Web-based vs traditional desktop app

There are 2 ways (or more) to go about buying software - and this isn't just for OD EMRs.  Web-based and traditional desktop applications.  Remember when we all used to use Outlook or Eudora to get email?  We had to download this software, install it and then configure it to download our emails.  The program would download our emails onto our hard drives so we could then view them and reply.  Nowadays, most of us use a free web-based application such as Hotmail - or my favorite, Gmail.  These web pages are actually complex programs that you download every time you log into them.  They load into your computer's memory and you are always up-to-date and connected... there is no chance of you losing your emails because of a hardware failure.

Definitions:

Web-based app: an application that is run from an off-site location.  The application is downloaded as a whole every time you log into it.

Desktop app: the software is installed and maintained on on your local network.

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	Web-based	Traditional Desktop Install
Requires a "startup" fee.
Requires monthly "access fees" - which will never stop as long as you use software
Requires yearly "upkeep fees" which may or may not stop*
Must buy computers for each area you need software
Does not require installation
Does not require manual updating - updated automatically when you open prorgam
Does not require user to backup nightly
Work from anywhere. Check schedule from home.**
Does not require server purchase (saves ~$3500-$8000)
Does not require complex internal network with special permissions
Connects more easily to your other instruments and databases (e.g., photos)***

*There are some companies out there that will sell you their software outright with no strings attached. This means that unless you require an update, it is your's to own forever. Most however, require you to pay them for support (even if you do not use it) and then they give you free updates and support.

**This is a feature of virtually any software (not just web-based) as long as you use a 3rd party program such as "PC Anywhere" or the popular "GoTo My PC". It'll be slower than the web-based option, but still "doable".

***Desktop applications have a major advantage in this arena... they have access to your internal network very easily. For security purposes, your browser-based program does not have the ability to search your network or reach into other computers. This can still be done, however, but with "plugins" that you install and give special permissions. Not every web-based vendor has this capability yet.

As you can see there are a lot of positives for the web-based option.. There are some drawbacks to this method, however. I'm sure by now you've said to yourself, "but, what happens when you lose your internet?". Well, "hopefully that will never happen" so the saying goes. Internet up-times are a lot better now than even 2 years ago. With DSL, cable, and now FIOS, it's easier than ever to maintain a constant connection. The problem you need to watch out for isn't your connection - it's your vendor's.

These programs run on a server which is a complex computer somewhere in a far away place. It too can suffer from the same pitfalls as your desktop with bad drives, faulty memory, etc. You just hope your vendor has thought of this and is using redundant everything - hard disks, motherboards, networking, backup domains, etc, etc. Even so, there may be times when you're ready to work and you'll see a "Sorry, we hope to be back online ina a few minutes." Then what?? Grab a paper chart, do your exams and then scan them later - that's what I'd do. Dont' wait for anyone to come back online. If you\'re thinking about going the -web-based route, be sure and ask about their "up-time".