Contract Review
Protecting Interests of Physicians In Acquiring and Licensing Electronic Medical Records

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This long awaited guide has been in development for over a year.  This guide assists physicians in purchasing an EMR system and reviewing the contract they will sign with their EMR/PMS vendor.  It is important to remember that the contract is written primarily to protect the EMR vendor, not the physician.  This guide will review topics and make suggestions in hopes to better protect physicians in the process of purchasing a system and implementing/integrating that new system.

Table of Contents

  • Summary
  • Definitions
  • Software Licensing
  • Software Maintenance
  • State and Federal Regulations
  • Training
  • Software Documentation
  • Refurbished Equipment
  • Existing Equipment
  • Server Memory Leaks
  • Anti-Virus
  • Microsoft Updates
  • System Backup
  • System Integration
  • Templates
  • Implementation Timeline
  • Product Features
  • Data Conversions
  • Service Level Agreements
  • Trouble Tickets
  • System Access
  • Payment
  • Warranties
  • Company Organization Information
  • PMS / EMR Integration
  • ICD9 / CPT Codes
  • Implementation Responsibilities
  • Features / Benefits
  • ASP Environment
  • ASP - Faxing
  • Faxing Using Local Fax Servers from ASP EMR
  • ASP - Printing
  • ASP – Antivirus Protection
  • ASP – Protection of HACKING
  • ASP – Scanning Documents
  • ASP – Dictation – Dragon Naturally Speaking
  • Suspension of Application Access
  • Source Code in Escrow
  • Cancellation of Contract
  • Contract Assignment
  • Financial Statements
  • Client Data Confidentiality
  • Hiring Employees
  • Litatgation State

 

Sample Chapter:

ASP - Faxing

Faxing in an EMR system is a critical feature that must be a component of the system functionality.  The inability to fax can significantly impair the physician’s ability to communicate to other physicians and must be addressed in detail that explains how the fax process will work in a given system. 

 

The vendor should be required to identify exactly what can be faxed and what cannot be faxed from the system.  The answer that most vendors will give to this situation is to suggest that the practice print the document and then fax it with a standard fax machine in the office.  Obviously, this can be done with any EMR whether it is in a dedicated environment or an ASP environment.  This is problematic because it creates a potential disruption in workflow and the goal of the EMR approach is to improve the workflow of your office, not to impede it.

 

Typically, when searching for a new EMR, a vendor will show a prospect an incredible proprietary fax solution that has been designed as part of their EMR.  What they neglect to tell you is the system will only work in a dedicated environment or it requires an additional fax server not provided by the EMR vendor. 

 

If you choose to select a vendor using an ASP version of the product, discuss this issue with your attorney.  Hypothetically, the agreement language may look something like this:

 

  • Specified vendor’s EMR application will fax patient referral letters from the servers within the ASP located at the vendor’s ASP facility.  There is no equipment from the specified practice that is required for any faxing functionality.
  • Specified vendor’s EMR application will fax patient encounter detail from the servers within the ASP located at the vendor’s ASP facility.  There is no equipment from the specified practice that is required for any faxing functionality.
  • Specified vendor’s EMR application will fax prescriptions from the servers within the ASP located at the vendor’s ASP facility. There is no equipment from the specified practice that is required for any faxing functionality.
  • Specified vendor’s EMR application will fax orders from the servers within the ASP located at the vendor’s ASP facility. There is no equipment from the specified practice that is required for any faxing functionality.
  • All long distance calls initiated by the vendor to any fax destination required by physician will be at no cost to the specified practice.
  • Specified vendor will be capable of retaining fax confirmations which will be stored in the patient’s record for viewing at a later time.

  

Faxing Using Local Fax Servers from ASP EMR

 

If the vendor states that the EMR application will require the practice to purchase a dedicated fax server which will be located in the physician’s office, discuss this issue with your attorney.  Hypothetically, the agreement language may look something like this:

 

In case the physician has an existing fax server

  • Specified vendor will utilize the existing fax server located at the following address _______________________________.  The vendor of the existing application is ____________________.  The version of the existing fax application is _______________________.  The specified vendor’s EMR application will print any/all documents to this existing fax server.  The specified vendors EMR application will acknowledge and utilize any features that may be available by the faxing application.  Ex. Contact List within fax application.

  

If the EMR vendor chooses to print to an existing fax server within the practice, a VPN will probably be required to enable this functionality.  Their network must be able to connect directly to your network which can only be accomplished through some type of VPN.  Many vendors’ sales reps may not realize this themselves.  Make sure that the vendor includes the actual person responsible for the configuration discusses how the whole process will work in a conference call with your office.  You will also most likely need to have a dedicated IP address from your Internet Service Provider.  Make sure this is discussed in that conference call.

 

In the case the practice does not already have an existing fax server.

 

  • The specified EMR vendor has recommended the following fax software from the vendor _______________________.  This software will be installed by the EMR vendor on a server with the following vendor provided specifications
    • __________________
    • __________________
    • __________________
    •  

  

In case the practice intends on using their existing network-based Copier / Fax Machine / Scanner.

 

  • Specified vendor will utilize the existing Copier / Fax Machine / Scanner located at the following address _______________________________.  The vendor of the existing hardware is ____________________.  The version of the existing fax application running on this hardware is _______________________.  This device is connected to the practice’s local area network with the IP address of _____________.  The specified vendor’s EMR application will print any/all documents to this existing fax server.  The specified vendors EMR application will acknowledge and utilize any features that may be available by the faxing application.  Ex. Contact List within fax application.
  • Specified vendor will install exact driver and applications required to utilize the fax machines functionality on the servers that reside in the vendors ASP facility.
    • Vendors typically do not want to install the drivers for network based copier/fax/scanners because they say the drivers can be unstable and therefore makes their server farm an unstable environment for other customers that use the ASP server farm.

The author does not advise including any of the language provided in this document in any contract; before using this information consultant an attorney for accuracy and applicability

 

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