Management Services Organizations (MSO) can provide a cost effective alternative to physician practices that want to implement EHRs. MSOs work by using an application service to host one or more electronic health record systems through the internet and are positioned to leverage buying power plus manage EHRs.
MSOs use critical mass to manage costs and to implement the technology as opposed to standalone EHRs that require the physician practice to implement the necessary software and maintain the hardware. MSOs are a viable alternative to the standalone EHR model and have enormous potential to spur adoption.
Implementing EHRs requires a substantial commitment and willingness of a physician practice to make process changes that impact all levels of a physician practice. State designated MSOs on the other hand, will provide assistance to physician practices with planning and implementation.
According to a report released by the Maryland Health Care Commission in August 2009, the average cost of a client-server EHR system is around $53,000 per physician over three years as compared to the MSO model where the three year average would be around $28,800 per physician or $800 per physician per month.
MSOs are becoming increasingly popular around the country. For example, California and Florida are two states using MSOs to drive the adoption of EHRs, and the result has been to build confidence in physician practices. However, since broadband is required to access an MSO, some locations in states still lack access. For example in Maryland, some areas in Western Maryland, the Eastern Shore, and Southern Maryland have limited access to broadband.
This year, the Maryland legislature tasked the Maryland Health Care Commission (MHCC) with developing requirements for MSOs interested in obtaining a state designation. The criteria for a state designation would require privacy and security rules, make it necessary to comply with ARRA to receive incentive funding, develop provisions to safeguard network operating centers, and develop agreements on how the electronic data is accessed, stored, and maintained. State designated MSOs will also need to integrate hosted EHRs with the statewide HIE as the exchange becomes available.
Existing law requires the MHCC to designate one or more MSOs throughout the state by October 1, 2012. The next step is to convene a stakeholder workgroup to develop the evaluation criteria for MSOs that seek a state designation and there are plans to develop the criteria with the help of stakeholders over the next year.