Before you decide whether cloud computing is right for your medical practice, there are four questions that should be explored.
1. What are the cost considerations of making an upfront investment for an in-house or data center solutions vs. paying overtime for the cloud?
A capital outlay will be required to install EMR on an in-house or data center basis. Therefore, lease payments seem more manageable than the capital outlay. On the other hand, if you tend to keep your technology for more than a few years, the total fees paid to a cloud provider might end up being more over an extended period than the cost of purchase.
In contrast, data center fees, software maintenance/upgrade agreements and possibly IT staff or consulting costs could increase the total outlay for a purchased system. you typically don’t have to worry about the cost of IT maintenance in the cloud; it is generally included in the fee, as is the expense of upgraded software.
It is recommended that you have an accountant run the numbers to compare costs over a 5 year period.
2. What are the security issues with the cloud? What assurances can vendor give about security?
No matter whether your EMR is on a server in your office, in a data center, or in the cloud, it has to meet strict HIPAA security requirements. Assurances by any vendor should not be taken at face value. you should have the system evaluated by a third-party professional and a gap analysis created to identify any security issues that need to be addressed.
3. How does the cloud solution compare with the other approaches in terms of reliability, backup, upgrades, and bandwidth?
As a part of your subscription fee, many cloud vendors build in the cost of software upgrades and support. Some SaaS providers upgrade all of their clients at the same time. That is great if your solution is turn-key. The potential downside of this approach is that it could make vendors reluctant to customize your installation since they want to be able to easily upgrade all customers.
If you are a large medical practice, you also might want to consider whether the cloud solution has enough bandwidth to handle multiple users working at the same time. This could be especially true in practices where images are frequently used since they could require large file sizes.
Another factor to consider is downtime. Once a medical practice is on electronic medical records, it becomes very difficult to function without them. What reliability guarantees does the cloud vendor provide? If you are planning to house your EMR system on the premises, what are your provisions for a redundant system that could be used if your main system goes down?
4. Is the best solution for a mixed approach, with some systems in the cloud and others more traditional?
Of course, EMR is not the only system offered in the cloud. Billing systems, payroll systems, and others used by medical practices are also available as cloud solutions.
After analyzing your specific EMR needs, and financial and security issues, some of your systems might make more sense in the cloud. Some may instead be hosted in your office or in a data center. An evaluation of how well those different systems work together is critical.