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3 Reasons to Favor Cloud-Based EHRs Over In-House EHRs

Cloud-based EHRs not only have the ability to save health systems money, but they are also more secure and promote interoperability.

Cloud-based EHRs are becoming more prevalent in the healthcare field, raising debate about how effective they are compared to other types of EHR solutions.

According to information published by HIMSS Analytics, two-thirds of IT leaders from health systems and hospitals reported that they currently utilize the cloud-based technology.

Thirty percent of practices that house more than 11 clinicians are looking to replace their EHR system by 2021, according to a 2018 Black Book report. Ninety-three percent said a top priority was cloud-based mobile solutions for easy access to data.

"Traditionally, it’s been the smaller and solo practices with the highest dissatisfaction ratings for electronic health record applications but we confirmed also that the smaller the practice, the less likely they are to use advanced IT tools and that is where EHR frustration among small practices is generally focused," Black Book Managing Partner Doug Brown said in a statement.

While there are positives and negatives regarding both cloud-based and in-house EHR adoption, cost savings, security considerations, and data sharing benefits are a few major checkmarks that are in favor of cloud-based EHRs.

Economic benefits of cloud-based EHRs

EHR implementation – and subsequent optimization or replacement projects – are an industry requirement that can be a true drain on organization finances.

“With a lot of these systems, you have to buy the hardware, the software,” said Ellenville Regional Hospital CEO Steve Kelley in an interview with EHRIntelligence. “You have to install all that stuff — millions of dollars — and you have to install all these licenses, which are typically paid for up-front.”

“Then they develop new modules, and you have to buy those,” he continued. “You have additional expenses for maintenance. And all the contracts are laddered, so if you want to get out of them you have to pay off the remaining fee structures on the contracts”

Reducing health IT costs is a major checkpoint for cloud-based EHRs.

“Heavy capital expenditure can be avoided, because IT resources are acquired on demand as needed and paid for as an operating expense,” wrote Cloud Standards Customer Council (CSCC) authors in a 2017 guide on cloud computing in healthcare. “Also, the cost of staff resources required to deploy and maintain IT resources are included in the cost of cloud computing.”

This is especially true for small, rural, and community hospitals.

The recent surge of cloud-based EHR systems has granted for even greater savings. Smaller, cost-conscious hospitals no longer need to make large investments for in-house EHR systems.

The cost of implementing and maintaining a cloud-based EHR system is much cheaper than an in-house EHR system. Some cloud systems even allow users to pay a lower subscription fee that can be as low as $100 a month.

Cloud-based EHRs promote data security

Security is one of the major questions that health systems bring up when talking about EHR adoption.

Patient medical records contain valuable patient information. Patient names, addresses, social security numbers, lab results, and dates of birth are all included in EHRs.

While EHRs have made patient information more accessible than ever, and prevalence of EHRs opens the door for potential data breaches. However, experts say cloud-based EHRs are more secure than in-house EHRs.

“The cloud is more secure. I don’t want you repeating the infrastructure work that we’re doing. I want you all to focus on the innovation,” explained Technical Advisor and former Executive Chairman of Alphabet Inc. Eric Schmidt at the 2018 HIMSS conference.

EHR security gives patients a peace of mind and can prevent potential threats and breaches.

“Cloud service provider data centers are typically highly secure and well protected against outsider and insider threats using administrative, physical, and technical methods implemented and maintained by expert professional staff,” said CSCC authors.

“Cloud services can offer sophisticated security controls, including data encryption and fine-grained access controls and access logging. Medical systems built using cloud services can provide web access to data, avoiding the need to store information on client devices.”

The safety and security of patient information is one of the most important aspects of EHR adoption and cloud-based EHRs are a step in the right direction.

The cloud prioritizes interoperability and data exchange

Cloud-based EHRs allow systems to be interoperable and the sharing of health information to be done securely.

“These services offer the opportunity to extend the capabilities available to health organization staff in order to implement better ways of working and to offer new services to patients,” CSCC authors wrote.

It’s common for hospitals to switch to a cloud-based EHR system due to health data exchange issues with their old systems. Poor usability is a common occurrence that impacts clinicians and is a major cause of clinician burnout.

Basing EHR adoption off interoperability is a way for health systems to improve the exchange of data, while also nudging the EHR vendors to boost their interoperability capabilities.

According to a 2019 survey from PointClickCare, 49 percent of acute care providers and 31 percent of post-acute care providers explained they have limited patient data sharing access, but cloud-based EHRs could overcome those barriers.

“Enabling an actual exchange of data gives providers a much greater opportunity to optimize care and reduce problems that could result in patient readmission,” researchers said.

“By enabling all stakeholders to access and exchange insights through a secure, single source, the result is faster, more confident decision-making, resulting in smoother transitions of care.”

Changing from an in-house EHR to a cloud-based EHR may be a natural step forward for health systems that not only want to modernize their EHR system, but also focus on interoperability

“On an interoperability side, it’s a no-brainer,” said CommonWell Executive Director Jitin Asnaani in an interview with EHRIntelligence. “You have go-to cloud-based interoperability. You’re going to be building more connections over time. You’re going to be doing more with that data over time.”

“There will always be a new wave of interoperability,” Asnaani said. “There is a migration that has to happen now, and at the end of it we’ll say, what about the next migration? And then there will be another migration later.”

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