Data sensitivity
PHI, attorney privilege, trade secrets. The most decisive criterion for healthcare and legal.
Decision framework
Which AI stack for my practice?
Three options. Ten weighted criteria. A scoring matrix you can run in fifteen minutes that turns the question into a number you can defend in a partner meeting.
The three options
Pick a column to score against.
Option A
Cloud SaaS
A vendor hosted AI tool you log into. Per seat pricing. Fast setup. Limited customization. Best for non sensitive workflows on short time horizons.
Option B
Cloud API + custom UI
A model from Anthropic, OpenAI, or Google, accessed via API, with a custom interface built around your workflow. BAA available with major providers. Middle ground on cost and customization.
Option C
Local LLM + custom UI
An open weights model running on your hardware or private VPC. Highest data sovereignty. Highest customization. Highest internal expertise required. Best for long horizons with sensitive data.
The ten criteria
Each one weighted by importance.
Weight 5
Per month cost at year 2
Project to your team size in 24 months and compare. Day one cost is misleading.
Setup time to first use
Cloud SaaS is fastest, local LLM is slowest. Matters more for short pilots.
Customization to your workflow
How easily can the tool match your real process. Cloud SaaS is least flexible.
Vendor lock in risk
How much pain if you need to switch in three years.
Compliance audit difficulty
How easy it is to prove compliance to auditors.
Internal expertise required
Cloud SaaS needs the least technical staff. Local needs the most.
Data sovereignty
Where the data is allowed to live geographically and legally.
Reliability during outages
Local works offline. Cloud does not. Matters for some clinical workflows.
5 year total cost of ownership
Including switching costs and migration estimates. The deciding criterion for long horizons.
Run it yourself
The scoring spreadsheet.
CSV with formulas built in.
Open in any spreadsheet tool. Adjust the weights for your situation. Score each option against your real environment. The total row computes automatically. No email gate.
Download the scoring matrix (.csv)How ByteWorthy uses this
We score this with every client.
We run this matrix in 01-architecture for every engagement. The weights shift by vertical. Healthcare practices weight data sensitivity at 5 and reliability during outages at 5. Real estate teams weight setup time at 5 and per month cost at 4.
The total tells you the option to default toward. The qualitative judgment after the math is where we earn our fee.