One important decision to make when choosing practice management software is whether you want the program and data to reside on your computers or on computers owned and maintained by the software vendor. If you run it in-house, the solution can be referred to as a local, client-server, or desktop system; vendor-run applications are called application service provider (ASP), remote, or online solutions. Both options provide distinct advantages: consider which are more important to you.

Local solutions
Most of the software you use today is locally hosted – the program runs on your computer and stores the data either on your hard drive or on a network server in your office. This familiar setup gives you the greatest control over every aspect of your practice management software since the data resides on a computer in your office.

Having this total control can be a drawback, though. To meet HIPAA’s stringent data security standards, your computer network will need to employ advanced technologies including Secure Sockets Layer (SSL) security, firewalls, and variable access control which grants different permissions to each user. Installing these technologies and maintaining the patient information database can take considerable expertise and effort – not to mention considerable expense for consultants and hardware. In addition, keeping the data in-house gives you the responsibility of making regular backups – preferably daily – in case of a system crash.

Proponents of desktop applications point out that MPM software is highly stable and requires little database maintenance. In addition, some vendors will handle setup and installation for you – either through an office visit or by accessing your computers remotely. And you can fairly easily create scheduled backups that copy your data to off-site computers. (Interested in remote backup services? Get a free quote today!) Plus, there is the bonus that because the data is local, overall application speed tends to be higher.

If you go the desktop route, you are more likely to pay a lump sum to buy your software outright, then a small ongoing monthly fee for support.

Online solutions
There are two slightly different approaches to online practice management software. In the most common model, an ASP, both the application and the data reside on the supplier’s servers, and your staff uses a regular web browser to access the software. A relatively new variation is a hybrid between the local and online models: client software is installed on your computer, but the critical data still resides on the vendor’s computers.

Both options provide the same main advantage: the database is maintained by IT professionals at the vendor’s office. Multiple layers of firewalls and security, uninterruptible power supplies, fail-over (instant switching from one computer to another in case of a crash) and reliable backups are all standard operating procedures for these vendors – and they combine to virtually guarantee that your data will always be secure and available.

The biggest risk of online solutions is that they require an active Internet connection, which is no small requirement. No Internet connection works 100% of the time: your internal network may fail, your ISP may experience an outage, or an Internet worm may cause congestion that prevents you from accessing your data for a while.

Online medical systems offer various workarounds for this potential bottleneck – some allow you to download some patient info, work with it, then re-upload, but this is only useful if you can anticipate outages before they occur. Others work in batch mode, pulling down a whole set of data you are likely to need (that day’s patients, for example), then re-uploading it at the end of the day.

With online providers, payment is more likely to involve a small setup fee, then ongoing monthly payments based on usage.

Which is right for you?
Since both options provide secure, reliable practice management applications in almost all cases, one way to make the choice is to consider which of the potential downsides you fear more: being unable to access your data while your Internet connection is down, or losing data and time because your server crashes.

If your practice has access to an immediately available IT resource, an in-house solution may be your best choice – but make sure you involve the IT staff in the purchasing decision! Smaller practices with little to no computer expertise may be better off choosing an online solution.

Whichever option you choose, make sure the system can export your data in an accessible format. Many medical software providers are small businesses, and if your chosen vendor goes out of business you'll need to be able to transfer your data into a new system.

One way to determine which software package is right for your practice is to compare products and services from multiple medical software providers.