The answer depends on whom you ask. For a physician in his late 60’s – absolutely not! It takes five years or more to realize the returns on investment. For others, the answer may not be that clear cut. Several factors need to be considered to help physician practices decide:
Scalability – the ability to grow or scale back. This is one of the biggest advantages of cloud-based software, and careful thought should be given to the needs of a practice before choosing an EMR. A stable and well established practice will not need to grow staff and infrastructure as much or as rapidly as a smaller or newer practice may.
Portability – the ability to travel with the EMR. If a doctor needs access to his patient information from anywhere, except on a cruise ship “plying Alaska’s inner-passage”, as Dr. Alvin Lin writes in his blog EHR vs EMR vs PHR , cloud-based EMR may be the answer.
Licensing costs – never underestimate this! Anyone who has been burned by software licensing costs, will appreciate the advantage of not having to pay for licensing, or paying for exactly what you need – no more, no less. Due to the measurability of cloud-based services, much like utility services, it is possible to figure out exact usage needs.
Opex Vs. Capex – buying a server is a capital expense that practices have to commit to, long-term. Pay-as-you-go for a cloud-based EMR frees up your capital, and gives you the flexibility to even change EMR vendors.
No Hardware purchase/maintenance – this may be very attractive for small practices with no in-house IT. Infrastructure maintenance is a hidden cost that many businesses do not take into account when comparing cloud-based services with traditional client-server environment.
Older computers can be provisioned – the quality of service depends on the speed of the network and not the processor. If a practice has brand new hardware, cost-savings may be in a client-server environment.
Speed – when uploading large image files such as patient X-rays to the web makes everyone go on coffee breaks, the practice is losing money.
Data Security – although cloud-based services can sometimes provide better data security and are more likely to follow industry regulation/compliance than the practice itself, many physicians are loathe to put their information on the web.
Data ownership – when EMR vendors reassure physicians that the data belongs to them, they are speaking the truth. Just make sure that when the physician wants the data back, it is in a compatible format.
Cohesive integration – giving up control over your software, data and hardware can be challenging when they are “Just a Bunch of Cloud Services” (JBOCS!). Lack of cohesive integration can lead to higher costs in the long run.
In his article Pros and cons of cloud-based or web-based EMR system, Peter J. Polack, MD, FACS advises adopters of cloud-based EMR solutions to crunch the numbers. If a physician is considering a long-term partnership with the EMR vendor, it pays to buy rather than lease, he asserts.
Regional Extension Centers are Government funded organizations that help Physicians choose the right EMR for the practice. Consulting with other experts in the field before choosing a cloud-based EMR may help practices find the right solution for their specific needs.