So much of what we do nowadays, we can accomplish online—from tax preparation and banking to movie watching and shopping. It’s no wonder that so many electronic medical record (EMR) systems—tools that allow medical providers to digitally document, schedule, and bill—are accessible online, too. Of course, these EMRs aren’t all the same. Most do not take into account the workflow or treatment style specific to physical therapy. Beyond that, some aren’t even truly “online.” That’s right, there are server-based EMRs out there masquerading as web-based applications by calling themselves “web-enabled.” Don’t be fooled; here’s why you should skip the tricksters and go for the real deal:

True Web-Based

In a cloud- or web-based system, the EMR stores your clinic’s data—which can include anything from patient records to appointment schedules—within secure data centers. You can then access that data online using any web-enabled device with an Internet connection. You don’t store your data on internal hardware (e.g., the computers at your practice). Instead, you access your EMR—and all of the information it contains—via your web browser (e.g., Google Chrome, Mozilla Firefox, or Internet Explorer). With that kind of flexibility, you can document, schedule, and bill from anywhere, at any time. And many web-based EMRs charge month-by-month and do not have contracts—making them a very affordable option.


In contrast, server-based systems require your practice to store all its data as well as the EMR software itself. This means you need a server, corresponding hardware, and quite possibly an IT person or staff simply to maintain everything. It also means that you can only access the EMR from the computers on which it’s installed. To offset the costs associated with producing and supporting such expensive equipment and software, server-based companies use long-term contracts to ensure returns on their investments. Frequently, they also tack on maintenance and support charges, which ups the upfront expense and long-term cost burden on your end.


In an attempt to compete with the web-based EMRs hitting the market, many server-based systems have developed “web-enabled” versions. With these pseudo-cloud options, you still have to install software on your computer, and your computer still does all the processing. However, at certain intervals, the software will connect to the Internet to sync your account and data to the cloud. So even though your access is a bit more flexible, your EMR and its data does not update online in real time. Furthermore, such software may require you to manually sync the software with the web. Not only is this process tedious and time-consuming, but also your practice will still need the aforementioned hardware, servers, and IT staff.

Why You Want the Real Deal

At the end of the day, web-enabled EMRs are basically just as clunky as their server-based predecessors as they often require additional hardware, servers, and IT resources. Talk about cumbersome. Plus, business in the modern world is inextricably tied to Internet capability. Workers in every sector—health care included—have come to expect the convenience of anytime, anywhere access to their files. And they want all that data in real time. Web-enabled simply can’t provide that.

Furthermore, if you have multiple clinics or different therapists accessing records simultaneously, you run the risk of individuals accessing or altering data that’s not current. When the EMR connects to the Internet to sync, someone’s entries might replace someone else’s work depending on timestamps. I hate when someone accidentally saves over work I’m doing in a shared file, and I’m just writing blog articles. Imagine if it were a patient’s record! Another drawback of web-enabled: you must download and install web-enabled software, meaning it resides only on the computer to which it’s installed and you can only access it from that computer. Talk about chained to your office. 

When you go with web-enabled rather than true web-based, you also must deal with the security drawbacks of server-based systems. Storing data on local servers, like the computer under your front desk, is just about as secure as keeping your money under a mattress; there’s no failsafe. True web-based systems, on the other hand, provide top-notch security features like unique password-protected access, bank-level security encryption, and automatic data backups. And the best web-based EMR vendors keep your data in a secure, defensible facility with 24/7 surveillance.

Because web-based EMRs undergo regular updates, they can easily integrate new compliance measures as they’re introduced. Built-in alerts ensure you always document completely, correctly, and defensibly.

Another reason to go web-based: the trust factor. Server-based EMR systems never manage your data. You do, because the data is stored locally, like on that server under your desk. So, when server-based systems switch to web-enabled, they’re essentially entering uncharted territory. That’s an issue. It takes a particular skillset to not only develop an application, but securely and compliantly manage the data associated with it. You want to go with the people who are the experts and have been managing data all along. Patient medical records are too important to trust with the inexperienced.

Lastly, true web-based EMRs are more cost-effective over the lifetime of the service than web-enabled EMRs because they feature low, month-to-month, per user costs. Web-enabled EMRs either offer the pricing structures of their server-based forebearers (contracts, hefty upfront investments, maintenance fees, etc.) or employ cost-per-chart pricing. You’re focused on growing your business, but that’s tough to do in a per-chart pricing structure where you pay more money for every patient that you add. In my book, your EMR should work for you and your business, not the other way around.

How to Avoid Getting Tricked by Web-Enabled

The value of EMR is pretty clear—as it relates not only to your business’s bottom line, but also to the quality of care delivered to your patients. Now it’s imperative that you choose a true web-based system by asking the following questions:

  1. Do I need to download anything? (With a true web-based system, you don’t need to download anything.)
  2. Do I need to install anything? (With a true web-based system, you don’t need to install anything.)
  3. Does your EMR need to sync with the Internet occasionally to update my online data? (A true web-based EMR is always functioning in real time.)
  4. Will I need to store any data locally? (With a true web-based EMR, you needn’t store any data on your computer.)
  5. When it’s time to document, how do I open the EMR? (You access a true web-based EMR simply by opening your web browser, going to the service’s website, and logging in.)

Your documentation is important. It’s how you demonstrate your expertise and value; it’s also how you prove that the services you provide are beneficial and necessary. That’s why you should choose an EMR worthy of you and the great work that you do. For that reason, go with a physical therapy-specific, cost-per-month, web-based EMR. It’s secure, mobile, and compliant; it’s quick to adapt and update; and it’s super easy to use. Most importantly, it is what it says it is. If an EMR vendor isn’t truthful about how its product actually operates, what else is the company hiding? Your EMR should be a reliable, honest business partner, dedicated to helping you achieve greatness in practice. Don’t settle for an EMR that provides you with anything less.