A Cloud EHR vs. a Local Server EHR

by | Jan 11, 2022 | Blog | 0 comments

Back in the day, the medical industry used to run on paper files. Then in the late 2000s, the U.S. government initiated major efforts to encourage a shift to electronic records. Medical organizations that demonstrated use of certified, up-to-date EHR technology received large financial compensation from the government. Over time, and thanks to all of the benefits it offers, EHR has become an indispensable part of the industry.

As the name suggests, electronic health records (EHRs), alternately called electronic medical records (EMRs), enable a medical practice to maintain comprehensive records for every patient who receives services. This information is stored securely in the server and can be updated with each encounter. EHRs also facilitate the transfer of records to another party, like an insurance company or a specialist providing a consultation.

Whether its staff members are used to an old-fashioned paper-based system or have been working with an EHR system for a while, any practice can benefit greatly from upgrading the way it stores patient records. An electronic medical record clearly offers a vast range of advantages over the traditional paper-based system. But choosing the right electronic solution can itself be a daunting task. Factors like practice type, organization budget, and patient population all contribute to the choice of an EHR architecture.

Broadly speaking, there are two types of framework for an EHR system: an in-office server or a cloud-based system. The basic difference between the two is where the data is stored. A local or client-server EHR system is what we traditionally think of as software. It is installed on a desktop or laptop computer and the information is saved on that machine. By contrast, in a cloud-based EHR system, users log in to a web-based tool that saves the information on a server located elsewhere. The difference between the two system types is analogous to that between the use of Microsoft Word and Google Docs to create and store documents.

Over the past few years, all industries have started to shift to cloud-based software in order to take advantage of its considerable benefits. Gmail, Facebook, Amazon, and Netflix are all cloud-based platforms that store data on a privately-owned cloud or a third-party server. These services are not physically based in the office, but work using shared pools of storage, networks, servers, and applications. Let’s take a closer look at the most vital advantages of a cloud-based EHR system.

Cyber Security

Information like the patient’s name, address, social security number, and lab results are all stored in the EHR. So, ensuring the security of patients’ confidential and sensitive information is one of the highest priorities for any medical organization. Independent medical practices become entirely responsible for the cybersecurity of an in-house server. They need to make sure that their network’s firewall and backup systems can stand up against viruses, malware, ransomware, and hacking attempts. By contrast, a cloud-based EHR system comes with many more layers of security than a traditional in-office server. Cloud-based EHRs offer state-of-the-art security and are monitored 24/7 to prevent any potential breach.

Physical Security

Organizations running an on-premises server always face the risk of data being stolen or destroyed. When compromised, these organizations often end up paying heavy compliance or ransomware fines to recover their own records. A physical server breach also leaves them exposed to lawsuits for failing to maintain privacy as specified by the Health Insurance Portability and Accountability Act. As a bare minimum security measure, medical practices need to restrict access to the local server by placing it in a locked server room. But even after taking all necessary precautions, unpredictable events like natural disasters can crash the entire system. On the flip side, a cloud-based EHR’s data is all but impossible to destroy. Cloud-based systems are hosted on enterprise-grade servers in highly controlled environments. Information in the cloud also has multiple, redundant backups that are safely kept in multiple locations around the world.


An in-office server-based system comes with a very high initial cost of EHR implementation. The set up and installation of specific hardware and software throughout the medical office can cost $40,000 or more. Hosting a local server also incurs many additional expenses like periodic licensing fees, physical hardware maintenance, software upgrade work, and other unexpected costs. A cloud-based EHR system provides the same utility at a fraction of the cost. A cloud-based EHR system has simple, low monthly costs that are predictable and therefore easily budgeted. Cloud-based EHR even saves additional IT resources by including maintenance and upgrade features in a single package.


In-office servers can go down at any time because of issues with the power, operating system, or network card. Practices become completely dependent on the local IT department when this happens. Unexpected downtime reduces efficiency and ends up costing thousands of dollars long-term. By contrast, cloud-based systems have nearly 100% uptime. A Cloud EHR comes with thorough security measures to protect against software failure, server downtime, user error, and other unexpected incidents. Even if the system experiences a fault, redundant resources kick in automatically and the services remain available.


Medical records saved on an in-office server are completely static and cannot be accessed from outside the office. But cloud-based records are accessible anywhere there is an internet connection. Physicians, RNs, nurse practitioners, and others can save much time and effort by accessing patient data via their tablet, smartphone, or laptop when they happen to be away from work. This ease of access also facilitates data sharing and collaboration amongst team members. Many top cloud-based EHR services even offer Android/iOS apps that practitioners can use to look up patient notes and test results on the go.

Final Thoughts

A cloud-based EMR offers a host of advantages over the traditional in-office server-based system, at a fraction of the price. It has better accessibility, reliability, and scalability, while still maintaining the highest security and compliance standards. For independent practices looking to implement or transition to a cloud-based EMR system, TRIARQ Health’s cutting edge EMR offers a complete solution that comes with premium features and support.

TRIARQ Health is an industry-leading management services organization that empowers independent medical practices with value-based services. Learn more about our comprehensive EHR system here, or get in touch with us today!