Cloud-based EHR: benefits, use cases, & a migration guide
February 22, 2023
Ever since the healthcare industry started its journey toward digital transformation, switching to electronic health records has been one of its target missions. In the US in particular, the demand for EHR development services is rapidly growing, especially in the cloud-based segment. Let’s discover why healthcare providers specifically opt for cloud-based EHR systems, compare the two types of EHRs, review the challenges of switching to the cloud, and learn how to overcome them.
Cloud-based EHR software market statistics
estimated global cloud EHR market size by 2027
Brandessence Market Research
cloud-based EHR segment’s revenue share in 2021
Grand View Research
of hospitals want to replace their on-premise EHR with a cloud system
EHR Intelligence
Considering cloud-based EHR for your organization?
Cloud-based vs on-premise EHRs: 10 comparison criteria
Choosing between a cloud-based and on-premise solution is how any provider’s EHR implementation journey begins. The main difference between these EHR types is the deployment method: it determines the resources needed for the system’s adoption, its scalability, interoperability, security, installation time, and other factors that ultimately have a significant impact on the medical practice.
Factors to consider/Cloud
Factors to consider
On-premise
Cloud
On-premise
Implementation cost
Implementation cost
Lower upfront costs, but potentially higher TCO over the years of usage
Higher upfront pricing but lower annual expenses
Implementation time
Implementation time
Quick setup
Longer setup
Security and privacy
Security and privacy
Higher risk of a data breach
More secure, but companies must ensure EHR security themselves
Interoperability and integrability
Interoperability and integrability
Highly interoperable with cloud-based systems and easily integrated with other apps
Interoperability and cloud apps integration is often a challenge
Scalability
Scalability
Scales easily
Requires additional extensions to scale
Customization
Customization
Customizable only to a degree enabled by the vendor
Functionality can be customized extensively for your organization’s specific needs
Safety and backup
Safety and backup
Vendor takes care of data security and backups
Regular backups and disaster recovery planning is the owner’s responsibility
Support and maintenance
Support and maintenance
Fast and effective vendor IT support
Requires dedicated hardware and in-house personnel
Accessibility
Accessibility
Requires high-quality internet connection and can be accessed remotely
Doesn’t require a 24/7 internet connection and cannot be accessed from outside the facility
Data management
Data management
Fewer data management and control options
All data storage is in one place and under the organization’s control
4 steps to migrate EHR to the cloud
When a healthcare organization decides to move its medical records to the cloud, one of the biggest challenges is data migration. If not executed properly, it may result in patient information loss or damage and negatively impact the cybersecurity and operation of a newly adopted cloud-based system. Luckily, you can prevent such an outcome by following these migration steps.
1
Preliminary analysis
Studying the specifics of a current system helps plan the transition and bridge any existing gaps in data formatting or storage beforehand. For instance, a legacy on-premises EHR can contain a specific patient record with “seafood allergy” entered in plain text. This “seafood allergy” record in the patient chart should be translated and codified according to ICD-10. At the same time, the plain-text record should be automatically deleted to avoid duplicating the information. Otherwise, the new EHR won’t be able to trigger respective patient safety alerts, for example in case of allergies.
2
Team assembly & strategy selection
Ideally, the decision-making team should consist of a project manager, a business analyst, end users of the system (e.g., a registered nurse should be consulted during the data migration to the nursing EHR from the general system), and an internal or hired expert who analyzes, chooses a cloud EHR vendor and works closely with them. When it comes to an EHR migration strategy selection, there can be several time-proven ways for a particular platform. For example, AWS cloud migration can be done in seven different ways or a combination. So, hiring a migration consultant can help you make the right choice.
3
Virtualization
Complex applications like electronic medical records can be delivered by offloading them into a virtual ecosystem that isolates and secures big data sets for performing big data analytics in the future. There are three major virtualization options: application packages and streaming (the system is deployed to a server and streamed to the endpoint as a package), hosted applications (similar to the previous one, but the app is deployed to a virtual server), and virtual desktops (specific solutions are deployed to virtual desktops with policy-based access, allowing system administrators to make user actions visible and controllable).
4
Data security
To protect your patient information, consult your vendors or IT teams on dividing data into manageable chunks for gradual transferring, possible network security reconfiguration, or other measures. Major EHR vendors use third-party cloud service providers to ensure maximum security and compliance: for example, Epic uses AWS, and Meditech collaborates with Google Cloud. Make sure your migration strategy fits your overall data governance and security strategy before initiating the transfer.
Cloud-based EHR: 5 real-life examples
There are many examples of healthcare organizations adopting cloud-based systems to enhance their patient care, help personnel with daily tasks, and increase productivity while spending less time and resources.
Novant Health
We have to be able to adapt to patient shifts in care. Those open-minded and willing to look at things differently and invest in people differently will be the ones who see the benefits.
Veteran Affairs
Carter Clinic
A Kansas school district
CareCloud
Running our SaaS platform on ClearDATA on the AWS Cloud takes a lot of guesswork out of compliance and high availability. That gives us fewer things to manage, so we can spend our time creating new features that help us grow right alongside our high-performing practice clients.
Benefits of cloud-based EHR systems
Cloud-based EHRs let providers benefit from improved interoperability and accessibility without the need to add new software to their on-premise systems.
Quick and secure data exchange
Multiple business model options
Scalable and easy to integrate
Low upfront costs
Strong search capabilities
Scheduled efficient backups
Accessible from anywhere
Few to no runtime errors
Cloud-based EHR
Pitfalls of cloud EHR software and how to avoid them
While many providers swear by their cloud-based systems, they still present several persistent challenges. Below, we explore these difficulties and how you can overcome them.
Challenge
Possible solution
Low upfront cost but higher TCO
In addition to paying for the out-of-the-box EHR solution itself, healthcare providers can be charged additionally for its customization, storage increase, hardware upgrade, and data transfer to the new system.
If you want to make your system more cost-effective, consider its performance optimization, as well as various monetization paths for cloud EHR. For example, you can charge patients for access to their health information via a patient portal or to schedule an appointment, making them the system’s end subscribers. In other cases, EHR and EMR software bring their owners revenue from advertisements embedded into the system.
Higher risk of a data breach
The cost of data breaches in healthcare is the highest among all industries, and the number of violations is among the top five. Web-based EHRs are especially vulnerable due to their remote accessibility.
Opt only for reliable software providers when choosing a cloud-based solution. Ask vendors about their security capabilities in detail to understand whether it aligns with international and local regulations (e.g. HIPAA), so that your patients’ medical history is sufficiently protected. Additionally, conduct personnel training to minimize human factor breaches and adopt a legal mechanism to protect your company from industrial espionage.
Medical personnel’s reluctance to change
Switching to a new system is always stressful for users. Physicians report having to work overtime to manage their EHR software and feeling overwhelmed by the necessity to change workflows.
Listen to your employees and address their concerns in a constructive way and don’t expect them to master the new system on their own. Instead, conduct training sessions before and during the EHR implementation process and make sure that department leaders teach others by example. Leave room in your organization’s business strategy and budget for reduced productivity during the first three to six months after the new system’s adoption.
Adopt cloud-based EHR to future-proof your company
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FAQ about cloud EHR
What is the difference between a server-based EHR and a cloud-based one?
The server-based EHR is just another term for an on-premise system, as it refers to the locally hosted server. Meanwhile, cloud EHRs are web-based systems, hosted remotely on third-party servers.
What are the top cloud EHR platforms?
The most popular cloud-based EHR/EMR platforms are Cerner, Allscripts, Practice Fusion, NextGen, Athenahealth, CareCloud, DrChrono, and Greenway.
Can I migrate my EHR to the cloud?
Almost any specialized software be it nursing, pediatric, or dental EHR can be moved to the cloud. Yet, one should consider all the pros and cons first – they may vary depending on the particular case.
How can EHR data be secured?
Most software providers employ data encryption, different levels of authorization, and multi-factor authentication as the most common security techniques.
How much does cloud EHR cost?
The cost of cloud EHRs varies significantly depending on the features they offer, the amount of storage space needed, and the vendor’s business model, among other factors.
Is cloud EHR suitable for a small practice?
Usually, cloud EHR is the preferable type of software for smaller practices due to low upfront costs and simplicity of implementation.
Is cloud EHR better than an on-premise one for a telehealth clinic?
As a rule, cloud EHR offers more flexibility to medical professionals who hold teleconsultations out of the office. They can access patients’ histories even via their iPads or other devices and deliver remote actions like treatment prescribing or real-time vitals input into the system. These operations wouldn’t be possible with an on-premise EHR in this scenario.
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