I moved to the ac hosted cloud solution about two months ago and am very pleased. A few comments:

1. The speed is perfectly acceptable. Including for the opening of imported items. I was worried that opening large imported items would take a long time to download, but that was because I misunderstood how the cloud solution works. It's basically a remote desktop solution, so the imported items get opened on the host and the image of the file gets transmitted, not the whole file.

2. This means that any application you use to open an imported item must be present on the host. Not a big deal, though I used to use adobe acrobat rather than adobe reader (which is used on the cloud); I used to be able to edit my imported pdf's that way, can't do it anymore; not a big problem but surprised me initially. And if anyone has a custom application to use on imported items, it would have to be installed on the cloud to work (you could always download the item to your computer, use the application and then upload it again if necessary, but that would be a bit time-consuming).

3. I have found the connection gets interrupted anywhere from zero to two or three times a day. I was told it would be due to a hiccup in my internet connection; not sure about that. At any rate, when it happens the reconnection is automatic, a screen saying attempting reconnect pops up and within about 30 seconds I'm back where I had been.

4. Customer support has been good and very responsive so far. It's a pleasure not having to worry that when the system goes down, I'm the one responsible. All I have to do is make sure I have an internet connection, and the rest is their responsibility.

5. The cost depends on the number of simultaneous connections you need, not on the number of users you can have. I'm pretty much a solo operation when it comes to the EMR, so I got away with one connection. I use it at work and then at home. When I went on vacation I added a second connection so my coverage could log on and I could too at the same time without booting him off the computer unexpectedly. Adding the connection was quick and easy. If you have a setup where three or four or more need to be able to access the system simultaneously, it could get pricey.

6. Printing locally from the cloud took a bit of doing. When I first set up the system, I was able to print to my old HP printer without a problem. I then bought a new HP printer, and it just wouldn't work. Support then had to install a utility call tsprint on the host and a client for my desktop computer, which ultimately solved the problem.

All in all I'm happy with the service.

Michael
New York, NY