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Feb 23

Cloud-based EHR VS. In-House EHR

Practices today are faced with the choice of whether to host their EHR software in-house or subscribe to cloud-based service. Each option comes with its own challenges and benefits. So which is best for your practice? Let’s take a look at the characteristics of each.


Cloud-based systems are hosted on a shared server and accessed via the internet. These are sometimes referred to as Software as a Service, or SaaS. Accessing software in this way comes with a number of advantages, first of which being ease of implementation. Since cloud-based software is hosted elsewhere and accessed through the internet, there is no hardware or software to install, making for a very efficient implementation and a faster return on investment. Another benefit of cloud-based software is the cost savings, at least when it comes to cost of implementation. Again, because there is no need for hardware or software installation, implementing cloud-based software simply requires a small start up cost and the regular subscription fee which is typically more affordable than the up-front implementation costs for on-site software.

When accessing your EHR through the cloud, your IT requirements are reduced. This is because the security is taken care of by the SaaS provider, reducing the practice’s need for an in-house IT team to install, configure, and update hardware and software. Increased flexibility is another advantage of cloud-based software. Because the EHR is accessed through the internet, providers aren’t at all limited in the locations where they can access their system. Smartphones and tablets are both fair game, even away from the office which allows providers to work on the go as needed. Finally, cloud-based EHRs are more easily scalable than their on-premise counterparts. If your practice is going through a period of rapid growth, with a cloud-based system you will simply need to add another new user as opposed to setting up another machine for in-house systems.


On-premise software is hosted locally within the practice’s office on their own private network. A lot of practices prefer on-premise software to the cloud because it allows more control on the part of the practice. When dealing with on-premise software, practices will have their own in-house IT to maintain security and keep everything functioning. These practices will control how and where the data is stored, including infrastructure configurations, allowing them to customize this setup to their specific needs. Another benefit practices see to keeping their software on-site is that they can access their system even if their internet goes down. While vendors work very hard to ensure their internet stays up and they don’t have interruptions to service, sometimes things happen. Additionally, if the practice has an issue with their internet, that will also limit their ability to access the software. Again, these types of situations should be rare, but for practices located in areas where they often have trouble with their internet, they will likely prefer to keep their software hosted on-site. Finally, there is a difference in cost between cloud-based and in-house software. The greatest difference here isn’t so much in amount, but rather in timing. In-house software requires a greater up front investment, which some practices might be put off by, but over time, the cost is less. Whereas cloud-based systems require a monthly fee over the lifetime of the software’s use, meaning an ongoing expense that some practices may want to avoid.

Your decision will likely come down to…

For most practices, the decision between cloud-based or on-site software will likely come down to two factors: cost and reliability. For cost, while there is a slight difference depending on vendor in the amount of cost between on-site and cloud-based, really the biggest difference is in timing of cost. On-site software will require a larger upfront investment in hardware, software, and setup, whereas cloud-based systems require a much smaller up front investment followed by the monthly subscription fee. Choosing which situation is best will vary practice to practice, and really neither is better than the other.

When it comes to reliability, cloud-based systems have gained somewhat of a reputation for being less reliable over the years, but in practicality, that isn’t actually the case. As long as a practice has a reliable high-speed internet connection, issues with connectivity should be few and far between. Obviously, that connectivity isn’t much of a consideration at all when it comes to on-site software, so for practices that are located in areas with subpar internet service, on-site might be the better way to go to avoid service interruption.

EHR software is important to a medical practice’s success, and it’s imperative that each practice choose the best method for accessing this software for their particular setup. There are a lot of factors to consider, but truly neither option is better than the other, it’s purely up to the practice’s preference. This is why MicroMD offers both cloud-based and on-site software solutions. MicroMD Cloud Based PM + EMR software offers a cost-effective and hassle-free alternative to housing your own server, software, and data and it helps organizations reduce the spend on costly IT staff and the time required to perform necessary data backups. MicroMD’s on-site systems also offer the same amazing features as our cloud-based systems, while also allowing practices to control how and where their data is stored, their own security measures, and eliminate concerns of downtime in areas where internet connectivity can be problematic.

If you’re ready for more information on MicroMD’s amazing suite of software, or to get started, visit or call 1-800-624-8832.

About the author,
Crystal Stanton

Crystal is a Digital Marketing Specialist at Henry Schein MicroMD. Content creation, social media management, and SEO optimization are just a few of her areas of concentration as she seeks to educate clients and prospects alike about the simple, customizable, and connected solutions we offer at MicroMD.

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