Have been on AC Cloud for about a year.
Very satisfied in general, wouldn't dream of going back to local machine.
Speed of access from home or elsewhere is the same as in the office, obviously.
Occasional hiccoughs, responded to by AC fairly promptly.
Shifting the responsibility to a third party has been a huge relief for me.
I have some concerns about AC in the long term; for instance the speed of opening and closing patient charts is noticeably slower since version 8.1.1, which I find troubling and hope it won't get worse in the future. But these concerns have little to do with cloud vs. local.
Michael
NY