2Trusting the Service Provider
3Not Knowing Where Data Is Stored
4Not Knowing Exactly Who Has Access
Check the service-level agreement very carefully: Who exactly will have access to your records? Caregivers, cloud IT personnel, hospital administrators, security staff – the list may be longer then you realize. “You would hope that it’s not personally identifiable data, but you’re never sure,” Bertman said.
5Cloud Service Companies Can Change or Disappear
As is true for any cloud service, cloud storage is a business that can change at any time. In 2001, GE Healthcare bought health records provider Encounter EHR and eventually ended up shutting it down – giving records holders 30 days’ notice to reclaim their data or lose it. This caused a great number of problems. This is a rare occurrence, however.
6Cloud Medical Record Storage Is Not Cheap
7Privacy Rights Not Readily Understood
Companies hosting the cloud services control, and thus can monitor, data and communications at will. How much of your health care information should be seen by you and your health care provider only? This information is buried in legal verbiage and is often easily overlooked or misunderstood by caregivers and patients.
8Ad-Based Cloud Services Present New Issues
To help save their own costs, many physicians are using a free-of-charge cloud EHR system called Practice Fusion that provides pharmaceutical ads to the physician at the point of care. “This is a little bit of a slippery slope,” Bertman said. “For example, a doctor may see an ad for Prilosec while he’s seeing a patient for heartburn.” Because such ads are targeted, tracked and carefully monitored, the question is whether a cloud-based EHR compromises patient privacy as well as the quality of care.
9Inherent Slowness of Web-Based Systems Cause Problems
On most EHR setups, every click takes you to a new screen, thus documenting even simple notes can take dozens of screens, Bertman said. Because they are often so slow-moving, many users of these cloud-based EHRs can’t finish a note while seeing the patient. “If you’re seeing 25 patients a day, which is an average, and the system is slow, it can be impossible to finish documentation,” Bertman said.
10EHR Cloud Services Are Subject to Poor Internet Service Quality
With a cloud-based service package, just like any other cloud service, the Internet is the thoroughfare and it is subject to service outages, power outages, acts of God and other uncontrollable events. Physicians need to have their charts in front of them at all times; if the patient’s chart is not available because the ISP is down, then patient care could be compromised.
11Cloud EHR Systems Are Prime Targets for Hackers
Because of the sensitive health, and in many cases, financial, information in this data, cloud-based EHRs are much bigger targets for hacker attacks from around the globe.