Differences Between Cloud-Based and Regular EHRs

Today, the focus is on how information collected in electronic health records is stored. Choices are basically up to a physician and his or her comfort level with traditional server-based electronic health record (EHR) storage or cloud-based storage options—and costs.

As with anything, cloud-based and “regular” storage options come with benefits and drawbacks. This discussion is nothing new. Even with advancements in technology and security, the decision to go with cloud or traditional servers is just about split down the middle. So what’s the difference?

Major differences between cloud-based and traditional EHRs

Financial outlay

Financial outlay for a cloud-based EHR/electronic medical record (EMR) systems is less than those associated with traditional EHR systems and their servers. Initial outlay and systems set-up costs for a traditional system installation and implementation can include a number of expenditures for maintenance, software, updates, and licensing fees.

A cloud-based EHR system does not require licenses for software or hardware installations. A monthly fee is often all that is required with a pay-as-you-go service (software as a service or SaaS).

The cost of a traditional EHR can cost over $100,000. According to one article:

• Average cost of software, hardware, network connection and peripherals: nearly $6000
• Average cost of information technology (IT) support: approximately $3000
• Out-of-pocket expenses during the first 6 months: $6500

Those costs are a bit outdated, but serves the point. Actually, the average outlay of cost for a client/server EHR system is roughly $40,000 today, not including maintenance costs, updates, licensing fees, and so forth. Still, a multi-physician practice can spend much more when it comes to regular EHR implementation, with an additional tens of thousands often ear-marked for maintenance costs during the first year

Compare that to today's integrated and cloud-based EHR systems which are much more affordable and easier to install and maintain. SaaS costs are much more attractive to smaller and independent medical practices not only because of lower upfront costs but due to a lack of IT staff and expertise in smaller practices.

Of course, other factors must be considered into initial outlay including:

• Size and specialty/multi-specialties of a practice
• Need and degree of customization

Customization and usage capabilities

Today, the majority of cloud-based EHR systems are fully customizable with a wide range of specialty-specific templates and custom solutions. Such solutions can depend on whether you're a small practice or a hospital, or other medical organization. And vendors. Built-in features and easy to use interfaces found on most cloud-based systems today don't require highly skilled IT professionals or programmers to develop.

Cloud-based systems offer convenience and versatility as well, with the capability of logging on with any device and anywhere an Internet connection is provided. Collaboration, interoperability, and data-sharing is made easier, ensuring greater continuity of care.

Cloud benefits of access, easier upgrades and maintenance

A cloud-based EHR system can be accessed from anywhere via external servers that offer gateways to the web. All you need to access a cloud-based system is an Internet connection and a computer.

The client-based or traditional EHR system requires a server, in-house data storage and software and hardware installed at the physician’s location.

Cloud-based EHR systems are based on subscriptions. Today, technology evolution requires relatively frequent updates. Using the cloud, updates are performed automatically, ensuring that the provider is running consistently on an up-to-date version. Doing so on a traditional server is more complicated, time-consuming, and costly.

Compliance and security

Today, HIPAA requirements and ever-increasing government regulations regarding protected health information, control of access, security concerns, and compliance are the name of the game whether you opt for cloud-based or traditional EHR/EMR and practice management software systems. Web-based servers continue to be more liable to malware, viral, and hacking attempts than cloud-based, but both require vigilance in regard to security.

With cloud-based systems, physicians don't have to worry about system meltdowns, natural disasters or weather patterns that can literally crash systems in a horrifying blink of the eye. Backup requirements, protocols and capabilities with traditional EHR/EMR systems are not always as secure nor provide safeguards. Patient data stored on the cloud will always be there, accessible from anywhere and at any time.

In either case of traditional or cloud-based software, it's important to know how data is protected. Liability issues must always be compliant with HIPAA, regardless.

When it comes to cloud-based systems and security, how does the system interact with a practice’s mobile devices? Is security provided or is data security the responsibility of the cloud server? Or is it your responsibility?

About security

Security of protected health information(PHI) will always be a concern, regardless whether you opt for cloud-based or traditional EHR systems. Routine analysis, audits, and vigilance is required in both types of system and storage capabilities and options utilized by large and small practices.

Employee use of mobile devices has increased the risk of PHI getting into the wrong hands, so human interaction with either system is essential. A number of physicians still remain skeptical about the level of security that cloud-based EHR software is capable of.

When choosing a cloud-based EHR system, using and enforcing encryption methods is still safer than not only traditional paper records, but client/server systems. This is especially important depending on where those systems are located and how they are protected.

The bottom line is that the choice between traditional or client/server EHR systems and cloud-based systems when it comes to practice management software will always be, at least in the near future, a matter of preference. Compare the differences before you make a decision.