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How to work with your vendor to work out connectivity and remote access


In addition to learning how to use your EHR, you will also need to work on connectivity and remote access. Here's what you need to know.

Key Points

Whether the electronic health record (EHR) system you use is Web-based, software-as-a-service (SaaS), or a client/server arrangement, your EHR vendor will take responsibility for most of the EHR connectivity issues you'll face. That does not mean, however, that none of an EHR's connectivity needs are your responsibility and are out of your direct control. Some aspects of EHR connectivity always will be yours to establish and maintain.

EHR connectivity refers to the internal EHR system connections within your practice or the external connections between your practice's EHR and other organizations. It is the physical wiring between your EHR servers, external hard drives, and broadband Internet connection, and it refers to the network connections between your registration/check-in desk, exam rooms, and billing department. EHR connectivity also can refer to the wireless systems in your practice and the remote terminal you use at home, as well as the mobile devices you use when on the move.

The most critical element of connectivity for practicing physicians, however, is access to patients' records.


"It touches a little bit on interoperability between disparate systems and also on making sure the hardware is up and works in a safe and secure fashion," says Robert Rowley, MD, a practicing family physician and healthcare information technology consultant who blogs at

Rowley also was an early creator of electronic medical record technology for his own practice that eventually became the Practice Fusion EHR.

"Keep in mind, there are two types of EHR connectivity," he says. "There's technical connectivity, like making sure your Internet connection doesn't go down and everybody can access the patients' records-especially during natural disasters like hurricanes. And then there's the connectivity of getting all the departments in a practice communicating and exchanging data between disparate system, which is more difficult."

According to Rowley, Web-based EHR systems don't experience as many issues with lost connectivity as do practice EHRs that are hobbled together piecemeal from different vendors.

Even external billing companies that receive electronic super bills from practices are interconnected to the practice EHR and generally fall under the responsibility of the vendor for maintaining connectivity.

"A physician-consumer [with that type of EHR] doesn't have as much to worry about," Rowley says. "Those are unified EHR systems. They work well, and there are plenty of them in the market place, so internal system connectivity really isn't an issue for them."

External connectivity, however, is another matter. The Centers for Medicare and Medicaid Services meaningful use EHR incentive programs established the Internet as essential to practicing medicine electronically and to receiving Medicare and Medicaid reimbursement payments. A practice's broadband connection, therefore, is of utmost importance to EHR connectivity.

"We have an electronic healthcare system now," Rowley says. "And because it's Internet-based, we can work from home, from mobile devices, from wherever."

Your Internet connection, therefore, must be strong and reliable to ensure that your practice's EHR connectivity remains accessible.

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Jennifer N. Lee, MD, FAAFP
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