I have done both local and AC in the Cloud. I prefer AC in the Cloud. Just easier for me with little or no need for my local IT guy to ever get involved much anymore and upgrades much easier. The only issue with AC in the Cloud is the dreaded black box if my nurse or I click too fast and double click and freeze the cloud server. Then I have to get AC support to unfreeze the cloud server, easy fix but sometimes especially if on a Holiday or weekend may be tough to get IT support quickly.
A valid point being made - we have been taking calls on nights and weekends from Doctors for over seven years, so who provides your services is a key decision to make. We even sometimes go to bat for Doctors who host with someone else on long weekends because we can - we do.
