Cloud Vs On Premise EHR Systems: What Is The Right Prescription For Your Healthcare Organization?

The healthcare industry's computing needs are as varied as its providers. From electronic health records and HIPAA compliance to the myriad paperwork involved in practice management, it is essential that software systems and files are easy to access and as secure as possible.

An important decision for healthcare organizations, medical labs, physicians and other healthcare providers face is whether or not to maintain an on-premise server or use a Cloud-based solution for their electronic health record (EHR) system. A further Cloud consideration is whether to go with a private Cloud solution, or use a public Cloud option (if it's available from your software manufacturer.)

Let's examine some determining factors to help you decide which type of server to choose for your healthcare organization.

Security and Control

Healthcare organizations should be highly sensitive to their data security and storage requirements. Auditing and HIPPA compliance, controlled access, and location of data all come into play.

Although many healthcare providers assume that hosting files on a server in their office is more secure than storing it in the Cloud, this is not necessarily true. For instance, cleaning crews and office visitors can easily come in contact with your on-premise server and cause trouble (a pulled plug or worse). Therefore, it is important with on-site servers to provide a physically secured location to store your server, including adequate ventilation and backup power (at least battery backup), and a business-class firewall to protect from virtual intruders.

Cloud-based file storage offers data security with file encryption--of special concern when transferring the sensitive and confidential information contained in patient files--and the data is further secured from cyber theft thanks to physical security protocols at the data center where the remote server is housed.

All that being said, you will maintain maximum control with an on-premise server; there is no third party that can access your systems as there is with a Cloud service provider. With an on-site server, you can control who has physical access to your server.

Redundancy

Cloud-based servers offer important protections against power outages, hardware failures or vandals. These virtual servers have redundant hardware, air conditioning, and power systems so that a single failure shouldn't cause you to lose access to your EHR system.

There are also HIPAA-compliant hosting company's/data centers available so that electronic medical records may be safely stored in the Cloud. In the event your location is off limits for any reason, employees can still access critical files from the virtual server at any time.

Small healthcare organizations typically cannot match the redundancies that data centers provide for server hosting, making the Cloud an attractive option.

Backup

Backing up your organization's electronic medical record information is critical. With an on-premise server, you retain control of how/when your data is backed up. But with public Cloud solutions, you typically have no control of how or when the Cloud provider is backing up your data, or for how long they retain it.

Also, it's likely your data could be permanently lost if your Cloud provider goes out of business or gets hacked. The recent demise of CodeSpaces.com is a reminder that Cloud providers are highly visible targets for hackers, and vulnerable to permanent data loss if they don't maintain a redundant backup system.

If you are using a Cloud hosting service, you should regularly backup your data to a third-party or retain it yourself if a secure location (like a safe or at a bank.)

Connectivity

On-site servers don't usually require an Internet connection; all users on location who are connected to the server can quickly and easily access systems and share files, even if the location's internet service is down. This is especially helpful for billing departments that must access records quickly when talking to patients or insurance companies, or diagnostic imaging centers that share large files.

With Cloud-based EHR systems, users are at the mercy of the Internet and a robust connection; large files or heavy traffic can easily clog up that information pipeline.

And if that connection is down, then so is your business - so a secondary, redundant Internet line is crucial to avoid costly downtime.

Integration and Scalability

Organizations who are running different systems may require integration between their applications, which is usually not possible with a public Cloud offering. Similarly, if your organization requires heavy customization of an EHR system, then an on-premise server may be your only choice.

When making your decision on which type of hosting is best for your EHR system, consider how your organization may grow in the future. If you expect your number of users will expand, you want to make sure your EHR system can expand at a cost that isn't hard to swallow.

Cost of Ownership

As we noted above, one cost consideration is the per-user subscription fees of the Cloud vs. the cost to purchase, install and service your on-site computing infrastructure.

Organizations with a small number of users (physicians, technicians and office staff), will find that public Cloud-based systems are the most convenient, cost-efficient option. All that is required is a good internet connection and users can access and share EMRs, patient billing and insurance records, and other files from any location.

Larger healthcare institutions such as hospitals and medical treatment centers with a large number of users are more likely to find the monthly-cost-per-user model of public Cloud systems to become cost-prohibitive. Also, they are likely to already have on-premise servers and the necessary infrastructure to support them.

If you are considering an on-premise server or a private Cloud server, then software licensing and upgrades, hardware costs and the expected life span of your hardware should factor into your decision.

If your facility does have an on-site server, we strongly recommend you have a fixed-cost IT support agreement with a reputable IT services firm to ensure your computing infrastructure is in good health at all times.

Making Your Decision

IND Corporation's IT professionals can provide your organization with a cost-benefit analysis so you can view total cost of ownership and weigh the many pros and cons of these EHR hosting options. Our TotalCare IT Support and Consulting Service provides unlimited remote and onsite technical support, 24x7 monitoring, strategic IT consulting, and more to healthcare organizations throughout New Jersey and New York City. Contact us to review your IT needs or to discuss migrating your current on-site system to the Cloud.