Cloud-based EHR: 
benefits, use cases, and a migration guide

Cloud-based EHR: benefits, use cases, and a migration guide

February 22, 2023

Cloud-based EHR 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

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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, yet 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 practices' performance.

Factors to consider

Cloud

On-premise

1
Implementation cost

Factors to consider

Cloud

On-premise

Lower upfront costs, but potentially higher TCO over the years of usage

Higher upfront cost, but lower annual expenses

2
Implementation time

Factors to consider

Cloud

On-premise

Quick setup

Longer setup

3
Security and privacy

Factors to consider

Cloud

On-premise

Higher risk of a data breach

More secure, but companies must ensure EHR security themselves

4
Interoperability and integrability

Factors to consider

Cloud

On-premise

Highly interoperable with cloud-based systems and easily integrated with other apps

Interoperability and cloud apps integration is often a challenge

5
Scalability

Factors to consider

Cloud

On-premise

Scales easily

Requires additional extensions to scale

6
Customization

Factors to consider

Cloud

On-premise

Customizable only to a degree enabled by the vendor

Functionality can be customized extensively for your organization’s specific needs

7
Safety and backup

Factors to consider

Cloud

On-premise

Vendor takes care of data security and backups

Regular backups and disaster recovery planning is the owner’s responsibility

8
Support and maintenance

Factors to consider

Cloud

On-premise

Fast and effective vendor IT support

Requires dedicated hardware and in-house personnel

9
Accessibility

Factors to consider

Cloud

On-premise

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

10
Data management

Factors to consider

Cloud

On-premise

Fewer data management and control options

All data is in one place and under the organization’s control

4 steps to migrate EHR to the cloud

When a healthcare organization makes the decision 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 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 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 drug allergies.

2

Team assembly & strategy selection

Ideally, the 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 services 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 without spending too much time and resources.

Novant Health

Novant Health is a four-state integrated network of hospitals and healthcare clinics with a total of 28,000 employees headquartered in North Carolina, USA. Novant Health has been using the Epic EHR system locally since 2011. At that time, the EHR system often required multiple advancements and changes in the infrastructure. Moving to Epic’s Virtustream Healthcare Cloud platform helped Novant Health save time and free up engineering staff for other projects.

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.

James Kluttz

Chief Technology Officer at Novant Health

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.

Cloud-based EHR

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

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

Challenge

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.

Challenge

Possible solution

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 may bring their owners revenue from advertisements embedded into the system.

Higher risk of a data breach

Challenge

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.

Challenge

Possible solution

Opt only for a reliable software development company when shopping for a cloud-based solution. Ask vendors about their security capabilities in detail to understand whether your data is protected and aligns with international and local regulations (e.g., HIPAA). 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

Challenge

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.

Challenge

Possible solution

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

Adopt cloud-based EHR to future-proof your company

The rise of cloud computing has changed the healthcare industry. Health IT services became more accessible for all types of healthcare service providers, helping them to adjust to the rapidly changing requirements and become more resilient in the face of natural disasters, pandemics, and other emergency events. Our experts use their experience in cloud computing and healthcare industry knowledge to ensure patient information safety and help providers successfully move from legacy on-premise software to the new, more flexible, systems while getting value for their money.
Adopt cloud-based EHR to future-proof your company

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FAQ about cloud EHR

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