I understand the appeal from a cost perspective, but I work in Healthcare IT, and the constant issues we face from network issues make me extremely reluctant to require internet to be able to do any work at all. Also, from a personal perspective, I prefer buying software once, and not paying a subscription for it forever.
The technical part of me wants to ask: what network issues do you face on a daily basis within the hospital? Are you losing network connectivity? Are apps/services slow to respond?
Don’t forget: if Microsoft owns the software service, they can FORCE you to upgrade - ready or not.
Theoretically, they could fail to renew your subscription if they don’t like you or feel threatened in any way.