Cloud Computing and EHR/EMR

The rage is “Cloud Computing” and its spreading to Health IT, including EHR.  What is it really and what does it mean to the EHR/EMR purchaser and customer?

What is “Cloud Computing”?  According to Wikipedia, it is:

a style of computing in which dynamically scalable and often virtualized resources are provided as a service over the Internet. Users need not have knowledge of, expertise in, or control over the technology infrastructure in the “cloud” that supports them.

What does it mean to EHR/EMR?

There are generally 3 types of systems being sold today:

  1. Client-server: The practice purchases the server and operating system.  The EHR/EMR software is installed on the practice’s server.  This is not Cloud Computing.
  2. Hosted Client-server:  The vendor hosts the same or similar client server system in their data center and the practice accesses the system using a Virtual Private Network (VPN) over the Internet.  Some vendors will call this ASP (Application Service Provider) or use “Internet”, “Web” or other Internet terminology.  Regardless of what it is called by the vendor, it is important to find out if the vendor is really just hosting the client-server system, which is what most of the older EHR/EMR vendors are doing.  This is not Cloud Computing because the system was designed as client-server and is not dynamically scalable.
  3. Internet-based:  The application was created using multiple tiered architecture and specifically designed for use over the Internet.  All customers are are using the same software/release and it is dynamically scalable.  This is Cloud Computing.

Why is Cloud Computing benefical for EHR/EMR?

For all the same reasons it is good for other applications, including (per Wikipedia):

  • Agility improves with users able to rapidly and inexpensively re-provision technological infrastructure resources.
  • Cost is greatly reduced and capital expenditure is converted to operational expenditure.
  • Device and location independence enable users to access systems using a web browser regardless of their location or what device they are using.
  • Peak-load capacity increases.
  • Reliability improves through the use of multiple redundant sites, which makes it suitable for business continuity and disaster recovery.
  • Security is often as good as or better than traditional systems, in part because providers are able to devote resources to solving security issues that many customers cannot afford.
  • Sustainability comes about through improved resource utilization, more efficient systems, and carbon neutrality.  (so Cloud Computing is GREEN!  – my comment)

C Huddle, VP, Market Development