Do we still need a server?

The honest version of this answer, because it is frequently oversold in both directions.

You probably still need one if: your imaging software requires a local server, which many still do; you have a CT generating large studies that need to be fast to open; your practice management is an on premise version and you are not ready to move it; or you have equipment with software that only works on a local network. In a lot of practices, imaging alone settles it.

You probably do not if: your practice management is already cloud or hosted, your imaging is cloud capable or the vendor supports a cloud path for your specific sensors, and nothing else in the building needs a local machine to talk to. That shape of practice exists now and it did not really five years ago.

What actually changes when the server goes away: no hardware to replace every five or six years, no server operating system to patch, and one fewer thing that fails on a Monday morning. What replaces it is a hard dependency on your internet connection, which then needs to be good and needs a backup path. You are trading one risk for a different one rather than eliminating risk, and for most practices it is a favorable trade.

What does not change either way: you need backup, and you need it verified. A cloud practice still loses data to deletion, corruption and compromised accounts, and the vendor protecting their infrastructure is not the same as you having a recoverable copy.

If your server is approaching end of life, that is the natural moment to ask this question properly rather than reflexively buying another one. Give us the model and age of your server and the specifics of your imaging setup, and we will tell you which of the two situations above you are actually in. It is a short conversation and it occasionally saves a significant purchase.