Over the last 5 years, the healthcare IT industry has begun a massive shift to the cloud. A confluence of factors has triggered this move, including the availability of secure, scalable, and affordable cloud computing resources such as Amazon Web Services (AWS); the increase in health information exchange activity, which is greatly facilitated by cloud technologies; and the proven success of a handful of cloud-based EHR offerings.
As part of the growing trend of cloud-based health IT offerings, there has been a corresponding upswing in the number of cloud-based enterprise master patient index (EMPI) offerings on the market. I wrote this blog for organizations that are considering using a cloud-based EMPI, but that are unsure whether to simply use a hosted EMPI, to use a managed EMPI, or to subscribe to a fully software-as-a-service (SaaS) EMPI. I’ve outlined the differences, benefits, and challenges of each option below.
What is a hosted EMPI?
A hosted EMPI is simply a cloud-hosted version of EMPI software that would otherwise sit on-premises. In other words, the EMPI technology is exactly the same, but instead of the software sitting on an organization’s premises, it sits in the cloud. Someone from the organization still has to operate and monitor the technology.
What are the benefits of a hosted EMPI?
Organizations that utilize cloud-hosted EMPI technology see benefits primarily through a reduction in some installation and operations management activities. Because of this, cloud-hosted EMPI solutions will have an incrementally lower total cost of ownership (TCO) than on-premises EMPIs.
What are the challenges of a hosted EMPI?
Hosted EMPI technologies can be much more cumbersome to use since they aren’t on an organization’s premises. And like on-premises technologies, cloud-hosted EMPIs still have huge upfront costs, take months to implement, require lengthy algorithm tuning exercises when they’re implemented, require algorithm re-tuning with each newly connected data source, require periodic clean-up services to improve their data quality, need database administration efforts, and require expensive software upgrades every few years. And, of course, because they use the same patient matching technology as on-premises solutions, they cannot automatically resolve hundreds of thousands or millions of duplicate records—and thus require teams of data stewards or health information management (HIM) professionals to manually review and resolve these duplicates.
What is a managed EMPI?
A managed EMPI is very similar to a hosted EMPI except that a managed services provider (MSP) operates and monitors the technology—actively checking the environment, doing the maintenance, etc. A managed EMPI is still fundamentally the same EMPI technology as an on-premises solution.
What are the benefits of a managed EMPI?
Because an MSP is operating and monitoring the EMPI technology, organizations that use a managed EMPI see significant reductions in the amount of effort and resources they need to invest in implementing and maintaining the technology. This in turn means that managed EMPI solutions will typically have an incrementally lower total cost of ownership than hosted EMPI solutions.
What are the challenges of a managed EMPI?
Like hosted EMPI technologies, managed EMPI technologies also have huge upfront costs, take months to implement, require lengthy algorithm tuning exercises when they’re implemented, require algorithm re-tuning with each newly connected data source, require periodic clean-up services to improve their data quality, and require expensive software upgrades every few years. And, of course, because they use the same patient matching technology as on-premises solutions, they cannot automatically resolve hundreds of thousands or millions of duplicate records—and thus require teams of data stewards or health information management (HIM) professionals to manually review and resolve these duplicates.
What is a SaaS EMPI?
Software-as-a-service (SaaS) EMPI solutions, like all SaaS software, consist of offerings that are more transformative and that provide significantly differentiated capabilities—features that are only possible because the software is cloud-based. SaaS EMPI technologies are built from the ground up to operate in the cloud, and thus the technology is designed to take full advantage of cloud architectures and management techniques.
What are the benefits of a SaaS EMPI?
SaaS EMPI solutions deliver far greater value and dramatically lower total cost of ownership (TCO) than hosted or managed solutions, while simultaneously providing features that are only possible with SaaS software. They require significantly less time and effort to implement, no effort to maintain, and no periodic costly software upgrades. And some SaaS EMPI solutions are already HIPAA compliant and HITRUST-certified, so you can rest assured they adhere to the highest standards of security and privacy.
SaaS EMPI solutions also offer features like auto-scalability to hundreds of millions of patient identities, high availability, and disaster recovery, that are all pre-built into the cloud environment. And SaaS EMPI solutions can offer technology that is significantly differentiated from on-premises, hosted, and managed solutions—like built-in reference demographic data for your patient population, as well as new patient matching architectures like Referential Matching that leverage this reference demographic data to achieve unprecedented levels of matching accuracy out-of-the-box. This accuracy in turn means no extensive algorithm tuning during implementation or during new data source integration, as well as dramatically less data stewardship and HIM effort to manually resolve duplicate records.
What are the challenges of a SaaS EMPI?
The biggest challenge of a SaaS EMPI tends to be getting buy-in from stakeholders across a healthcare organization to leverage and trust cloud-based SaaS technologies. Everyone is—and should be—invested in improving patient data, delivering complete patient information to the point of care, and lowering healthcare technology expenditures. But some are still unsure of the benefits and cost-savings of SaaS technology and have reservations about the privacy and security of SaaS EMPI solutions.
If you need more convincing of the benefits and cost-savings of HITRUST-certified SaaS EMPI solutions—or if you help developing a business case around switching to one—I urge you to reach out to us, to read this Modern Healthcare article about why Healthix dropped IBM Initiate to deploy a SaaS EMPI, or to read this case study about how a healthcare organization deployed a SaaS EMPI in 4 months and is seeing $400,000 in direct cost savings.