $30,000 on a system as a solo practitioner about 10 years ago and found the ongoing maintenance expenses overwhelming. She also had to hire in-house staff to do billing, which is now handled by her ASP.
Dangers and hindrances
Many physicians are still tentative in using ASPs. For example, it is not uncommon for the Internet connection to go down. When this happens, it becomes a traumatic experience because physicians rely on those connections to access patient records, schedules and billing information. To solve this problem, ASPs have installed back-up digital subscriber line service to the Internet that they can use if their main connection fails, but the danger of not having a connection still exists.
Physicians are also hesitant to use ASPs because of the effort in getting the technology in place and learning new software. Getting started with an ASP involves dealing with phone companies, computer resellers, or signing up with an Internet Service Provider and physicians are already in need of time. The frustrations in getting started are a definite reason why ASPs have not become more common, but with the familiar feel of web-based systems, the ease of getting data from hand-held wireless devices and the ability to practice medicine and not deal with upgrades and maintenance issues, all reflect an emergence and increased popularity of ASPs.
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