If you’re just starting your new EHR search, you might be wondering if hospital or ambulatory EHRs are best for your practice. Maybe you work closely with the local hospital system and figure it would be easier to just switch to their vendor. Not necessarily; there are some major differences, pros and cons between the two that you need to explore before making a final decision. Otherwise you could end up with even more of a headache than your original system.
The primary difference between hospital and ambulatory EHRs are the way they were each originally conceived and designed. Hospital EHRs were created to capture medical documentation and link it to entirely in-house facilities such as the lab, imaging center, and pharmacy, meaning single internal connections were needed. All professionals were writing into the same electronic chart. These systems were originally created on site only, with a high degree of customization necessary to match the hospital’s large, but unique work processes.
Meanwhile, ambulatory EHRs came about from the need to capture a longer-term record of the total health of a single patient. These systems were designed for smaller physician-owned practices who might deal with hundreds of different pharmacies and several different referring hospitals. Depending on the facility’s capabilities, connections might need to be external to imaging centers and labs. Ambulatory systems often offered a cloud option since many smaller practices don’t have the internal IT resources to support an on site system. Finally, ambulatory systems are built to create a summary for each encounter while inpatient systems are built for discharge summaries.
Hospital EHRs are more well known, offering hundreds of apps and integrations. Many of the larger options now offer cloud-based solutions as well. The large customer base and brand recognition make many people more confident choosing such a system; the rationale is that if hospital-based systems can handle the volume and complexity of a hospital, it should be easy to handle a smaller facility. Additionally, everyone within the hospital system has automatic access to your chart.
Ambulatory EHRs are in general less complex and provide a more longitudinal view of a patients medical history and treatment. Because they provide a longer term view of a patient’s health, chronic health conditions can be easier to diagnose and treat. Detailed, specific information about each patient is easy to access, and ambulatory EHRs are often tailored to serve specialty-specific workflows.
Hospital EHRs will not prioritize a smaller practice’s needs over a larger hospital system client. Implementation can be especially costly after customization and modifications to the base system are taken into account. Considering the size and complexity of these systems, there can often be many repetitive actions and clicks that need to happen to perform an action, with a steep learning curve for users. Finally, if a physician decides to leave the hospital, the records stay within the hospital system.
Ambulatory EHRs won’t work well for any type of inpatient setting. Since they’re smaller systems, they might not offer as many options in terms of integrations and add-ons. And if you’re a specialty practice, certain ambulatory systems only cover certain specialties. If you're looking for an orthopaedic specialty option, consider a system like ours here.