Looking to the Cloud Is Not the Best for All Practices

As some of you may know, I have a presence on many dental social media sites where I am happy to answer questions that are posed to me. One of the most frequent questions I get is about whether dentists should switch to a cloud or web-based practice management software, or continue with the more traditional model, which is called client-server. It’s never a bad idea to revisit such a popular question that practices have.

In a nutshell, in most cases, I do not recommend switching to a cloud-based practice management software for most dental practices. There are some situations, like multilocation practices and dental service organizations (DSOs), where it makes perfect sense, but for solo or small group offices, it usually is difficult to justify. There are a few reasons why this is my best recommendation:

1. Cost savings, or better, lack thereof. Many cloud vendors will claim that offices can save a lot by moving to a web-based solution, but in my experience, this is almost never true. Most cloud-based dental software averages around $500 to $700 a month by the time you add in the subscription, extra modules, support, etc. Compare that with the average client-server software, which is typically around $100 to $150 per month for support. In a given year, you’d spend $5000 to $6000 more for cloud software, and that repeats itself every year. The assumed hardware savings don’t exist.

2. Speaking of hardware, this is one of my pet peeves with cloud software companies—their claims that since your data is in the cloud, you don’t need a server, backup, antivirus software, firewalls, or any Health Insurance Portability and Accountability Act (HIPAA) compliance. Nonsense. While it’s true that a lot of your patient data would reside in the cloud, in almost all cases, not all of it does. Consider images, emails, Word documents, spreadsheets, Invisalign, QuickBooks…you get the idea. All that data is electronic protected health information, meaning you need to log access, back it up, encrypt it…all of which requires a server. And if you have digital x-ray sensors, then you can’t get by with cheap dumb terminals for computers. To work efficiently, you need pretty much the same specs you’d need if you were using a client-server configuration.

3. While cloud vendors often talk about their software as some sort of complicated, fancy system that mere mortals can’t possibly understand, that’s not the case. Here’s another definition of the cloud: “somebody else’s server.” That’s really all it is; you’re just hosting your data on another company’s server and accessing that data through a web browser. And, that’s the next issue for many practices: What happens if that connection goes down? We all dream of 100% internet uptime, but the reality is that most dental offices suffer regular outages lasting minutes or hours. And, you guessed it, if your internet is down, then so are you: no access to your schedule, treatment plans, past treatment; you’re dead in the water. I always recommend that practices using a cloud software system have a backup internet provider.

As I mentioned, the cloud is usually a better option for larger practices with multiple locations; remote access software and virtual private networks (VPNs) are challenging to set up and maintain. But, for the majority of solo and small group practices, there are not, in my opinion, enough compelling reasons to switch to the cloud for most dentists.