There is little argument that a variety of business, governmental and even professional organizations are rallying together for the wholesale adoption of electronic medical records software (“EMR”) by providers of many disciplines. The dust has settled somewhat and two architectures have arisen to fight for top billing. This installment of Tips4EyeDocs, is a brief overview of cloud and local server based software architecture for the eye market.
The most signicant difference between the two architectures is the location of the processing servers. In a cloud, the servers are housed in a “farm” away from the end user customer. In the local, the servers are located at the end user’s actual location
Data centers are physically secure and are locked. No one without proper authorization can enter. They are also thoughtfully located in areas with ample electricity and space and housed in temperature-controlled rooms. Most local servers are not physically secure and often share a room where other activities occur. Many times, they are located in a back office without regard to adequate ventilation or temperature conditions
Adding a user to a cloud application is relatively easy; even more so if it is the 100th one. The servers and software configurations are standardized so that one configuration will work with most, if not all, clients. In contrast, a local application usually requires an onsite visit to install. Computers are probably different than those in the data center and vary with each end user. Every installation becomes unique without the benefit of economies of scale.
A cloud application is easy to upgrade. There are no CDs or software to download and all users are upgraded at the same time. Customer service easier because every is theoretically on the same version. A local application allows a user to skip upgrades making customer service difficult because a user may have an older versions.
Two choke points of cloud applications are their dependence upon a good internet connection and simultaneous failure. Both are not usually so critical for local servers.
Internet connection is a foregone conclusion for most businesses but they can vary greatly across the country. Bandwidth is important because transactions are performed on the internet. Adequate bandwidth, howev cannot be guaranteed to be equal for all users with some users experiencing better performance than others. In fact, uptime (the time duration that the internet is working) may be different simply because of network infrastructure or traffic.
Cloud applications fail like any other piece of software. Failures occur either by serendipity or by human error or mischief. Regardless, a failure in the application can affect all users at the same time. Application slowdown is also a failure. If internet traffic is exceptionally high due to a hacker, then it impacts all users.
In summary I like cloud applications. They lessen my anxiety or concern for physical security, is available outside of the office from any computer and generally performs as fast as a local server application. For the individual doctor, a cloud application makes a lot of sense. While it may not be the perfect solution or have the exact features or have the same sense if ownership as a local server application, overall it is a good alternative to the local server application.