Costs and Requirements of Certified Health IT

Capability

Description of Capability

Costs or Fees

Drs® Enterprise

The Drs® Enterprise is a certified EHR that is available as either cloud-hosted or local server-hosted (client/server).

Client/Server :  There is a one-time fee for the software, setup, installation, and training.  There are also one-time and monthly fees that include support, maintenance, updates, and upgrades.  This model is priced on a per-workstation basis with additional fees for ePrescribe, patient portal, and registries (see below).

Cloud Hosted :  There is a one-time fee for setup, installation, and training.  There are also monthly fees for the hosting which include support, maintenance, updates, and upgrades.  The cloud hosting version is priced per provider per month with up to four named users.  Additional named users and registries would incur additional one-time and/or monthly charges (see below). 

Patient Portal

This provides patients with the ability to view (or assign the right to their responsible party), their medical information on a secure electronic portal.  The patients also can download and transmit their medical records to other providers as well as communicate directly with their providers.

This portal is provided through Updox and there is a one-time setup fee as well as monthly charges per provider for this service.  This is directly interfaced with Drs® Enterprise and therefore will need to be purchased through Keiser Computers.

Direct Messaging

This provides physicians with the ability to securely send messages and/or documents to other healthcare professionals.

This ability is included in the cost of the patient portal mentioned above.  The physician will be given one direct messaging address for sending and receiving direct messages and other documents.  Occasionally a practice may want an additional direct messaging mailbox for a staff member.  This would be at a small additional monthly charge.

ePrescribe

This provides physicians with the ability to send prescriptions electronically.  It can provide feedback to the physician when prescribing as to contraindications for drug to drug, drug to allergy, formularies, and more.  There is also the added ability to electronically prescribe controlled substances (EPCS).

There is a one-time setup fee as well as recurring annual fees for the ePrescribe. There are additional fees for identity proofing (vetting). There are also additional one-time fees (nominal) for lost EPCS tokens.

General Registries

There are many different depositories of clinical data that are commonly referred to as clinical registries.  Some practices may be required to send clinical data to a registry to fulfill CMS requirements.

Registries often require complex schema for the data to be accepted.  This will usually require the outgoing data to be programmed thereby requiring some one-time costs to be borne by the practice.  Additional recurring monthly costs will be required to maintain the interface.  There might be other costs imposed by the particular registry.

Immunization Registries

This provides the ability for the practice to record immunizations.  There is also the optional ability to send these immunizations to state registries.

Many practices do not administer immunizations but would like to record the historical immunization data for their CMS compliance.  There is no charge for recording the immunizations into Drs® Enterprise. However, there are additional one-time and recurring monthly charges for the ability to send the immunizations to state registries.  Each state will have its requirements and there may also be fees from the State Health Information Exchanges (HIE) to participate in their state registry.

Syndromic Surveillance

According to the World Health Organization (WHO), "the continuous, systematic collection, analysis and interpretation of health-related data needed for the planning, implementation, and evaluation of public health practice."   Many states can receive this information from the EHR. 

Though it is rare for the independent ambulatory private practice to be required by a state to submit the syndromic data, Drs® Enterprise has this ability.  Because this would need an interface, there would be one-time and recurring monthly charges if this becomes required for the practice.

Interfaces

An interface is software integration between disparate systems to allow the sending and/or receiving of clinical data electronically.  Usually, these are automatic systems that work in the background to deliver/receive data.  Sometimes there will be the need for notifications in place to alert users to data that is received.  Examples of interfaces include pathways to/from practice management systems, labs, imaging systems, registries, portals, ePrescribe systems, medical devices, and diagnostic equipment.

Some interfaces are at no charge and are included with the Drs® Enterprise system.  Certain practice management systems are examples of this.  The ePrescribe and Patient Portal interfaces are included in the pricing of these features.  Other interfaces are customized for the entity that will be interfaced.  Labs, imaging systems, registries, and medical devices are examples that will require programming and quality assurance testing and therefore will incur additional one-time and monthly costs.

Clinical Decision Support (CDS)/Decision Support Intervention (DSI)

CDS/DSIs are notifications that can help the care provider become aware of important and relevant clinical information at the point of care.

CDS/DSIs for primary care and many other specialties, to be able to meet CMS compliance, are included without cost.  However, some practices in some specialties may prefer additional CDS/DSIs to be available and there may be additional one-time and/or recurring monthly charges for these CDSs. 

Clinical Quality Measures (CQMs)

CQMs are measures that provide clinical data for data analysis by CMS and others.  Currently, ten CQMs in three domains are available.  Drs® Enterprise offers many CQMs in various domains.

CQMs for primary care and many other specialties, to be able to meet the MIPS program, are included without cost.  However, some practices in some specialties may prefer additional CQMs to be available and there may be additional one-time and/or recurring monthly charges for these CQMs.  There may also be additional one-time and/or monthly charges for assessment profiles if the CQM requires the use of special assessments.

Computerized Physician Order entry (CPOE)

CPOE enables the physician to record, change, and access medication orders and lab orders. It can also help to track compliance with the orders.

The CPOE ability in Drs® Enterprise does not require any additional costs.  However, Drs® Enterprise can provide customized workflows within the CPOE function.  This optional customization could incur additional one-time and/or recurring monthly costs.

API Interfacing using FHIR

FHIR enables devices, databases, and other systems to interface with the Drs Enterprise database.

There may be one-time fees and recurring fees for the API server.  These fees may also include installation, maintenance, and training fees.

AMA Fees

CPT codes are the copyright property of the American Medical Association. Their CPT coding system is used in the Drs Enterprise software.

There may be recurring fees required for the use of their CPT coding systems.

Multi-Factor Authentication

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Drs Enterprise supports Two-Factor Authentication.

Two-factor authentication (2FA) protects the user logins to access the Drs Enterprise application from attackers exploiting weak passwords or using stolen credentials.

The 2FA, also called "two-step" verification requires users to provide the username and password (something you know) with an authenticator app installed on the user's phone (something you have) that generates a one-time authorization code to access the Drs Enterprise application. The 2FA is an optional security feature that can be enabled for all users.

There are no known additional costs or fees for this feature.

A smartphone will be required for each user to generate the one-time authorization code. Free third-party authentication apps, such as Google Authenticator or Microsoft Authenticator will be required.