Cloud based practice management software is now the default rather than a choice, so the useful question is not whether but what changes when the record leaves the machine under the desk. Three things do: where the data lives, who can reach it, and what happens when the internet does not. This page is those three, and the figures that make the decision concrete. On the worked example the practice keeps 3,036 notes a year for clients whose records it must be able to produce on request.
Where the data lives, and who is the controller
You remain the controller of your clients' records; the supplier is your processor. Ask where the data is stored, who can access it in support, and what the contract says about sub-processors. Get the answers in writing before the trial, not after the migration, because they are the answers a regulator asks about.
Who can reach it, and how you would know
Two-factor authentication for every user, a per-clinician view so a caseload is not the whole practice, and an audit trail showing who opened a file. On a three-clinician practice these look like overkill until the week somebody leaves, and then they are the only evidence you have.
What happens when the connection does not
Ask what a clinician can do offline and how the practice would run for a day without the internet. A printed day list is not a sophisticated answer and it is the one most practices actually rely on, which is worth knowing before it is needed rather than during.
Questions people ask about cloud based practice management software
Is the cloud safe for clinical records?
It is what almost every practice now uses. Safety is a function of access control, encryption and your own password practice more than of where the server sits.
What about backups?
Ask how often, how far back, and how you would get a copy yourself. A backup you cannot request is a promise rather than a control.
Can we self-host instead?
Very few small practices should. The maintenance and patching burden is real and it lands on whoever in the practice is least busy, which is nobody.