How long do on-premise EHRs have left?

A few years ago, market shares for cloud versus on-premise EHRs appeared to be a toss-up. However recent trends are showing that cloud-based systems appear to be adopted at a greater rate by providers. However, one should not expect the on-premise delivery method to fade into obscurity quite yet.

According to the HIMSS Analytics 2016 Cloud Survey, which polled IT leaders at 105 healthcare provider organizations, close to 50 percent reported that they were planning a future move to the cloud. The survey results from HIMSS only tell part of the story as provider preference for cloud or on-premises systems is the product of individual preferences and practical circumstances.

Practical considerations such as cost and connectivity have been the primary drivers and barriers respectively behind increases in cloud based adoption. Additionally, the landscape of evolving Meaningful Use requirements and the need to contain costs and improve outcomes through population health monitoring and patient engagement have been facilitated by applications that are largely native to cloud based EHRs.

Low bandwidth as a shrinking barrier to cloud EHR adoption

Practices which are unable to secure a high bandwidth internet connection largely have been a difficult market for cloud EHRs to reach. However, as an outreach strategy to providers who may have lower bandwidth connections, cloud-based EHR providers have rolled out software based solutions which allow cloud-based systems to function on lower bandwidth networks.

Use this free online comparison tool to compare cloud and on-premise EHRs

These solutions allow cloud systems to perform better on lower bandwidth connections by using software to compress data files to facilitate a faster transfer. Additionally, some providers can delay large data transfers  through a process known as buffering to be sent when bandwidth is most available during off-peak hours.

Cost effectiveness as a continued driver behind cloud EHR adoption

One of the main value propositions of cloud-based EHRs has been their lower cost when compared to on-premises products. For providers operating on thin margins or reluctant to invest in the hardware, software, and network personnel needed for an on-premises system, cloud based systems offer an attractive solution, particularly among rural providers who may be hard hit by a less favorable economic climate for these providers.

The rationale of adopting a cloud-based system in response to thin margins is reflected in a recent article published in Healthcare Finance News, which chronicles how rural hospitals who are experiencing financial pressures have increasingly elected to invest in a cloud-based EHR to reduce EHR related costs and achieve financial gains driven by quality of care and patient satisfaction improvements.

Patient engagement and population health

Another major push that may swing the pendulum further in favor of cloud EHRs is the growing demand by healthcare consumers for more interactivity and engagement with their providers through mobile applications. Further, on the provider side interactivity and engagement serve the goals of insight into and management of population health and patient engagement. Although, on-premise EHRs can function in this regard, cloud-based systems, and their enhanced ability to interact with mobile applications may be a driver behind increased adoption of cloud systems.   

At present, on-premise EHRs certainly aren’t obsolete. However what may have been a balanced market a few years ago now shows signs of shifting in favor of cloud-based EHRs due to innovations which remove connectivity-related barriers. There is also a greater demand for cost-effective deployment and mobile-friendly cloud based EHRs, which can better engage and interact with patients and leverage population health data, provide this.

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Jeff Green

About the author…

Jeff Green, MPH, JD works as a freelance writer and consultant in the Healthcare information Technology Space.

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Jeff Green