Pros & Cons of Cloud-Based EHR Systems

Health care’s prognosticated transitions in recent months and years have spurred a series of questions that healthcare providers and practice managers would’ve never dreamed of asking just a decade ago.

The cloud versus server question is a behemoth among EHR-related questions.

Take a minute to think about what you know about EHRs and how your practice functions. Is a cloud-based EHR easier for your practice to deal with, or do you still believe the client-server route is the most efficient?

The Pros and Cons

In a cloud-based EHR system, a practice’s information is stored on external servers, meant for web-based access from wherever you can take advantage of an Internet connection.


  • Low monthly licensing costs, which is great for smaller practices.
  • Don’t typically require startup costs. When they do, don’t expect a hefty bill, which isn’t always the case with client-server systems.
  • Better client support, and vendor companies have better built-in service security. Best of all, cloud-based vendors can assist your practice remotely, so you don’t have to wait days for an IT professional.
  • No in-house hardware or software, which rids a practice of maintenance worries. This hearkens back to the point above.
  • It is ideal for mobile physicians and often works on various tablets, i.e., an iPad or a Toughbook. Client-server systems don’t generally work on mobile devices.
  • There is more focus on the vendor to meet Meaningful Use requirements.
  • A cloud-based EHR may make it easier for your practice to meet HIPAA regulations.


  • Cloud-based EHRs allow little to no customization.
  • The host company controls your data.
  • The cloud-based system can make uploading large files a bit impractical at times.
  • There is often a certain degree of latency when trying to access the web, which may cause even more difficulties for rural practices.
  • Many practices fear expenses. A practice may own its client-server-based system within five years, but never ‘truly own’ a cloud-based EHR.

Debunking the Myths

There seems to be a valid list of complaints associated with cloud-based EHR systems. They can’t all be myths, can they? Let’s dig deeper, starting from the top.

No Customization – This isn’t the case with a number of cloud-based EHRs. Many systems allow users to customize a number of elements, from switching between and/or combining narrative and form-based note-taking techniques to color coding the patient scheduler.

Data Control – This is an oft-cited complaint about client-server proponents. However, most EHRs allow for one-click downloads of any chart or bit of data the healthcare provider may need. In other words, all information in the system is storable in a more permanent way – with encryption.

Uploading Large Files – Why would your practice concern itself with huge files? This complaint is the case with any web connection, particularly for smaller practices. Uploading and downloading large files strains both your hard drive and your web access, and it’s simply unnecessary.

The main concern here is access to the system. However, most EHRs boasts a fully functional system in the event that it’s necessary for your practice to upload an abnormally large file.

Latency – While a client-server is not web-based, neither the latter’s software nor your practice’s hardware guarantees lightning speed. A cloud-based EHR is a lightweight system that can work at optimal speeds when your web connection isn’t acting up.

Expenses – Sure, you’ll own your client-server EHR system in a half-decade. But considering the speed at which technology is moving, a five-year-old system may be outdated. It’ll hurt to cough up more cash for a new one. A cloud-based system boasts the luxury of constant updates, which helps keep your practice relevant.

Cloud-based systems boast a level of practicality that clunky client-server systems can’t match. What do you think is best for your practice, and why?

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