Cloud models are starting to provide an attractive option for large and influential regional medical centers to get lots of small, local, laggard doctor offices trading in their paper patient files for electronic medical records. Are there clouds in your forecast?Beth Israel Deaconess Medical Center (BIDMC), together with its Beth Israel Deaconess Physicians Organization (BIDPO), is just one of a handful of large and prestigious health care organizations in the country helping small doctor offices in their region (in this case, the Boston area) to deploy e-medical record systems.

A cloud model allows these doctor offices to use software to manage their practices and patient data, but the servers are located remotely and supported by BIDMC and Concordant, a services provider. BIDMC is covering about 85% of the non-hardware expenses for the practices to deploy the eClinicalWorks software, and the doctor offices pay a monthly subscription fee of between $500 and $600 for support.

A similar cloud plan is also being used by University Health System of Eastern Carolina to get small doctor practices in rural North Carolina using 21st century technology, says CIO Stuart James. "Most providers can't afford to hire IT people to keep these systems running," he says. "This keeps the costs down."

The loosening nearly two years ago of federal Stark anti-kickback regulations allows hospitals to donate e-health record software and services to doctors.

Those relaxed rules are what's allowing University Health System of Eastern Carolina to provide the software (from vendor Epic) and services with little or "no upfront cost" so far for about a half dozen doctor practices to get going with e-medical record systems in their offices, James says. "We worked hard to eliminate costs," he says. Practices pay a monthly subscription fee based on the number of users, or for larger practice, by volume.

University Health System is considering extending this cloud-based model further by offering to host EMRs for doctor practices that aren't affiliated with the organization. "We've gotten a lot of interest from other clinics," James says.

Besides easing the costs and technical support headaches that smaller doctor practices face in deploying and running e-medical record systems, the cloud model offers professional security expertise and better data privacy protection than most physician offices are capable of maintaining themselves, James says.

Is there a place in the cloud for your organization's health data? Tell us what you think.

An upcoming InformationWeek story will delve into this subject more.