Cloud Based Complete EHR Systems: Solving the Build it or Buy it Debate

Author Archives: Fuller Harvey

About Fuller Harvey

Fuller is a creative consultant who is bringing her passion for connective, encouraging, and practical communication to Patagonia Health. She considers her greatest strength to be creating an adhesive environment where individuals are valued, supported and celebrated for the contributions they bring to the “team table” and where all communication -both within and without the company – has positive purpose and impact.

Cloud Based Complete EHR Systems: Solving the Build it or Buy it Debate

cloud based complete ehr systems solving build it or buy it

When shopping for an Electronic Health Record (EHR) solution, one of the first decisions to be made is whether to build it (modular EHR) or buy it (complete EHR). Cloud based, complete EHR systems are solving the build it or buy it debate. Modular EHRs give healthcare agencies the opportunity to make a custom solution. Buying an out of package product may seem easier. Both have their benefits and drawbacks. However, cloud-based, complete EHR systems offer functionality that resolves drawbacks of both modular and complete solutions and gives healthcare agencies a 3rd choice that may be a much better option. 

Much has been written about the pros and cons of both modular and complete EHRs. As outlined by AmericanEHR:    

Pros – Complete EHRs

  • No finger pointing as to which module is not working as everything is in one solution.
  • Less hassle with software and hardware updates/upgrades.
  • Relatively seamless user interface. (Features within the EHR system work with the same look and feel rather than constantly switching between different programs).
  • Simpler to interface with labs and hospitals (Interfaces should not break when the EHR is updated).

Cons – Complete EHRs

  • Less customizable. May not meet the needs of all the providers in your office.
  • Existing EHR systems may not have complete EHR certification.
  • Up-front costs may be more expensive.

Pros – Customizable EHRs

  • More flexible.
  • Can allow practices with existing software to add new functionality without needing to change the rest of the system.
  • Can be a good choice for those who want the flexibility of mixing purchased certified EHR technology with self-developed technology.
  • May have a lower upfront cost.

Cons – EHR Modules

  • A high level of technical expertise may be required in order to assemble a Module-based EHR.
  • Purchasers are responsible for evaluating the companies offering the technology as well as assembling and interfacing a sufficient set of modules to support all meaningful use objectives.

Since these pros and cons were established between complete and modular solutions, another option has arrived: the option of purchasing a COMPLETE EHR which is also customizable to your agency’s needs and locality (i.e. takes into account and is responsive to your state-specific reporting requirements). Cloud based, complete EHR systems are customizable, less expensive than  Now, the “look back” to the “Cons” regarding Complete EHRs takes on a different hue: each and every “con” raised has been addressed, remedied, and is now eliminated. The best complete EHRs are, indeed, able to be personalized to an agency’s needs, federally certified, and totally competitive regarding pricing – if not outright less expensive – in comparison with assembling a modular system.

Following the recommendation of the Department of Health and Human Services June 2017 report which spotlighted the critical importance of taking action to protect agencies against cybersecurity threats, the decision on which option is the best for healthcare agencies becomes more clear.

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Patagonia Health Expands EHR for Home Visit Intervention Tracking

Home Intervention Tracking in EHR System

Patagonia Health enhances its electronic health record (EHR) software by improving functionality for Home Visit intervention tracking and documentation. Home Visits, used by both public health and behavioral health agencies, create specialized needs for the providing agency.

Intervention Tracking with Enhanced Usability

According to Patagonia Health Chief Enterprise Architect, John Ramsey, the software improvements enhance usability for both on-site documentation and after-visit reporting. “A home visit is very unlike a clinic environment,” Ramsey notes. “Additionally, the necessary documentation varies greatly from state to state and agency to agency.”

Patient Interventions and the information gathered during home visits can now be managed and modified within Progress Notes. The enhancement makes the user experience more streamlined, eliminating double data entry. According to Ramsey, “Users make the modifications to the interventions, and the information gets stored in both places:  Patient Interventions and Progress Notes.”

Custom Reports for Home Visits

Further, Patagonia Health continues to develop customized forms to assist public health and behavioral health agencies. These reports allow staff to pull data from patient records easily. The ability to demonstrate procedures and care administered during a Home Visit is critical for agencies to provide supporting documentation for both grant and insurance funding.

Electronic health record software, which enhances the home visit, says Ramsey, “is good for the patient and good for reporting.”  

Expanding its public health and behavioral health EHR with Home Visit intervention tracking and documentation is evidence of Patagonia Health’s continued commitment to both its customers – and the clients they serve.

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Millennials’ Dark Side: Change-makers of Life Expectancy

Millennials' Life Expectancy

And now the Milliennial discussion takes a very hard and very dark turn … and leads us down a path toward a subject impacting nearly every sector of healthcare:  the opioid crisis.

Prepare to read the most startling sentence we have come across in a long time:

“US millennials are now dying at such high rates that it’s driven life expectancy in the country to decline for two years in a row, the first time that’s happened since the early 1960s. The primary cause for the trend is the opioid crisis … Not since 1995, at the height of the HIV/AIDS epidemic, have death rates been so high among this group.”

-Dan Kopf; Web Article:  “The opioid crisis is driving up deaths of millennials in the U.S.”, QUARTZ, January 3, 2018

US life expectancy is on the decline for the first time in decades.  While we seem to be putting on a good show of getting healthier (protein shakes, work out clubs, organic produce sections, and diet mocktails flood our social media news feeds), these dark-and-getting-darker statistics should shake us to our “take-your-calcium-with-magnesium” infused bones.

The hard, dark truth of life expectancy declining is that death rates are rising at terrifying rates:

The upswing at the right side of the chart scarily does not appear to have a slowing or plateau in sight.  This “change-making” of the life expectancy rate is occurring primarily because of the soaring death rates of one generation particularly.  You guessed it:   Millennials.

While death rates for older generations are decreasing, according to the US Centers for Disease Control (CDC), death rates for those aged 25 – 34 rose 20.5% between 2015 and 2016.

From running out of space at morgues (Ohio) to skyrocketing costs of the transportation of corpses (West Virginia),  states are scrambling to get a grasp on the opioid crisis from every level.

Each and every death represents more than one victim and one body – it reveals an entire family in need of emotional and physical help.  Thus, the catastrophic effects of opioid misuse are exponential. The subsequent burden on behavioral health and public health is crushing.

When Governor John Kasich (OH) signed limits regarding the amount of opiates primary physicians and dentists can prescribe into law, he was quick to point out that healthcare providers and lawmakers cannot tackle this beast alone.  He said, ““We all need to stick our noses into somebody else’s business.”

At Patagonia Health we agree.  So, while it’s not light and happy, we’re facing the dark side of the opioid crisis.  We want to join our customers (and future customers) in walking and wrestling through the statistics.  We know the statistics are more than numbers:  they are the people and families you serve each and every day.

They are why you do your jobs.  Therefore, you are why WE do ours.

Bi-directional Lab Orders Interface

bi-directional lab orders interface

Patagonia Health users are now able to send bi-directional lab orders directly to LabCorp, the world’s leading health diagnostics company, with Patagonia Health’s new Lab Order Interface.

Order requisition information is created in the Patagonia Health EHR system and sent electronically to LabCorp. This feature increases operational efficiency and saves time and money by eliminating double data entry and reducing data entry errors.  The bi-directional feature allows users to retrieve reports and lab results directly via the EHR.  Report notifications are sent to the provider and results are added to the the patient record.

If you are a current user, you may sign up to add the Lab Order Interface feature to your system.

Training will be provided for this feature at your organization’s request.

For more information, contact

Rural Communities Grant Applications to Fund Opioid Response Deadline Approaching

Rural Communities Grant

July 30, 2018, is the closing date for applications for rural communities grant opportunities totaling $15,000,000 through the Health Resources and Services Administration.    Funding opportunity HRSA-18-116 will be awarded to 75 agencies.  Eligible agencies are “all domestic public or private, non-profit or for-profit, entities, including faith-based and community-based organizations, tribes, and tribal organizations, who will serve rural communities at the highest risk for substance use disorder and who meet the RCORP-Planning specifications for the Applicant Organization and Consortium as described (on the website).”

This funding opportunity has no cost-sharing or matching requirements.  The grant falls under the “Discretionary” category and will expand the opportunities for successful applicant- agencies to implement critical resources, including electronic health records systems to accelerate response to the opioid epidemic.

As a caution, posts: 
 is experiencing high volume and delays.  If you have tried to create or update your registration but have not been able to complete the process, you may not be able to apply for a HRSA funding opportunity via in a timely manner prior to the application deadline.  If so, please email”