EMR in the “Cloud”: Is It for You?

The next time you think about implementing or upgrading an electronic medical record (EMR), put your head in the “cloud.”

New web-based EMR systems, also known as cloud-based EMRs, allow physicians to pay a monthly subscription fee to access their EMR rather than having to purchase it. That means not having to buy an expensive server for your practice with its associated hardware and software; all you need is a computer with an Internet connection.

Rather than being stored on a single server, your EMR information may be stored across a network of data storage centers and in no one particular place at any time, i.e., in the “cloud.” Many EMR systems out there today work as either a cloud-based system or the more traditional a client-server system. Which is better? Peter J. Polack, MD, FACS, an ophthalmologist who blogs on medical practice management and EMR implementation, says cloud-based EMRs are cheaper to set up, but client-based systems usually have a better a better return on investment, with a typical break-even time of about five years.

In a blog post on KevinMD.com, Dr. Polack offers these pros and cons of cloud-based or web-based EMR systems.


  • Less up-front cost for licensing,
  • No server hardware or software to purchase/house/maintain,
  • Possibly easier to transition to a different system,
  • More cost-effective for solo/small group practices,
  • Better support,
  • Easy to set up hot-site in case of disaster,
  • Host companies typically have more sophisticated security measures/data protection,
  • Vendor more likely to meet HIPAA regulations than the practice can,
  • Onus more on vendor to meet “meaningful use,” and
  • Good for physicians who are not office-based or travel a lot.


  • Customizability limited,
  • Latency or lag time accessing information across web/slower response time,
  • Patient information may be compromised if comingled with other clients’ information,
  • At the mercy of the vendor regarding backups and security,
  • More expensive over the long haul,
  • Captive client — host controls your data,
  • Practice is dead in the water with Internet outage,
  • May not be viable for rural practices with limited Internet options,
  • Practice can lose data if vendor goes out of business,
  • May be impractical for uploading larger imaging files, and
  • Bandwidth limited by practice’s Internet connection.


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Last Updated On

October 07, 2022

Originally Published On

June 06, 2011

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