Accessing the Software: Client Server vs. ASP


Physicians can access health information software through two different models: client server and application service provider (ASP).

Client Server vs. Application Service Provider (ASP) Models


Client Server


Security and Backups  Responsibilities

Practice is responsible for maintaining a secure data center

Decide with the vendor ahead of time who the responsible party is

Technical Staff

Practice is responsible for  providing technical support for the servers and operating systems

Vendor typically provides support and service.


Higher up-front costs used for hardware and installation

Lower initial fees, but there is a monthly fee payable to the vendor for access

Location of Software/Data

On a server located in the physicians’ office

Located on a remote server and commonly accessed via the Internet

Client-Server Model
The most common is the client-server model. In this model, the software is installed on a server located in the physician’s office and is accessed through the practice’s input devices.

ASP Model
Alternatively, in the ASP model, the software is located on a server at a remote location and accessed most commonly via the Internet.

The primary advantage of the ASP model is lower initial costs. The medical practice pays a monthly per-physician fee for access to the software, the storage of the practice’s medical records on the software company’s server, and the costs of the high-speed Internet connection.

Health information software can provide the following transactions using an ASP:

  • EMRs including transcription and voice recognition;
  • Patient scheduling and registration;
  • Claims submission, eligibility inquiries, referrals, and, depending on the health plan, preauthorizations;
  • Financial reporting and collections management; and
  • Supply ordering.

Advantages of the ASP model include:

  • Upfront cost savings. Practices pay $100 to $500 per physician per month, as long as they are using the vendor’s server, for ASP-based software vs. a multi-thousand dollar per physician initial investment plus annual maintenance costs as in the client-server model. Offices with ASPs still will incur costs to set up a networked, wired office, which is required for this model.
  • Easy upgrades. An ASP can install software improvements at its central server overnight, and the office can take advantage of them the next day.
  • Staff or contract savings. Most ASPs manage all of the software maintenance so that the practice will have less need to hire any IT staff or outside contractor.

However, ASPs do not automatically assume responsibility for data backup. Practices using an ASP will need to negotiate backup services as an explicit, additional benefit.

For more information on client server and ASP models, read the TMA article 21st Century Practice: The ASP — It’s Not a Snake, But it May Bite You.

If you have questions about electronic medical records or other health information technology, contact the TMA Health Information Technology helpline at (800) 880-5720 or e-mail



Content reviewed: 6/08/07

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