Cloud-Based EHR vs. In-House EHR: What’s Better for Behavioral Health?

January 4, 2023

Cloud based EHR: employees working together

Technology makes the biggest impact when it’s used to solve the right problems. Electronic health records (EHRs) not only provide an alternative to paper documentation, but they also create a less intensive means of transmitting patient information between providers. As a result, there’s a more integrated and team-based approach to patient care. 

Additionally, an EHR allows behavioral health providers to be active members of the healthcare team as they gain access to medication records, vital signs, lab results, and evaluations of physical well-being.

Despite these benefits, behavioral health teams have been slow to adopt EHRs. This guide will look at some reasons for the hesitancy and address ways to clear these obstacles so you can decide whether an in-house versus cloud-based EHR would be best for your behavioral health practice. 

Reasons for Slow Adoption of EHR Among Behavioral Health Professionals

According to a recent MACPAC report, behavioral healthcare providers report three main barriers to EHR adoption:

Cost: Providers feel unable to invest in the hardware, software, and training needed to start using EHR.

Compliance: Unlike medical practices, behavioral health practices may be subject to additional regulations regarding data sharing and they face unique challenges implementing compliant EHR systems. 

Support: Adopting an EHR is a major shift in how many behavioral health businesses run. Not only do you need training and education to promote buy-in, but you need ongoing support to ensure that your EHR integrates with peer systems. 

In-House EHR Cost Considerations

The cost of implementing an EHR system depends on many factors. For example, if you’re going to host an in-house EHR system, some of your biggest expenses may revolve around the following activities:

  • Choosing a vendor and purchasing software
  • Subscribing to high-speed internet that can support server traffic
  • Purchasing and installing onsite servers
  • Hiring a full-time HIT professional or IT staff to maintain your servers, back-ups, and security patches, as well as handling server crashes and minimizing downtime
  • Hiring a compliance officer
  • Training clinicians and onboarding staff
  • Purchasing additional software to ensure functionality with your practice management software, billing and revenue cycle management (RCM) system, EMR software, patient portal and mobile access apps, internal and external communication platforms, telehealth, and e-prescribing

Moreover, ongoing expenses may include software updates, licensing fees, security patches and updates, additional training, and onboarding new employees. To ensure scalability, you may need more servers and additional secure space for servers.

Cost Benefits of Cloud-Based EHR Solutions

If you choose a cloud-based EHR solution, you can eliminate some of the costs associated with in-house EHR software. For example, ContinuumCloud's EHR is SaaS. That stands for "software as a service" and it means you don't need to purchase software, and there’s nothing to install on your end. 

At ContinuumCloud, our EHR solution is 100% cloud-based, so you don't have to purchase and store a server to host your EHR system. You (and your patients) can access information securely, 24/7, no matter where you're located. And because your service is managed remotely, you won't need to hire extra HIT-trained employees. 

In-House EHR: Privacy, Security, and Compliance

group of people discussing in a circle

When it comes to privacy and security, you must be prepared to comply with the relevant laws for an in-house EHR system. Today, it isn't enough for a provider to be aware of ethical practice. You also have to follow rules that apply to licensure, informed consent, and confidentiality. Furthermore, you have to understand the laws and best practices should a data breach occur. 

In addition to any state laws, some common federal regulations you’ll want to know about include:

  • Health Insurance Portability and Accountability Act (HIPAA)
  • Family Education Rights and Privacy Act (FERPA)
  • Children's Online Privacy Protection Act (COPPA)
  • Health Information Technology for Economic and Clinical Health Act (HITECH) 

When using technology in behavioral care, a range of potential data security issues can arise. You’ll have to take extra precautions not only with the methods you use to interact with patients like email, videoconferencing, and telephone, but also written records like therapy notes. 

Ultimately, it's your responsibility to restrict unintended access and disclosure of any protected health information (PHI) and patient data through physical safeguards like encryption, password systems, and administrative safeguards.

Cloud-Based EHR: Privacy, Security, and Compliance

One of the key benefits of cloud-based EHR systems is that you can rest a little easier knowing that all of your sensitive information is stored securely on HIPAA-compliant servers. Unlike general EHR service providers, ContinuumCloud's EHR is designed with behavioral health practices just like yours in mind. We are one of the only EHR vendors that serves the behavioral health and human services community exclusively. 

Choosing a one-size-fits-all solution may leave gaps in your compliance needs. For example, if you provide care to students, your data needs to be COPPA and FERPA compliant, as well as HIPAA compliant. As a provider of a solution tailored to your industry, we can work with your practice to make sure you are meeting all the HITECH standards. 

In-House EHR Support, Implementation, and Interoperability 

Choosing to set up an in-house EHR system doesn't mean you won't have support. Most software vendors offer support packages. However, hiring an on-site IT professional is recommended for multiple reasons:

  • To learn your software, implement it, and onboard your employees
  • To keep up with licensing
  • To keep your system online and reduce downtime
  • To maintain servers
  • To keep your system security up-to-date
  • To prevent or address data breaches
  • To perform backups 
  • To assist you with MACRA or other regulatory audits
  • To install upgrades

Finally, you’ll need to make sure your system is Meaningful Use certified. That is the government's way of ensuring it is functional and interoperable. In-house EHRs that aren't interoperable make it difficult to exchange data effectively and can suffer from poor usability.

Support for Cloud-Based EHR Systems

ContinuumCloud’s cloud-based EHR solution designs your system for interoperability. We understand that this step is key to usability. Therefore, we start by providing an EHR that is Meaningful Use III and ONC-ACB certified — and that's just the beginning of the support we offer. 

Getting started with a cloud-based EHR shouldn't be stressful. And ongoing support shouldn't be costly, take your time away from patients, or cause you to worry about system downtime while you wait online for an agent. Our support begins with implementation and never ends.

ContinuumCloud provides a custom 4-phase design and implementation process along with the ongoing support you need to be fully successful with our cloud-based EHR.

1. Discovery and planning

We start by identifying each organization’s specific requirements and goals to understand your unique software needs. Then we create an implementation plan.

2. Configure, develop, and test

During a thorough setup process, ContinuumCloud configures and executes your custom plan. 

3. Onboarding and training

Once your system is ready to launch, we begin an in-depth onboarding and training program to get your employees up to speed and ready to go live.

4. Ongoing support

After a successful launch, your EHR project team will help you transition to the dedicated, ongoing support team assigned to your practice.

ContinuumCloud’s EHR PlatformCloud based EHR: woman working on laptop and phone

As a technology partner, ContinuumCloud aims to help you configure a comprehensive EHR platform that not only provides secure access to medical records but also streamlines your workflows, integrates with your practice management solutions, engages your patients, facilitates communication, and improves peer interoperability. Here are a few of the features our behavioral health IT experts created with your practice in mind:

  • Welligent EHR: The leading cloud-based EHR system for behavioral health with solutions for mental health, substance use treatment, foster care, and human services
  • Welligent Express: A mobile-optimized EHR experience containing the most-used features; perfect for managing clients in the field
  • Welligent Connect: A patient portal hub to connect clients and clinicians
  • Welligent Messenger App: A HIPAA-compliant secure messaging center for clinicians to coordinate care 
  • Welligent Chat: A secure instant messaging platform for employees

Last Take: In-House vs. Cloud-Based EHR

Despite research that illustrates the benefits of using an EHR, private mental and behavioral health practices are falling behind other healthcare professions in adopting the technology because of three primary concerns: cost, privacy, and support.

In-house EHR may seem like the easiest and most cost-effective choice. But as we've discussed, there are a lot of hidden costs to consider. Plus, it takes a lot more than a secure internet connection to implement a compliant and secure EHR.

Keep in mind that digital health tools are not just an investment in technology, they’re also an investment in the improved health of your patients and in the performance of your healthcare system.

Cloud-based EHR systems like ContinuumCloud’s EHR ensure that mental and behavioral health practices don't need to worry about storing confidential clinical data and patient health information on their servers. You don't have to hire additional IT staff or worry about providing training to employees. Extended support options are a part of your custom plan so you can rest easier knowing someone is there for you. 

Are you ready for fully integrated and interoperable healthcare data sharing that can be done securely, faster, and more efficiently? Let’s get in touch.

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