There are compelling reasons to move to the cloud for your practice management and electronic health records software, including the cloud vendors' economies of scale, reducing your capital equipment costs, leaving security and infrastructure to their specialized experts, and reducing —but not eliminating — your internal HIPAA compliance burden. The cloud makes sense in particular for small practices, eliminating the need to maintain internal IT infrastructure such as servers and storage area networks (SAN) and staffing adequate in-house expertise to manage these resources.
Of course the forecast for your cloud future isn't totally sunny. There are legitimate concerns about security, data ownership, vendor lock-in, and the viability of your cloud vendor. These concerns most likely are shared by other practices, and generally they can be answered and addressed adequately by the vendor. While many practices share a common fear of "giving up patient data" to an outside vendor, that doesn't mean they aren't justified in feeling this way. You should be very careful in the selection of a vendor.
Note that when we refer to the cloud, there are variations among vendors. For instance, some vendors host their own Enterprise Performance Management/EHR software. Likely the vendor will also include add-ons tools and services such as code-set libraries, assistance with interfaces (e.g., to payers) and HIPAA compliance, to name a few. Cloud vendors also vary in whether the vendor shares servers among multiple practices or offers the option for your practice to be on a separate (physical or virtual) server not shared with others.
But all vendors are not created equal, and once you commit your practice to a vendor, it may not be easy to reverse course. Thus it's crucial to ask questions upfront about your practice's IT systems, the vendor, and the vendor's performance.
Here are seven question you must ask your vendor before a move:
1. Does the vendor have references from practices that are similar to your practice? This may be easier with a specialty-tailored EHR, but even with non-specialty vendors, references which reflect your size, specialty, and your geography (especially if you rely on critical payers or programs such as Medicare) can give important insights into whether the vendor will work for you.
2. What changes will we need to make to our internal network? If you are moving from in-house servers, your network is designed to maximize the speed (bandwidth) among your practice locations to those internal servers. When you migrate to the cloud, all data flows in and out through your internet connection, increasing the amount of internet traffic dramatically. Be sure to look at the vendor's bandwidth requirements for each computer and ensure that you have an internet connection(s) capable of handling both the cloud vendor, and your other internet uses.