Cloud Hosted or On Premise EHR Software – Which is Best?
In general, a hosted (Software-as-a-Service, or web-based EMR) system hosted by an ASP (application service provider or data center) has a smaller upfront cost. This is because you are leasing software licenses on a subscription basis. Hosted systems are also referred to as Saas (Software-as-a-Service), or Web-Based. While these terms have specific meanings, we’ll use ASP, Web-Based, SaaS, and Hosted interchangeably for the purposes of our simplified discussion here.
Web-based EMR systems appeal to medical practices that wish to save on the upfront costs and hardware requirements of on-premise servers. Some practices may prefer to make smaller payments indefinitely. You might compare a hosted EMR to a Server-Based EMR as you might leasing vs. owning a vehicle.
Differences between hosted and server-based EHRs
- Saas EMR – For us, this means that your EHR software and patient data are hosted by MDS Medical, in our data centers, on MDS servers. Redundant data center and remote backups are performed constantly by MDS, and physical security is ensured by a multi-layered access protocol.
- Server Based (On-Premise) EMR – For us, this means that your EHR software and data is housed on your servers, at your location. Physically securing your servers and performing regular backups are your responsibility. MDS offers mdsBACKUP – automated cloud backup of Greenway Prime Suite data so you do not have to worry if you are getting daily backups, the biggest concern when you maintain your own onsite server.
- Server Colocation – You can also host your EHR software on your dedicated server in our data center. This enables you to use, control, and maintain your own equipment, but ensures high speed data delivery and physical security of your servers. This service is performed through mdsHOSTING.
Why should we consider an EHR that can be used as both a hosted or server-based system?
If your needs change or your vendor doesn’t deliver on system speed or uptime promises, you can modify the delivery model. By purchasing an EHR that can only be delivered as a web-based system, you are at the mercy of your vendor’s promises of system speed and uptime, as well as the quality of your internet connection. This can be a concern for practices in rural areas that experience internet connectivity challenges. If you experience unacceptable slowness or downtime that your vendor is unable or unwilling to resolve, you have few options aside from switching systems altogether.
Additionally, if your organization grows and speed of data access is a chief consideration, you may elect to move to an on-premise server model. Alternatively, if you begin as a on-premise installation but no longer wish to maintain hardware or backups on site, you can move from a client/server system to a web-hosted system (if you’re using Greenway Prime Suite).
When vendors outsource EHR hosting
Some EHR vendors choose to outsource their hosting responsibilities, requiring you as the customer to navigate multiple vendors to identify and resolve performance and speed issues.
With MDS, customers can easily and quickly switch from a hosted version to a server-based version since we do not outsource hosting. Our deep understanding of the EHR systems we host, and how upgrades affect speed and performance, enables us to optimize and modify our hosting and delivery model constantly as the software evolves.
A key difference in the up front cost for an EMR is the substantial hardware requirements that are typically associated with server-based installations.
Considering both options? Have your IT company, or MDS Medical evaluate your existing hardware to help determine if a server-based or SaaS model makes more financial sense.
Hosted EHR vs. Server-Based EHR
A Hosted EMR should have a lower upfront cost. Fewer hardware requirements reduces cost of system implementation. Is susceptible to internet connection disruptions, so T-1 line is absolutely essential. Still, a hosted system is generally a bit slower than if the server was housed at your facility.
Server licenses are a finite software investment. Aside from recurring annual maintenance, you will not need to continue making payments on the software licenses. Increased speed and system performance as opposed to a SaaS model. You can continue to work and document encounters even if your internet is down. However, you will need to be rigorous about securing your servers and ensuring data backups are occurring.
Web-based EHR software
- MDS hosts the system in our secure data centers, and your clinical and administrative staff simply accesses the system through a web-browser or any mobile device (iPhone, iPad, Android).
- Ability to access your system from anywhere at anytime with a SaaS model.
- Cost of web-based system is lower in the beginning, but payments continue indefinitely (again, think about leasing a new car every 3 years) so over time the cost is generally higher than a Server-based system that you own.
- Hardware requirements are fewer with hosted systems – a web-browser and a workstation is all you need to get up and running.
- One potential disadvantage of a hosted system is that it is not immune to technical disruptions such as internet outages, line failures, etc. Should you have an interrupted internet connection for any reason, you will not be able to access your billing or patient charts via your networked workstations. Additionally, some EMR vendors outsource hosting to 3rd parties and have little control over system slowness problems that can occur. So, “technical support” for system slowness issues may not be handled through normal typical support channels, delaying or preventing resolution of the problems.
- Your practice does not need to worry about data backup, physical security, or disaster recovery of your EMR, as MDS’s IT department does that for you.
Server-based EHR software
- Your practice owns the software and the licenses, and you host the system in your office on your own server(s).
- Access your EMR software from anywhere at anytime using remote connectivity configurations – so this is essentially the same.
- Cost of a Client/Server EMR is higher in the beginning due to increased hardware requirements, hardware installation costs, and the cost of purchasing the software licenses. Over time, however, the cost may be less than leasing SaaS licenses.
- You probably will realize increased speed and performance of your system when it’s at your facility, particularly if you do not have guaranteed bandwidth on your internet connection.
- You will need to contract with the MDS I.T. department or your own I.T. vendor to ensure that your system is backing up and disaster recovery procedures are in place.
How do we choose the best option for our practice?
It depends on your budgetary constraints, organization size, existing investments in hardware and software – and knowing the pros and cons of each. If your capital expenditure budget is small but your operational budget has more flexibility, perhaps a SaaS model might be a good fit. However, if speed and 100% reliability is a key issue, a Server model may be a better option.
Please contact us with your questions – we’d be happy to help you weigh your options! Call 1-800-494-3188 to talk with someone right away, or complete the form below and we’ll call you quickly.