There are so many considerations to take into account when you are assessing your ROI that I would recommend hiring a consultant to help you work through the issues, the first one being the cost of remotely housing both the EHR software and its associated data. However, keep in mind that there are no claims to the completeness of any system’s otolaryngology knowledge base or to a software’s usability. Only you and your partners can assess these factors, which I believe are the most important aspects to consider in choosing a cloud-based system.
Let’s look at the infrastructure-as-a-service (IaaS) model. With IaaS, all networking, routing, data storage and retrieval are handled by an outside vendor, but the actual software is housed on the users’ computers and is not a part of the service. One thing is for sure: The cost of digital storage has really gone down in recent years. Storage is now so cheap that some say you are better off holding your own data and not relying on another party. In a recent article in Informationweek (March 2012), Jonathan Feldman wrote that when Amazon started hosting data, the cost for storing 50 TB of data was approximately $360,000. In today’s dollars, the cost has dropped to about $259,000. On the other hand, you could link together 25 2-TB drives, which would give you the same 50 TB of storage, for $3,000. While you will certainly not need 50 TB of storage for your practice, it’s clear in this example that the potential savings in storage costs are not being passed along to users by companies providing IaaS services.
A Middle Ground
The return on your investment obviously does not come from storage and retrieval of data alone. IaaS provides other types of support, such as securing data, providing redundancy and insuring compliance with the ever-increasing burden of HIPAA regulations. The question is: Do you need a cloud facility for a small- or medium-sized practice to get these services? The answer is no.