A cloud EHR system is a software application that is operated within a users web browser whereas a server EHR system is an application that is operated by a program installed on the user’s computer. The Office of the National Coordinator for Health Information Technology reports that the number of office-based health professionals using electronic health record (EHR) systems has “nearly doubled” in recent years, rising from 42 percent to 82.8 percent. It comes as no surprise then that the electronic management of medical records has grown as an industry, climbing to a projected $35.2 billion by the year 2019. This means that if your chiropractic practice doesn’t already use an EHR, it’s likely that it will in the near future.
While there are certainly lots of different EHR systems to choose from, one of the primary factors to consider before making your purchase (or before switching to a new one) is whether it is cloud-based or server based. What’s the difference and, most importantly, how do you know which technology is right for you?
Cloud Based EHR’s
In the simplest terms, Cloud EHRs are programs that manage and store your patient’s information on other companies computers called servers and the provider uses a web browser with internet to access the program and patient information. In other words, you pay to use the software as a service (SaaS). Cloud EHR’s seem to make sense because nowadays almost everything can be found in the cloud. From photos to music to important documents, the public, in general, is turning over the storage of their most coveted personal and professional information to cloud-based systems of one type or another.
There are obvious benefits to using cloud EHR’s. These include having little, if any, upgrade costs and being able to access your records anytime and anywhere using the Internet. Other benefits to cloud EHR’s are:
- Automatic off-site backups
- No computer networking required
- Works with any operating system
But, there are disadvantages to cloud EHR’s as well. For instance, if your Internet is slow, you and your staff may spend a lot of time waiting for the desired information to appear. This can lead to a condition called cognitive drift, a temporary lapse in mental focus that’s shown to be connected to medical errors, doctor dissatisfaction, and patient frustration. Additionally, if the internet service goes down—for whatever reason—so too is your ability to access all your patient’s records. Good luck working within this environment.
Another drawback to cloud-based EHRs is that they tend to be very costly. Not necessarily up front, but definitely over time. For example, if it costs you $200 per month for your cloud-based EHR, you’ll spend $12,000 in just five years. Compared to a server-based system that cost only 5,000 up front you could be spending double or more in a relatively short period of time.
Server Based EHR’s
In contrast, server EHR’s manage and store your patient’s information in-house on your computers. Since you own the system, you have complete control over when and how to access your patient’s information. A big benefit of this type of EHR is it doesn’t rely on any internet connection. As long as you have electricity, your records will always be available. Also, server EHR’s, are generally able to retrieve and record patient information faster because local area networks are many times faster than the internet connections.
Of course, it goes without saying, server-based EHRs can have their shortcomings too. For example, if you want to upgrade the software, the cost is completely on you. Additionally, a server EHR requires a local area network (LAN) with database connectivity, whereas cloud-based systems require only the Internet. In some cases, you may need to purchase special hardware like routers, wi-fi adapters or actual server computers. For some, this can be a technical challenge that may require paying an IT person.
Which One Is Best for Your Chiropractic Business?
Based on all of this information, you may be wondering which option is the best for me? Realistically, only you can answer that based on your individual abilities, needs, and finances. But before making your decision, ask yourself one question: Who do I want to own my records?
So consider the fact that when you choose a cloud EHR, all of your information is stored with another company and you will pay to access this information. This becomes a big problem if you want to switch EHR’s and most statutory regulations require you to access to your records for 7 years. So now you’re now in a position where you must continue to pay the EHR company for as long as the statutory limitation expire.
Elect to use a server EHR on the other hand, and you always have access to your health records anytime without paying extra. Again, you own the software and your data, allowing you to switch EHR systems much more easily.
In the end, while there does seem to be some major advantages to choosing a cloud-based EHR over a server-based EHR, if you plan to stay in business for some time, a server-based EHR makes the most sense. With it, you retain control of your patient records at all times—and you don’t have to pay an arm and a leg to do it.