Pricing is one of the first things a prospect wants to know. There are two basic EHR architectures, each with their own pricing models. Both systems have their benefits and drawbacks, and ultimately you will have to decide which one is right for you. Client-server, or on-premise EHR software is the first model. You host client-server systems at your office on hardware you own. Software-as-a-service (SaaS), or cloud-based software is the second model. SaaS EHR systems are hosted on the web. You access the EHR through your web-browser.

For a more detailed discussion on EHR pricing and cost of ownership, see this video by SoftwareAdvice.

Hardware: Client-server systems are hosted at your office on hardware that you own. You may need to purchase or upgrade your server. You may also need to purchase or upgrade your workstations and networking equipment.

Benefits: Client-server EHR systems offer you better control. The hardware and data resides on-premise, so you can ultimately put your hands on your data, and know you know where it is stored and backed up at all times.

Client-server software usually allows much greater customization and configuration than SaaS systems. If you are a specialist, or if you have unique workflow requirements, client-server systems may be better for you.

Reliability is one of the most important benefits of client-server software. Unlike SaaS models, client-server systems do not depend on an internet connection to use the system. If your connection is slow, unreliable, or if you live in a rural area with no broadband, client-server systems will be a better choice.

Price: Client-server systems are typically purchased. You pay for them up front in cash or through financing. The price is usually made up of license fees according to the number of providers at your practice. In addition to license fees, there are usually fees for training, implementation, customization, and additional interfaces to labs, other software and equipment.

Meaningful use-certified systems usually start around $20,000 for a single-doctor practice. This should include installation, training, and a limited amount of customization. Unlike SaaS, you purchase client-server software and own it in perpetuity.

Costs: Hardware, maintenance, and support are the main costs associated with client-server systems. Since you own your hardware, it is your responsibility to maintain and upgrade it when necessary. Support and maintenance for the EHR software is a recurring cost that normally amounts to about between 18 to 22% of the software.

Hardware: SaaS software requires much less hardware than client-server systems. However, you will still need workstations for each staff member who must access the EHR. You will also need a robust broadband internet connection and high-quality networking gear. The big savings comes from not needing to purchase and maintain a server and related equipment.

Benefits: The main benefit with SaaS systems is that there is no up front purchase. There is usually a small setup fee, but since you are renting SaaS EHRs, there is no large upfront investment.

Price: Most SaaS EHRs are usually around $400 per provider per month, for as long as you use the system.

Costs: SaaS EHRs bill you on a monthly basis for as long as you use the system. While it is usually more affordable to get started with a SaaS EHR, you will end up spending more money on them in the long run. You never own the software, and it will be a recurring cost to your practice, much like your internet or utility bills