The Complete Guide to Web-Based & Cloud EHR / EMR


There’s no doubt that cloud & web-based EHR/EMR is one of the top four trends in healthcare cloud computing.

Some of the main reasons for this are low up-front cost, less complicated maintenance, and reduced IT staff overhead.

Benefits of Cloud Based EHR

Avoiding Hardware Costs
Hardware is expensive to purchase, license, and to maintain. On-premise servers require specially secured rooms with additional ventilation and cooling elements.

In case of a physical disaster these would be the most important pieces of the business to save. A cloud-based EHR does not require a special facility at your hospital or medical office.

Instead, these are in secure storage facilities. Check out one of the world’s most secure and fascinating Data Centers HERE.

You Control More of Your Data, Not Less
Does fear of losing control over one’s critical data stop you from cloud adoption?

Fear not: in many ways cloud computing gives you more access to your data than a traditional server-based EHR.

Cloud environments lower the barriers for innovation and modernization of IT systems. They also offer a collaborative platform that is more universally recognized thus allowing for sharing and dissemination of healthcare knowledge.

Leverage Mobile
As mobile applications, bring your own device, patient wearables and telemedicine become more commonplace in the healthcare system, tethered computers and software will be replaced with mobile medicine.

Recently EMRs have become a vital component of modern Healthcare IT and have been widely adopted as healthcare administration saw the benefit to instantaneous and accessible yet, private health records.

Meaningful Use
To encourage the adoption of electronic medical records over paper records, healthcare legislatures are incentivizing HCP with measurable standards and goals, called Meaningful Use.

One aspect of the Meaningful Use engagement is requesting physicians and nurses adopt the EMR-based programs called Computerized Provider Order Entry (CPOE) and Clinical Decision Support (CDS).

These technologies were implemented to grant physicians immediate access to recommended best practices, standard-of-care guidelines, safety alerts, and medication interaction lists.

As these programs are updated and interfaced continuously, they afford physicians real-time evidence-based tools to use in making acute decisions about a patient’s care.

The cloud helps afford these systems the real-time data accessibility they require.

Additionally, some cloud services such as intelligent business process management suites (iBPMSs) and case management frameworks (CMFs) can support healthcare provider staff cognitive capabilities, which in turn can mitigate medical mistakes and minimize patient adverse events (PAEs).

Why Use Cloud-Based or Web-Based EHR over Server?

Cloud Based EMR vs Server

When you look at a cloud infrastructure, you really have to look at is the different layers of failover and redundancy.

So a lot of environments have a dedicated server on-prem and a lot of times – let’s say it’s your database server – there’s not a second clustered database server to failover to in the event that you have a hardware failure.

Whereas in a cloud configuration –  we use VMware for instance – those workloads and servers transfer seamlessly between different servers, discs and so on.

Hence, you inherently get some level of redundancy just at the server level that you may not have it in a physical, dedicated server chassis.

If you go to a rack space, they certainly have different redundant configurations, but there’s a lot of dedicated server-hosting companies that duplicate the same thing you do on-prem and you basically buy a dedicated server that’s in a rack somewhere in a data center.

Basically, you still have to buy a second server and configure it in a way that allows for that kind of failover and redundancy.

Not to say that on-prem environments completely lack failover, because in many cases people have certainly configured those environments correctly.

However, we do see a lot of single points of failure out there on servers that are on-prem simply because budgets don’t allow for complete redundancy across every service and server.

In a cloud configuration, however, every server we deploy has the ability to failover to another piece of hardware.

Read More about the Advantages of Using Cloud to Host EHR:

Other Benefits of a Cloud-Based EHR/EMR System

Affordable Cloud Security

Recall when we discussed scale in earlier: it’s much easier for a cloud provider to provide layers of security at a lower cost than an organization can on-prem.

The reasons for this stem from a scalability perspective, but when many of the necessary features are designed into the fabric of the offering, your internal IT staff no longer have to worry about maintaining, monitoring, babysitting or patching those systems that protect data.

Disaster Recovery as a Service

Second is data protection, which would fall into disaster recovery and backups. A lot of IT departments spend time babysitting backups and making sure the data is protected by either snapshotting or offsite replication.

These are just examples of managed cloud services baked into the delivery offering. These are obviously two critical concerns we observe for any organization: Is my data secure? Is it backed-up and protected?

The Importance of Cloud Speed & Performance

Speed and performance are certainly very important. It’s almost assumed.

That said we don’t develop the software. Different systems perform at different levels based on the software and how the software was designed.

For instance, you may have a software – perhaps for EHR or another application – that requires more resources as you grow.

Dynamic Resource Management

The key advantage in a cloud-based environment comes through where instead of turning-off a server and adding more discs or memory to compute, increasing performance is something that we (the cloud provider) can do dynamically.

If a software gets hungry and needs more resources – which equates to performance – the ability to do that seamlessly via a cloud provider is much more available than would be otherwise.

Images and Image Handling

Image handling services are at the forefront of the high-value services for healthcare providers utilizing cloud-based services and/or infrastructure.

These services allow healthcare organizations to scale storage services at a fraction of the cost that would be required to implement them internally by minimizing the overall TCO (reduced capital expense, reduced staffing costs, geographic distribution).

Disadvantages of EHR Cloud

While the benefits of cloud-based EHRs far outweigh the drawbacks, there are a few issues which may arise with cloud-based EMRs. Like any solution, your system is only as secure as you make it, meaning integrating security parameters from the beginning is key.

Identifying the potential security risks from the outlay, such as outdated security walls and software, and poor employee training programs will mitigate the risk of cloud adoption.

Well-trained employees have a better understanding of how their actions might impact system security. Given that human error is often the root cause of data breaches, educating employees about security policies, credentialing and authorization access helps ensure data protection.

In a rapidly shifting healthcare environment, simply deploying a cloud-based EMR is not enough. Your healthcare organization must maintain updates to your systems frequently enough to ensure smooth operation, as well as ongoing compliance.

Gaps in updates, no matter how small of an inefficiency, can make an entire EMR system vulnerable. Be sure to uphold your maintenance and security plans.

A successful move to the cloud means meeting expectations through proper planning. Before developing any changes or moves, develop and stick to stringent planning procedures that govern any cloud-based projects.

Potential Drawbacks of Cloud-Based EHR / EMR

There are a couple of disadvantages, but those disadvantages are only disadvantages based on how the EHR system is architected.

Are You Losing Control in the Cloud?

For example, IT directors tell us – at least from their perspective – losing control of the system is a disadvantage.

They want to ‘be able to turn the knobs themselves and jump in’ and so their fear is losing that granular control.

They ask, ‘am I going to be able to respond to my end users as fast as I am already using on-prem?’. That would be more of a perceived disadvantage.

Designing a Custom Cloud Based EMR Software

But it depends on the cloud system that you’re using. In our environment, we expose every single tool as though you’re running VMware onsite. Hence, there’s nothing you cannot do as an IT director that you wouldn’t otherwise be able to do if you’re running the virtualized platform on-prem.

Limited Internet Connectivity

That said, if all of your servers and systems live in your local network, you’re not dependent on a connection between your location and where your cloud environment lives, which is a genuine disadvantage.

For example, you’re in a very rural area and – while there are technologies that can certainly resolve this issue – you have low bandwidth capacity from the carriers in your network that could impact the performance and your ability to leverage a cloud platform.

Neutralizing Barriers with Cloud Based EHR Systems

Using Private Connections

In most cases, we resolve that by making sure that we’re using private connections with enterprise-grade bandwidth to our data centers in a redundant configuration.

So if you lose one circuit, the other circuit comes online and you’re able to continue operating.

This would be the same disadvantage for internet-use and outside connectivity if you had it on-prem. However, the difference now is if you have your critical applications hosted, you have now a dependency on a point of failure by a provider that you may not have had before.

What about Redundancy in case of Internet Loss?

We rarely see this becoming a major disadvantage.

We’re able to procure enterprise-grade circuits all over North America. Even when you enter some of the rural community house centers, technologies like SDWAN (Software Defined Wide Area Network) provides compression on a latent circuit.

It ultimately comes down to design. If an organization is unwilling to spend the money on a redundant enterprise-grade configuration, then we’ll advise them that maybe the cloud isn’t for them. Because that’s essentially just an extension – as if their data center was in a remote location.

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