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Practice Management Software (PMS) is arguably the most critical element in day-to-day clinic’s operations. It is meant to facilitate a wide range of managerial tasks and provide the means for compulsory compliance requirements. A time comes when new challenges urge the clinics to implement or to change the current PMS. It may be a new clinic that is seeking what is the best to acquire or an existing clinic in need to re-arrange the way things are managed.
There are two different models available on the market: the traditional Local Server Model that dates back to the 1970s and the modern Internet Cloud Model that originated some 15 years ago. The most important difference between them is where the database with your records is located, how it is managed and accessed.
In the Local Server Model, the data is kept on a local server that is located on your premises and is maintained by you or an IT company that you hire. The data is accessed over a local network via applications installed on your workstations. In the Cloud Model the data is kept on a remote server located at a data centre and it is maintained by the PMS provider. The data is accessed via the Internet (global network) and does not generally require installation of software on your workstations.
Let us look at the differences when it comes to various factors that define the suitability of each model for you.
We will only look at the costs, security and flexibility as the most frequently mentioned issues.
The Local Server Model costs include: the acquisition and configuration of the server, acquisition of the software (usually a set of individual licences), installation and configuration of the software on the server and the workstations, maintenance of the server and the workstations including backups, upgrades to the hardware and software, configuration and maintenance of the local network including security and access levels.
The Cloud Model costs are generally limited only to the monthly subscription fee that covers all of the above issues. The workstations only need to be connected to the Internet. All the maintenance, configuration and upgrades are performed by the PMS provider. The Cloud Model also normally provides redundancy (hot standby systems) in case something happens to the main server. The redundancy is extremely unlikely with the Local Server Model because of its very high costs.
The cost should also include the downtime from server upgrades and hardware or software failures that are hard to calculate, but which may be disastrous. The redundancy provisions of the Cloud Model make such failures very unlikely.
The Local Server Model relies on your premises to be secure. It is theoretically possible to provide 24 hours human and electronic monitoring of the premises, secure access (fingerprint and retina authentication), enterprise level Firewalls and electronic intrusion detection, etc., but it is very expensive and is simply unaffordable by small and medium size clinics. Thus, the security of the Local Server Model is very limited and can easily be compromised.
The Cloud Model generally provides the highest level of security within the same monthly subscription fee. The level that would be practically impossible to achieve on your own for a clinic.
The Local Server Model is fairly rigid and it takes effort to expand or modify the working environment to add workstations or new locations (clinics). Generally, it is platform dependent, e.g. Windows only. Adding extra services like VPN to increase flexibility further increases setup and maintenance costs of the system as well as its complexity.
The Cloud Model is platform independent and can be reconfigured by the PMS provider within minutes to include new locations or specific configurations. Adding new workstations does not require any effort at all. The data can be accessed from anywhere and anytime with the Internet access.
Overall, the Cloud Model provides better security and flexibility for lower costs to the clinic.