In a world where medical practices thrive on efficiency and precision, electronic medical records (EMR) systems play a pivotal role. These systems help healthcare providers manage patient information with ease and accuracy. Some systems focus on small practices, while others cater to larger hospitals. 

Choosing the right EMR system for your needs can help streamline workflow, reduce errors, and improve patient care. With the right tools, medical professionals can focus more on patient outcomes and less on paperwork, creating more efficiency. 

While the term EMR is sometimes used interchangeably with electronic health records (EHR), they're not the same.

Electronic Medical Records and Electronic Health Records

Electronic medical records and electronic health records (EHR) both represent the digital evolution of paper charts. While the terms are often used interchangeably, there is a technical distinction:

  • EMRs are typically used within a single organization, focused on documentation, treatment, and management for patients in that setting.
  • EHRs are designed for interoperability, enabling patient data to be shared securely across different healthcare organizations.

In practice, however, both systems serve as the central repository for patient information and play critical roles in the clinical, financial, and operational life of a practice. They digitize patient histories, medications, allergies, and care plans; reduce errors from lost paperwork or illegible handwriting; and proactively surface critical safety information such as potential drug interactions.

Modern cloud-based EMRs also bring advantages such as integration with other healthcare IT systems, compliance with evolving regulatory standards, and enterprise-grade security—while enabling secure access from any authorized location.

For medical practices considering their options, focusing on the difference between electronic medical records and electronic health records isn’t always the most helpful starting point. What matters more is selecting a system that matches the realities of your practice.

Key considerations include:

  • Clinical needs: How the system supports documentation, decision-making, and patient safety for your specific care model.
  • Operational workflows — The ability to streamline processes, reduce administrative burdens, and integrate with other systems.
  • Financial priorities: Whether the system helps optimize revenue cycles, reduce costs, and improve efficiency.
  • Scalability: How well the platform adapts as your patient population, service lines, or care delivery models evolve.

Regardless of the label, your EMR or EHR will become the central hub for patient data, workflows, and communication across every role in the organization.

Canvas EMR stands out for its customizable workflows, letting clinics tailor features for specific patient populations and operational needs. This flexibility means practices can iterate on the system as their needs grow.

Types of EMR Systems

The landscape of EMRs offers diverse deployment options, each designed to meet the needs of specific healthcare providers.

Modern EMRs fall into four primary categories based on their deployment model. Each type brings unique advantages and considerations that impact how healthcare providers deliver patient care. 

The choice between these systems often depends on factors like practice size, IT resources, budget flexibility, and specific workflow requirements. Here are some of the most common options:

Installed EMR

Installed (also known as on-premise) electronic medical records systems represent the traditional approach to digital health records. These systems live on servers physically located within the medical practice, giving healthcare providers complete control over their patient data and infrastructure.

Some traditional reasons to choose an installed system are:

  • Your patient data never leaves your building, which provides peace of mind for security-conscious practices
  • You control who accesses the servers, when updates happen, and how backups get managed
  • This level of control particularly appeals to larger healthcare organizations with dedicated IT teams who can customize every aspect of the system

Performance stands out as another advantage. Since clinical data doesn't travel over the internet, on-premise systems can deliver lightning-fast response times when clicking through a patient's medical history, pulling up imaging results, or running complex reports. For busy emergency departments or high-volume clinics where seconds matter, this speed makes a real difference in patient care delivery.

However, they’re not perfect, and as most software has moved to the cloud, on-premise medical records are becoming obsolete. Some of the challenges of on-premise hardware include:

  • The upfront costs can make practice administrators wince, as they involve servers, networking equipment, backup systems, and installation fees 
  • Ongoing maintenance requires either in-house IT expertise or expensive service contracts
  • When hardware fails (and it eventually will), the practice bears full responsibility for repairs and replacements
  • Adding new providers or locations means purchasing additional hardware and potentially reconfiguring the entire network
  • Software updates require careful planning to avoid disrupting patient care

Canvas Medical is a cloud-based EMR, which means that it eliminates the infrastructure burden of on-premise systems while offering enterprise-grade security, automatic updates, and the flexibility to scale with a practice’s growth. Unlike traditional cloud solutions that operate on a single shared environment, Canvas provides each customer with their own isolated production and development instances. 

This architecture offers the best of both worlds: the reliability and ease of cloud-based deployment, and the configurability, data control, and testing flexibility that healthcare organizations often seek from installed systems. Customers can safely customize, develop, and test new workflows in a dedicated development environment without affecting live patient care, and deploy updates to their production system on their own schedule. 

This approach supports high performance, rigorous compliance, and tailored clinical workflows—making Canvas particularly well-suited for innovative care delivery organizations that require both agility and stability in their EMR infrastructure.

Application Service Provider EMR

Application Service Provider (ASP) EMR systems occupy a middle ground between traditional on-premise solutions and modern cloud platforms. With ASP models, the software vendor hosts the EMR application on their servers, but each practice gets its own dedicated instance of the software.

Some of the pros of ASP systems are:

  • The vendor handles maintenance, updates, and server management while you get exclusive use of your EMR instance.
  • There are no server rooms to maintain, no hardware to replace, and no complex backup procedures to manage. 
  • Your practice's data remains isolated from other clients, adding an extra layer of security while avoiding slowdowns 
  • Many ASP vendors also offer customization options, allowing practices to modify workflows and interfaces to match specific needs

On the other hand, you may want to consider these points about ASP systems:

  • Internet connectivity becomes critical—if your connection fails, you can't access patient records
  • Response times might lag compared to on-premise systems, especially when dealing with large files like medical images
  • Some practices find that ASP vendors offer less flexibility for deep customization compared to systems they fully control

Using the Canvas platform to customize your EMR is a great approach if you are looking to extend and control clinical workflows, backed by an open core approach and a powerful plugin ecosystem. This extensibility addresses traditional ASP limitations by allowing practices to modify and enhance their systems without sacrificing the benefits of vendor-managed hosting. 

In contrast to conventional ASP models that may restrict how deeply a system can be customized, Canvas is designed from the ground up to be developer-friendly and modular. Each customer operates within their own isolated production and development environments, enabling safe and iterative deployment of custom functionality without disrupting care delivery. Plugins built on the Canvas SDK can deeply integrate with the EMR’s core logic—enabling teams to define bespoke clinical workflows, surface custom decision support, or connect third-party data sources—all while maintaining the stability, security, and scalability of a cloud-native system. 

This architecture empowers care delivery organizations to innovate rapidly and continuously, with full control over their clinical systems, even within a hosted model.

Software as a Service (SaaS) EMR

SaaS EMR represents the modern approach to healthcare technology, operating entirely through web browsers without requiring any local installation. These systems revolutionize how medical practices access and manage patient data.

Here are the upsides of a SaaS EMR:

  • Practices can log in from any device with internet access and immediately have full functionality
  • The economic model of SaaS electronic medical records avoids massive upfront costs in exchange for predictable monthly fees based on usage
  • Updates and improvements integrate seamlessly with SaaS systems as they become available
  • Security in SaaS environments often exceeds what individual practices could achieve as vendors invest millions in state-of-the-art data centers, encryption technologies, and security teams

Again, there are possible downsides to a SaaS system, such as: 

  • Lack of interoperability with other health record systems. Stick to industry standards like HL7 and FHIR from Canvas when choosing this option
  • Scalability may be limited depending on the digital architecture
  • Loss of availability if the host experiences technical issues 

To bridge the gap between traditional SaaS offerings and truly cloud-native systems, some modern EMRs—like Canvas—adopt a hybrid SaaS model that combines the ease of web-based access with robust developer tools, modular architecture, and tenant-level isolation. 

Unlike conventional SaaS platforms that run all customers on a single shared instance, Canvas gives each organization its own production and development environments, enabling safe customization, testing, and deployment of new features. This model allows practices to enjoy the low maintenance, security, and scalability of SaaS, while also unlocking the kind of deep configuration and workflow control typically reserved for on-premise or ASP systems. 

As a result, healthcare organizations can innovate faster, tailor the EMR to their care model, and maintain operational resilience—all within a secure, vendor-managed environment.

Cloud-Based EMR Systems

Cloud-based EMR takes the SaaS concept further by leveraging distributed cloud infrastructure to deliver unprecedented scalability and reliability. These systems represent the cutting edge of healthcare technology deployment.

The distinction between SaaS and cloud-based systems might seem subtle, but it matters. While all SaaS systems use cloud technology, cloud-based EMR specifically architect themselves to maximize cloud benefits. They distribute data across multiple servers and locations, and employ sophisticated load balancing to ensure optimal performance regardless of user volume.

With that said, here are some other reasons to choose a cloud-based system:

  • Scalability becomes virtually limitless with cloud-based systems
  • Processing power scales up during busy periods and down during quiet times, ensuring you only pay for resources you use
  • Modern cloud-based electronic medical records systems connect seamlessly with laboratory systems, imaging centers, pharmacies, and even patient wearables. APIs and standardized protocols like FHIR enable real-time data exchange, creating a comprehensive view of patient health
  • Data recovery is simplified as information is stored across multiple locations 

Canvas EMRs integrate SDK and automation features, supporting deep workflow orchestration and third-party integrations. This allows care delivery organizations to customize clinical logic, surface real-time decision support, and connect external systems directly into the EMR experience. 

By offering isolated production and development environments for each customer, Canvas supports safe iteration and deployment of custom features without disrupting live patient care. This combination of cloud-native infrastructure and extensible architecture empowers teams to innovate rapidly while maintaining stability, security, and compliance.

Benefits of Choosing the Right System 

For medical practices, the real value in selecting an EMR or EHR lies not in the label, but in how well the system meets the specific needs of your care model. The right platform becomes the central hub for patient data, workflows, and communication across the entire organization.

Benefits for Healthcare Professionals

  • Streamlined workflows: Automates routine administrative tasks and reduces time spent on documentation.
  • Integrated decision support: Flags potential drug interactions, surfaces relevant history, and ensures timely access to complete patient information.
  • Customizable workflows: Aligns with specific operational processes, enabling efficiency without forcing rigid templates.
  • Scalable technology: Adapts as service lines grow, care models change, or patient populations shift.

Benefits for Patient Care

  • Improved safety: Reduces errors associated with lost paperwork or illegible handwriting.
  • Coordinated care: Ensures all providers have access to the same up-to-date patient information.
  • Proactive interventions: Supports preventive care by highlighting risk factors and follow-up needs.
  • Better access: Cloud-based systems enable secure access to records from authorized locations, supporting timely care delivery.

Canvas EMR delivers both sets of benefits by combining robust interoperability with customizable, programmable workflows—helping practices optimize clinical, operational, and financial outcomes.

Choose Your EMR Wisely 

Success with any EMR system depends on thoughtful selection, careful implementation, and ongoing optimization. Whether you prioritize complete data control with on-premise systems, appreciate the balance of ASP models, or embrace the flexibility of cloud-based solutions, the goal remains constant: improving patient care through better information management.

Canvas Medical offers a programmable EMR platform that adapts to your unique workflows. With extensive customization options through our SDK and robust FHIR API support, Canvas empowers healthcare organizations to build exactly the EMR experience they need. Contact us today to explore your options. 

Frequently Asked Questions (FAQ)

What types of EMRs are there?

EMR systems can be categorized by deployment type (cloud-based, on-premis), functionality (general, specialty-specific), and setting (ambulatory, acute care).

What are the benefits of a Cloud-based EMR system?

Scalability is a big advantage, as it’s not limited to in-house digital infrastructure. It’s fast, secure, and doesn’t require a big up-front investment.

Why should I upgrade my EMR?

Modern EMRs increase interoperability, can help track patient progress, and speed up routine workflows for medical staff. 

What are the leading EMR system options?

Leading EMRs include both legacy enterprise platforms—such as Epic and Cerner—and modern, API-driven systems like Canvas Medical, which are built for customization, programmable workflows, and automated oversight. 

How long does it take to select and implement?

Selection can take several months, depending on the depth of requirements gathering and vendor evaluation. Implementation timelines range from a few weeks for smaller practices to a year or more for large health systems—particularly when migrating historical data, integrating with third-party systems, and training staff. 

What roles in my organization will be impacted?

Nearly every role interacts with the EMR in some way. Directly affected groups include physicians, nurses, and medical assistants (documentation and clinical workflows), administrative staff (scheduling, billing, reporting), and IT teams (system configuration, security, integrations).