Every clinic and pharmacy that talks to us asks the same question early on: should we self‑host this or run it in the cloud? The honest answer is that it depends on four things — and not on what most blog posts tell you.
1. Where does the data have to live?
Some regulators (and many institutional buyers) require patient data to remain within national borders. If that applies to you, your cloud options narrow to providers with a regional data centre or a self‑hosted setup on premises.
2. How reliable is your power and internet?
If your branch loses power for hours at a time, a fully cloud‑hosted system means staff cannot dispense, bill or reconcile during the outage. A local‑first design — small server on premises, data syncing to the cloud when connectivity returns — keeps the lights on.
3. Who pays the monthly bill, and for how long?
Cloud is operating expense. Self‑hosting is capital up front, lower monthly. Over five years, well‑run self‑hosted setups often cost 30–50% less. But they require someone competent to look after them.
4. How much does an hour of downtime cost you?
If a downed system means turning patients away, the answer is more than you think. Both cloud and self‑hosted setups can be made highly available — but only if you actually pay for it. Cheap cloud is no more reliable than cheap on‑prem.
How we choose
For a single‑branch pharmacy with stable utilities: cloud, almost always. For a multi‑branch hospital with patchy connectivity at outlying sites: hybrid — local‑first at the branches, sync to a central cloud for reporting. For a public health institution bound by data‑residency rules: dedicated, monitored on‑prem, with off‑site encrypted backups.
There’s no universal answer — only the right answer for your numbers. Talk to us if you want help working through yours.