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Nutrition Informatics Blog



What Do Remote Hosting and CITRIX™ Mean to Me?

Post by Cathy Welsh MS, RD
If you are documenting in the electronic medical record (EMR), chances are your information is stored, not directly, but in a land far, far away! More and more businesses are deciding to hire other companies to buy equipment and host applications, such as your EMR, over the Internet. I am most familiar with the software vendor, Cerner®, so let me explain “remote hosting” by quoting from its Web site.

  • Predictability—service level, budget, and resources
  • Operations excellence—client productivity
  • Disaster recovery prevention and protection
  • Client focus on core business of providing quality health care
  • Affordability

Because of the sensitivity of private health care information and the need to avoid downtime, more and more facilities are considering remote-hosting options. Is this process truly “transparent” to you? Or if your EMR is remote hosted, does this affect you every day?

In this scenario, when you use an EMR program such as Cerner’s PowerChart®, you are likely to use a program like CITRIX®. CITRIX makes software products that companies use to make sure that they can keep their information secure and control which applications users can access.

Here are some tips on how to work in a remote-hosting environment.


Your passwords will change every 3–6 months. Come up with a system to help keep it easier to remember your passwords, so you do not write them down. I use a word and then add a string of numbers at the end, which I increment each time my password changes. I also select passwords by first typing a series of numbers and letters that are easy on the fingers. Considering the number of times you will enter these keystrokes, it is something to consider!

Lost Work

The EMR is a dynamic system. When you log on to the EMR to do your work, my advice is to start your documentation, finish it, and then log off the system. Many things are going on in the system when you are doing your work. Other users may look at the same chart you are using. Sometimes software upgrades are running in the background. Many people have complained that they have lost their work when they stepped away from their computer. Do not let this happen to you.

Monday morning blues

Everyone jumps on the system first thing Monday morning, so realize that speed may remain slow for a while first thing on Mondays.

Smart Searching

Learn how to search smart. Even a few people running searches for a wide range of data from a long time ago really can impact the system. I once got a call from a medical student looking for documentation from 2008. I recommended that he go to Medical Records, because the kind of charting he was looking for was still on paper. In other words, do not become a “resource hog” (someone who uses more system resources than necessary).

Learn how to use flow sheets and filters, so that your searches are more direct, allowing you to pinpoint the information that you need. As the EMR matures and more and more data is input hourly, this will become even more important.

Access from anywhere

Depending on your facility, you may even have the ability to access the EMR from your home computer. This is a real benefit if you are on call over the weekend. Ask your Information Technology Department if you qualify for a device or if you can get added to the list of users who can have home access.


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