Skip to content
MarketScale
‹ Back to IndustriesHealthcare

Cloud-Based vs. In-House Electronic Health Records

Health organizations have been leveraging technology for some time to improve patient experiences and make workflows more efficient, and the central hub for clinicians to record, store and share data is their EHR. Many factors need to be considered when choosing the right EHR, including whether it’s cloud-based or on-site. The biggest difference between the…

This story was produced through MarketScale. See how Healthcare teams put it to work with Executive Thought Leadership.

Share

Get featured

Want to get featured in MarketScale Healthcare?

Create a free MarketScale workspace and get your company's expertise featured across our Healthcare coverage. No credit card, no demo required.

Request an invite

Health organizations have been leveraging technology for some time to improve patient experiences and make workflows more efficient, and the central hub for clinicians to record, store and share data is their EHR.

Many factors need to be considered when choosing the right EHR, including whether it’s cloud-based or on-site. The biggest difference between the two is where the data lives. In cloud-based EHRs, patient records live in an internet-based, on-demand network. On-premise EHRs require data to be hosted locally and housed on-site, which requires significant hardware investment.

So, which is right for your organization?

Cloud-Based EHRs Offer Many Advantages

The cloud has become a vital tool in how organizations use technology, and it provides many benefits for those who adopt it. Cloud-based EHRs are relatively popular, and a study from HIMSS revealed that about two-thirds of healthcare organizations use the cloud or cloud services. So, why have so many migrated to cloud-based EHRs?

The cloud presents multiple opportunities for healthcare entities to reduce costs, enhance security and improve interoperability.

Reduce Costs and Capital Investment

Setting up a new EHR can require substantial capital depending on your requirements, especially if you are responsible for hardware and upgrades. With a cloud-based EHR, you’ll reduce costs associated with EHR implementation, management, and storage.

Every time a new upgrade occurs, you won’t incur additional costs to enhance your servers. With the cloud, you are only paying for the storage that you need, and you don’t need additional IT resources.

Enhance Data Security

Keeping healthcare data safe is paramount and required by HIPAA and other privacy regulations. Moving to the cloud improves the security of your data. Cloud service providers deliver highly secure and well-protected data centers that easily thwart cyberattacks, mostly through tactics like encryption.

Having an on-site server means you are completely responsible for its security, which may be a hard task to ensure, especially for small healthcare entities that don’t have the resources.

Improve Interoperability for Better Patient Outcomes

The world of healthcare data places substantial emphasis on that the ability to share that data across applications. Healthcare interoperability is critical in the modern world, enabling greater access to information to improve patient care.

This data sharing must be secure and seamless, which is better accomplished by using the cloud. Interoperability boosts clinician satisfaction with EHRs, which is much harder to execute with on-premise EHRs.

On-premise applications suffer from poor usability, hampering the ability to exchange data. Cloud-based applications can be a huge help in overcoming interoperability barriers, which, in turn, improves patient outcomes.

Your EHR Should Deliver Advantages, Not Obstacles

Your EHR solution is one of your most valuable tools. Being stuck with on-premise systems is keeping you from realizing multiple benefits.

Your experts belong here

Every story in MarketScale Healthcare starts with a company putting its clinicians, service-line leaders, and field engineers on the record. Buyers are already reading this topic. The only question is whose experts they find.

Service-line buyers vet vendors quietly, and your clinicians become the proof they find while doing it.

Get your team featuredSee how it works15 minutes, straight to a calendar.

Follow Healthcare Insights

Get new expert content in your inbox.

Healthcare: are you visible to AI?

Before they reach out, Healthcare buyers ask AI engines which vendors to trust. See how AI describes your company today, and where competitors show up instead.

Free workspace

You just read one Healthcare expert. Your company is full of them.

This article was produced through MarketScale. The same platform turns your clinicians, service-line leaders, and field engineers into the articles, video, and social content Healthcare buyers are searching for. Create a free workspace and see it with your own people. No credit card, no demo required.

NPS +73 · 1,000+ creators · 38+ countries

What you get, free

Your own MarketScale Studio workspace
One video edit a month, on us
AI writing, editing, and publishing tools
In-platform coaching to learn the system

More Healthcare Insights

Interchangeable biosimilars cut drug spend only when pharmacies can actually switch them

Interchangeable biosimilars cut drug spend only when pharmacies can actually switch them

The FDA’s interchangeable biosimilar pathway is moving from a one-off insulin milestone to a repeatable playbook for pharmacy-level substitution, with Wezlana (ustekinumab-auub) approved as interchangeable to Stelara in late 2023 and a first interchangeable biosimilar to golimumab reported in September 2026. Evidence from a JAMA Health Forum economic evaluation cited by Podiatry Today found that insulin glargine interchangeability in November 2021 was followed by an immediate jump of more than 47,000 prescriptions for Semglee and insulin glargine-yfgn, suggesting the designation itself can change dispensing behavior. For hospitals, health systems, and payers, the operational consequence shows up less in the FDA letter and more in formulary design, NDC-level claims logic, pharmacy notification requirements that vary by state, and the inventory and education workflows that make substitution predictable instead of chaotic.

  • 01Interchangeability is a workflow change, not a clinical debate. The systems that decide spend are NDC mapping, e-prescribe defaults, and pharmacy switch rules governed by state law.
  • 02The pipeline is widening beyond diabetes. Wezlana’s interchangeability to Stelara (Healthcare Purchasing News) and a newly reported interchangeable golimumab biosimilar (Journal of Healthcare Management/AJN via Ovid) signal more specialty and infusion-adjacent categories will face pharmacy-level substitution decisions.

Sep 2, 2026

More nurses did not lift safety culture scores in a 205-hospital analysis

More nurses did not lift safety culture scores in a 205-hospital analysis

A 2026 analysis in the Journal of Hospital Management and Health Policy combined 2021–2022 HSOPC results with AHA, HCRIS, and AHRF data across 205 hospitals and reported that small increases in nurse and physician staffing lined up with slightly lower “percent positive” patient safety culture scores in several dimensions. According to the Journal of Healthcare Management abstract hosted on Ovid, the study described a 2% decrease in positive staffing perceptions with β=−0.02 per additional nurse FTE and a −0.01 change in perceived reporting of patient safety events per additional nurse, while additional physician staffing was associated with −0.01 changes in perceptions of communication openness and organizational learning, and joint ventures were associated with a −0.03 change in perceptions of management support for safety (all p<0.05). The operational read is that adding headcount by itself does not ensure stronger safety-culture signals; hospitals also need the workflows that turn observations into closed-loop fixes, from “just culture” reporting expectations to facilities work-order follow-through, as described by Sentara Health leaders in Chief Healthcare Executive and by Health Facilities Management’s environment-of-care guidance. For health system operators, the near-term consequence shows up in how HSOPC survey targets connect to leader scorecards, rounding programs, digital reporting tools, and joint-venture governance, especially where staffing growth is driven by complexity and handoffs.

  • 01If HSOPC “percent positive” scores are a board KPI, staffing increases can move in the opposite direction unless reporting and learning loops scale too. The study’s negative coefficients are small, but they signal a measurement risk during growth.
  • 02Facilities and clinical safety cultures converge in the same pipeline: observation, reporting, triage, work order, verification. HFM Magazine’s door-lock example is the same system problem as event reporting, it is throughput and closure, not awareness.
  • 03Joint ventures can add operational complexity that dilutes perceived management support for safety. That belongs in JV governance charters and integration playbooks, not only in finance models.

Sep 1, 2026

Smart ICU and ambient AI cut errors when they feed data and notes into the EMR

Smart ICU and ambient AI cut errors when they feed data and notes into the EMR

Two HIMSS26 APAC case studies point to the same operational lesson: hospitals are getting measurable gains from “smart ICU” device integration and ambient AI documentation only when those tools are tightly integrated into core clinical workflows. Pondok Indah Hospital Group in Indonesia reported reductions of up to 70% in ICU administrative errors and 40% in adverse drug reactions after integrating smart devices, according to Healthcare IT News. Sir H.N. Reliance Foundation Hospital in India reported ambient AI is now used for nearly 90% of progress notes and shift handovers across five live use cases on a single EMR-integrated platform, also reported by Healthcare IT News. New JAMA Network cardiovascular research adds a parallel signal on the clinical side, with AI-enabled acquisition and interpretation approaches moving into screening and triage workflows, which raises procurement questions about validation, interoperability, and change management at the bedside.

  • 01A useful benchmark is emerging for documentation automation: “nearly 90% of progress notes and shift handovers” on ambient AI when it is deployed as one EMR-integrated platform, not a set of point tools (Healthcare IT News).
  • 02The measurable ROI in ‘smart ICU’ programs shows up where operators feel pain: fewer administrative errors and medication-related events, not in abstract “digitization” metrics (Healthcare IT News reported up to 70% and 40% reductions, respectively).
  • 03For hospitals with multiple device vendors and fragmented documentation workflows, integration work, interfaces, identity, order context, and governance, is likely to consume more effort than model selection, so contracts and implementation plans should price integration explicitly.

Sep 1, 2026

Explore More Healthcare Insights

Read more expert perspectives from across Healthcare.

Browse Healthcare Hub

For B2B teams

Your experts could be publishing here

Stories like this one run on content MarketScale captures from real practitioners. See how your team's expertise becomes coverage in Healthcare and beyond.

Book a 15-minute demo

Or call us. No forms required. We pick up. 214-945-2512