Application service provider (ASP)
The application service provider (ASP) model exists as a means of simplifying the support and maintenance of the network needed to run the electronic medical record application.
This approach is in contrast to the local client-server model in which the users of the system run the program on their individual devices which are connected to a larger server. The server manages all the data, controls access to the internet, validates the users, supports the printers and backs up the data. As a more robust and complex device, there is significant work involved in its care and feeding.
In using the ASP model, most of the work in maintaining the data and network is done remotely, although it does not eliminate all the hardware chores. You still must manage scanners, printers, and workstations. The principle issue is that you must have a reliable internet connection that has enough speed and capacity to manage the volume of data your situation requires at a speed with which you can work.
The look and feel of most ASPs is similar to the traditional client-server system. In fact, many of the leading EMR vendors offer you the choice of either ASP or a client-server platform.
The financial implications of choosing ASPs versus client-servers are quite different. Where with a client- server, there is considerable cost up-front: purchasing more hardware, and a perpetual license to the software. Assuming that you finance the EMR, after the payments are done, your remaining financial obligation to the vendor is your annual support payment, which typically covers new updates and help desk support. Annual support fees range from 18 percent to 20 percent of the retail cost of the software.
In contrast, with an ASP, there is no upfront cost for the software, rather a monthly fee that continues as long as you are using the service. The fees range from $350 to $750 per provider, per month [Eriksen 2009]. In addition, many vendors recommend purchasing either a full or fraction T-1 line to ensure a reliable, high bandwidth connection to the Internet. This can run another $500 or more, per month, depending on the size of the practice and the number of workstations.
- Eriksen A. 2005. ASP VS. Client Server. Free EMR Solutions 
Submitted by Phillip Scott, DO