Cloud vs Local EHR: safe, reliable access to patient records

When choosing new electronic health record (EHR) software, chiropractors have a choice of local software that resides on their computer network or cloud-based software that is accessed live via the internet.

Both options have distinct benefits and possible drawbacks. By knowing the pros and cons of each, you will be better prepared to choose the best option for your practice.

Accessibility and reliability

Consistent access to your patient records is vitally important, and access using different devices can also be a significant benefit.

If your records are hosted online using a cloud system, you can access patient data when you need to from different devices. This allows you to access using your computers and also, perhaps, using a tablet computer or office smartphone.

“All records and billing can be viewed on any computer or device in the office, by any staff without having to pull a file,” said Dr. Chris Niedzinski of Innerlink Chiropractic in Wixom, Michigan.

At Niedzinski’s office, EHR reliability is not usually a problem unless internet access is significantly interrupted. When internet connection problems arise, access to patient information is unavailable until internet service returns. He considers it to be the only significant drawback to using a cloud-based system.

You can certainly build an internal network and access this data using a local system, but it may be more difficult to set up and host your own system for storing patient records. Each device must also have a copy of the software installed before it can access patient data.

Dr. Caleb Spreiter of Integrative Chiropractic in Claremore, Oklahoma uses a local EHR system. He says he prefers the reliability local EHR offers.

“Since my EHR is on my computer, I don’t have to worry about interruptions in service,” Spreiter said.

Privacy and Security

Software vendors are generally able to keep either type of EHR secure and private, but there are special considerations for each system.

An article published in the Journal of Medical Internet Research suggests that cloud-based EHR software requires additional security considerations, especially during a transition from a local system.ⁱ Cloud-based software places patient information on third-party servers for remote access by your staff and patients using computers and even mobile devices. While software companies do work hard to protect the security of patient data, it is important to understand how your software vendor prevents unauthorized access to data or other potential security breaches.ⁱ

If you prefer to keep patient data from being accessed outside of your office, perhaps using local EHR is better for you. With a local EHR system, you are responsible for all security and privacy measures and may not have as much direct security assistance from a vendor. Rather than hosting data on outside systems, patient data will be stored on your system and you must work with your vendor to maintain it.

Reputable vendors keep their software compliant and will offer you help with understanding how your software protects patient security and privacy. If you want to self-test your EHR’s security, the U.S. federal government’s HealthIT website offers a guide on conducting a free EHR security self-assessment. Privacy regulations for EHR are established and enforced by the Health Insurance Portability and Accountability Act (HIPAA). Asking your software vendor about how they maintain compliance with HIPAA will provide help you partner with them in preventing costly mistakes, regardless of the software you use.

Weighing the facts

Many vendors are moving in the cloud-based direction, but great local software is available and is also a great choice for many practices. Before you decide, be sure to consider how you and your staff will be using EHR software.

Find out what features are important to you, then ask your vendor how their software can best support your clinic and your patients.

Reference

¹ Rodrigues JJ, de la Torre I, Fernández G, López-Coronado M. “Analysis of the Security and Privacy Requirements of Cloud-Based Electronic Health Records Systems.” J Med Internet Res. 2013 21;15(8)