We have 4 locations with 3 surgeons and changed to Cloud base 4 years ago when we added our 3rd location. It made things so much easier with fluidity. We used to experience the server going down all the time before cloud. On occasion the server for Cloud might go down, but they seem to have worked out a lot of that. The only issue I have seen as of late is that sometimes our images down upload to the cloud, but we have a means to push them up so another location can see them. Viewing images at other offices was one hurdle we eliminated by going to the cloud.