Home Forums Discussions General Discussion AC in the cloud vs. server based

Hi,

Opening a second site. Have issues deciding what to do. Can someone give me pros and cons of AC in the cloud (who actually uses/used both cloud and local).

Have used logmein from 2nd site to 1rst site server with some connectivity issues and thinking about changing.

Thx

We have administered local AC servers for over 10 years, and we are the ones who who started providing a hosted environment for AC almost 7 years ago.

Since you need one AC DB to support multiple locations, here is the short & sweet.

The positives of running local servers are:
<> You have direct control of the hardware, software, infrastructure and network
<> Potentially lower direct costs

The positives of outsourcing (with us or another non-AC third party)
<> You choose what version you want to run
<> More responsive, more available support, including nights and weekends
<> You don't have to implement, manage and maintain the hardware, software, infrastructure and network
<> Support experts that know AC and can also solve other problems
<> More time to see patients or live life - you choose

Since you are going to be dependent on Internet-based connectivity to keep both locations on the same DB, it becomes a question of whether what it will cost you per month can be made back with greater efficiency and/or the quality of life of not doing all of your hardware, software, infrastructure, and network.

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.

Another advantage of a local AC server is being logged in on multiple workstations (in my office plus a few exam rooms) at the same time. I realize I could carry around an ultrabook, but I can't type well and Dragon needs major CPU muscle to run well.

I don't know whether multiple logins are possible with cloud AC or third party solutions, but that (plus the per login monthly cost) are big considerations for me.

We offer the practice the option of multiple logins on the same account, as they only pay for the connections that they use. So, that is entirely possible and we help the practice figure out what is best for their practice.

Indy, what is the price for the Cloud base storage? What is the size of the storage? Is it easy to switch from a server based AC to a cloud based AC?

I've sent you a Private Message so that you can reach me to discuss your specific situation if you so desire.

Storage is not really the performance constraint; I summarized in replying to your post what drives performance.

My biggest concern would be speed and the user feel. I really don't like Updox in the cloud, the web app as it's just not as easy to use as the desktop version. It's not as fast or responsive. Who has used both, and how do they "feel" in comparison?

I have used both desktop and cloud versions of Updox, and prefer the cloud version. I really like to hover the cursor over the document without clicking to enlarge the document. Makes it much easier to read and find the place to sign with minimal clicks. My nurse who does most of the heavy lifting with document management however prefers the desktop version of Updox. I do very little with Updox other than look and sign, and she sends it where it needs to go.

I wonder if going to the cloud would stop AC from crashing when I try to write a script or an order - happens about once a day, or any of a number of other bugs we've suffered with over the years.

Do you folks using the cloud get software crashes?

Chris,
I have not had an issue with AC crashing. Once in a while but not on a daily basis, maybe once or twice a week, I get the eternal drug interaction checker go on and on and on, then after about 20 seconds, a box comes up and says unable to perform drug interaction. But this may be more to do with New Crop and not AC. Not sure what the cause is, but I can still e-scribe without a problem, just a bit of a delay. AC in the Cloud works quite well.

Not to hijack, but Jim, out of curiousity... do you look at the drug interaction checker when you prescribe? I find that it gives so many potential interactions that I rarely look at it, and have thought about turning it off.

I do quite a bit, and I have quite a few patients ask about drug interactions, so I show them on the wall mounted large screens in each exam room and explain to them that I ignore the mild, moderate warnings, but if there is a major we talk about it and decide how to proceed.

Ok, that makes sense. While I am concerned about interactions, the issue I face is that a patient is referred for a consult and they are already on 8 medications. Before I even prescribe ranitidine or a bowel prep, the interaction checker lists 6 or 8 issues.
Anyway, probably a topic for another thread.

Do you think it is the interaction checker that is causing the crashing when opening the script writer?

It sure seems like it, but I am not sure. I have not tried turning off the interaction checker.