April 5, 2024

EHRs Unveiled: Your Guide to Seamless EHR Software Development

Alena Arsionava

Technology Evangelist

Healthcare

EHRs Unveiled: Your Guide to Seamless EHR Software Development
April 5, 2024

EHRs Unveiled: Your Guide to Seamless EHR Software Development

Alena Arsionava

Technology Evangelist

Healthcare

EHRs Unveiled: Your Guide to Seamless EHR Software Development

Introduction

Electronic Health Records (EHRs) have become indispensable tools for healthcare providers in today's fast-paced landscape. Their value is undeniable. They streamline workflows, enhance patient care, and improve overall efficiency. How do you create EHR software for your organizations? Join us as we unveil the secrets behind seamless EHR software development.

Key Takeaway

  • The benefits of EHR system development are improved patient care, streamlined workflows, enhanced data accessibility, and increased efficiency in healthcare operations.
  • EHR custom software development allows tailoring to your functionality requirements, giving you full control over the end solution. Among its drawbacks — higher initial costs and slower deployment.
  • Commercial EHR solutions offer pre-built features, quick deployment, and included support but lack flexibility in customization and scalability, potentially leading to higher costs over time.
  • Key EHR software requirements include patient record management, clinical documentation, e-prescribing, appointment scheduling, decision support tools, patient portals, reporting, and analytics.
  • The EHR development process involves requirement gathering, design, frontend and backend development, database setup, testing, deployment, and ongoing support. All stages require careful planning and execution.
  • The optimal team structure includes roles like PM, BA, Software Architects, Backend and Frontend Developers, Database Administrators, QA Engineers, DevOps Engineers, UX/UI Designers, and Technical Writers, with the number of specialists varying based on project size and complexity.
  • Starting your EHR development with a trusted Healthcare Software Development Company is key to ensuring the project success.

Now, whether you're a seasoned IT manager in healthcare or more of a business side, we're here to guide you through the process of EHR development step by step.

What is EHR Software?

EHR stands for Electronic Health Record, and the system's goal is pretty self-evident from its name — to record and store patient data electronically. The EHR represents a digital hub that helps both doctors and patients organize and manage data efficiently. More importantly, both parties can access it online whenever needed.

Within the last decade, the market of EHR software has boosted and is projected to reach a market value of $11.3 billion by 2034. As we stand in 2024, EHR software commands an impressive 70% share of the global market, a testament to its widespread adoption.

Factors Driving EHP Software Adoption

  • Government initiatives. Regulations, like the Health Information Technology for Economic and Clinical Health (HITECH) Act in the United States, have incentivized healthcare providers to integrate EHR systems at a large scale. 
  • Remote work. The COVID-19 pandemic has accelerated the development of telemedicine apps for healthcare organizations to deliver patient care remotely. From virtual consultations to remote monitoring devices and digital health apps, patients can now connect with doctors and get a reasonable level of treatment from their homes.
  • Increased access to data. EHRs, along with other health apps initially envisioned to help providers manage and store data, now let you also accumulate and share it on a global scale. It improves the way we treat diseases and the global health level. 

However, perhaps the most significant allure of EHR software lies in its ability to streamline workflows and truly deliver efficiency. 

By digitizing patient records and automating tedious administrative tasks, EHR software banishes paperwork and minimizes errors. The result? A healthcare organization that operates like a well-oiled machine, with productivity increased by times. Specifically:

  • A survey by HIMSS (the Healthcare Information and Management Systems Society) reported that a remarkable 83% of respondents admit EHRs led to increased efficiencies in clinical staff quality performance. 
  • In the same report, 88% of senior IT executives identified at least one positive outcome stemming from EHR implementation — from increased efficiencies to enhanced clinical staff performance.
  • Healthcare providers using EHR systems admit time saving compared to their paper-based counterparts and better document workflows.

Why to Develop an EHR App

EHR software benefits for healthcare organizations: improved patient care, enhanced clinical efficiency, better decision-making, reduced medical errors, increased patient engagement, comprehensive data management, and regulatory compliance.

EHR systems and apps offer myriad benefits to healthcare organizations, providers, and patients, contributing to their growing popularity in today's healthcare delivery.

As a healthcare provider, EHRs empower you by:

  • Facilitating access to evidence-based tools that improve treatment decisions.
  • Automating workflows and reducing manual work to enhance your clinical efficiency.
  • Offering a complete view of a patient's health to improve care and reduce medical errors.
  • Collecting and storing extensive healthcare data, which can be analyzed to identify trends, patterns, and insights that inform clinical decision-making.
  • Transferring health records between healthcare providers or specialists, ensuring continuity of care and reducing the duplication of tests or procedures.
  • Encouraging patients to actively engage in their treatment process by providing access to their health records, educational resources, etc.

For patients, EHR software allows to:

  • Access and manage their health records conveniently from anywhere with an internet connection.
  • Reach out to doctors faster through secure messaging features.
  • Get remote consultations or get clarification about their health conditions.
  • Request and schedule appointments remotely via a platform or app.

Overall, developing an EHR app is a great way to enhance your patient care, improve accessibility and efficiency, and engage patients. It helps you coordinate activities, support clinical decisions and automate processes and daily healthcare routines. Consider it a valuable tool for modern healthcare delivery.

Last but not least, EHR apps help healthcare organizations comply with regulatory requirements like HIPAA. The up-to-date EHR software implements security measures to safeguard patient privacy and ensure the confidentiality, integrity, and availability of health information.

EHR Software: Custom Development vs Commercial App

Should your healthcare organizations opt for EHR software custom development or rely on commercial apps? The answer is — it depends. Let's explore the factors that you need to consider (and do it carefully) before you opt for one of the options.

Custom EHR Software/App 

Going the custom EHR software development route lets you tailor the EHR system to fit the specific needs of your healthcare setting. Whether you’re a local wellness center or established provider with multiple clinics across the country, a custom EHR software will work the way you need. You outline requirements for an EHR Software Development Company and have full control over the process.

A significant pro is that you can prioritize functionalities according to what your organization needs most. This ensures that the final product is exactly what you need and works smoothly within your workflows.

Commercial EHR Software

On the flip side, commercial EHR solutions offer plug-and-play platforms, which you can deploy out of the box. These off-the-shelf software solutions come pre-built with standard features. The market of commercial EHR software is rather competitive, with established players including Quentic, AdvancedMD, Practice Fusion, Epic Systems, to name a few.

With them, you get access to a set of features, often shipped in a bundle, meaning you can’t exclude those that you don’t need. You pay for a subscription or license fee, monthly or yearly.

Things to Keep in Mind When Choosing Between the Two

EHR software: custom vs commercial apps. Custom development has higher costs, high flexibility and extensive customization, high scalability, and extensive integration capabilities. Commercial apps are subscription-based, have limited customization, are quick to deploy, and have limited integration opportunities.
  • Cost: Custom EHR development implies higher initial costs, but in the long run, it pays off. The commercial app subscription binds you lifelong. Eventually, the cost exceeds by times what you would pay for a custom app.
  • Customization: Functionality customization is crucial and often a decisive factor. Commercial EHR makes you pay for features you might not need. With custom development, the EHR feature set and user experience are in your full control.
  • Scalability: Custom solutions can easily adapt to evolving needs and scale alongside your organization. You are free to start with an MVP (basic set of features) and grow it steadily, adding the layers over the course. Commercial EHR apps imply no flexibility — adding custom features or its customization may cost a fortune simply because they already have their monetization model in place and resources planned for product development months ahead. 
  • Deployment time: With commercial apps, deployment is quick and straightforward. You start using the software almost immediately after you purchase it. EHR custom software development takes months of work.
  • Maintenance: Custom EHR software requires ongoing dedicated support resources — a team or an engineer. The issues are always resolved promptly and timely. With commercial software, the support is included, yet it all depends on the vendor. While established players may resolve your problem promptly, at small vendors, issue resolution may take weeks because of the limited in-house team.

EHR Software and Feature Requirements

Key features of EHR software include access to personal data, appointment scheduling, lab results viewing, bill payment, clinical notes, patient profiling, prescription management, decision support tools, etc.

Depending on the complexity of EHR software, the feature choice varies accordingly. Below, we list the most common features of the desktop EHR software suite for doctor-patient, administrative, and financial departments.

Patient Record Management

Patient record management functionality is the very heart of the EHR system. It lets you collect, store, and organize comprehensive patient health information in a single profile. The data includes medical history, medications, allergies, immunizations, and laboratory results. In fact, everything that used to be on paper in patient care flow can be easily transferred to a digital format.

Clinical Documentation

This feature will be helpful to healthcare providers, letting them electronically create, edit, and manage documentation. It includes clinical notes, progress reports, treatment plans, and others.

E-Prescribing

Both doctors and patients appreciate E-prescriptions, which drastically speed up the medication prescription process. You can handle any aspect electronically, e.g., dosage instructions, refill requests, and medication reconciliation. No more back-and-forth visits and time waste — the medication management process is automated and takes a few minutes.

Appointment Scheduling

Most EHR software lets patients schedule appointments directly within the system. This eliminates the need for separate scheduling tools or manual entry of appointment details. The standard functionalities include appointment reminders, cancellations, and rescheduling.

Decision Support Tools

By integrating decision support functionalities, EHR software empowers you to deliver evidence-based care and improve patient treatment. It includes alerts, reminders, drug-drug interaction checks, and clinical guidelines. By relying on software processing millions of data arrays in seconds, you can make informed decisions and avoid medical errors.

Patient Portal

EHR software can be integrated with a patient portal. It allows for convenient access to health records, appointment scheduling, communication with healthcare providers, and participation in health plans.

Telehealth Features

Many EHR software provide text messaging or video chat functionality to streamline communication between patients and doctors. More sophisticated solutions also provide telehealth app functionality, letting patients access different aspects of healthcare on the go.

Mobile App/Access

A part of EHR functionality can be transferred to mobile to make it accessible to more people. It can be a fully functional mobile app or a responsive web interface.

Reporting and Analytics

With EHR software, you can generate reports and analytics on patient outcomes, population health trends, utilization patterns, and quality metrics.

Additional Features

  • Integrations with other healthcare systems, e.g., laboratory information systems (LIS), accounting software 
  • User authentication feature to improve security
  • Role-based access controls to manage permissions and data entry
  • Document templates to streamline the documentation workflows of your organization 

EHR software can be a simple several-step app, or it can be a complex platform with a bunch of functionalities. It can be a simple storage of a patient's medical history or encompass a diverse array of data, including diagnoses, prescribed medications, treatment plans, laboratory test results, and etc. You can store this data securely in one place and share it with the parties you need.

How to Build an EHR System

EHR software development lifecycle: planning, design, development, testing, deployment, maintenance, and support.

EHR system development involves several steps, such as requirement gathering, design (UX, UI), frontend and backend development, database setup, testing, deployment, and the following support. Overall, it's a complex endeavor that requires careful planning, coordination, and execution across various stages of development. Let's see what each step implies in practice:

1. Requirement Gathering & Planning

In the very first step, it's important to document functional and non-functional requirements for your EHR development. Data management, security, interoperability, and user roles should be clearly stated. While the list of features may be pretty extensive, it's important to prioritize them, starting with only essential ones. A feasible option is to consider an MVP and scale over time. 

Based on the feature choice and business requirements, you choose the technology stack. 

Some questions to answer:

  • What are different stakeholders' needs and requirements (clinicians, administrators, IT staff, etc.)?
  • What clinical workflows need to be supported by the EHR system?
  • What data elements need to be captured and stored in the EHR system?
  • What are the security and privacy requirements for protecting patient data?
  • How will the EHR system integrate with existing healthcare systems and devices?
  • What are the budget and timeline constraints for developing and implementing the EHR system?

Before you kick off the development, you need to define clear milestones, deliverables, and timelines to track progress and ensure project accountability.

2. UI/UX Design

Next, working closely with the development team, you create interface drawing mockups to show the workflows, key screens, and the structure of the EHR software. You can iterate on designs based on feedback from end-users and stakeholders to ensure alignment with user needs and expectations.

Like any other healthcare software or app, your solution should target people with different levels of tech-savviness. Therefore, an intuitive user experience is paramount. After all, what good is powerful functionality if users find it cumbersome to navigate? Make simplicity your priority.

3. Frontend and Backend Development

When the primary requirements are in place, you kick off the project and go to the development stage, which includes your EHR system's front and back components.

  • Frontend development: Implement UI designs using frontend technologies like HTML, CSS, and JavaScript. Focus on responsiveness and cross-browser compatibility.
  • Backend development: Develop the backend infrastructure using programming languages like Python, Java, or Node.js, along with frameworks like Django, Spring Boot, or Express.js. Implement features related to data storage, processing, and security.

4. Database Setup and Configuration

The database component stores and manages data, including patient records and system information. Consider selecting a database technology that aligns with your EHR system's scalability, performance, and security requirements. The most common technology choices are SQL (e.g., MySQL, PostgreSQL) or MongoDB.

When adding the database component, you configure database settings, indexes, and access controls to optimize performance and ensure data integrity.

5. Testing and Quality Assurance

Testing of EHR software is essential to ensure its functionality, usability, security, and regulatory compliance. Depending on the complexity of your EHR application, the testing may include a single QA specialist to detect bugs or extend to a separate team that creates comprehensive test cases covering functional, integration, performance, and security testing scenarios.

The goal of this stage is to identify bugs, vulnerabilities, and fix them.

6. Deployment and Initial Setup

The deployment and initial setup of the EHR software is where you integrate with other healthcare systems, test interfaces, and ensure interoperability. Once you go live, you monitor EHR software performance and manage organizational change.

7. Support

Typically, support for EHR software is handled through a dedicated QA team or specialist who will address technical issues reported by users and offer guidance and assistance in navigating the software.

Conduct routine maintenance tasks such as software updates, patches, and system optimizations to ensure your EHR software's stability, security, and performance. Dedicated support specialists will also ensure this.

EHR System Development: Technology Stack

The technology stack for EHR development can vary significantly based on its type, complexity, deployment environment, and others. Here’s a table summary listing its key technologies and layers.

The EHR software development stack includes various options for frontend, backend, database, cloud platforms, APIs, security, DevOps, testing, and monitoring.
  • Web-based EHR: Utilizes frontend development technologies like HTML, CSS, and JavaScript for the user interface. Backend development may involve languages such as Java, Python, or .NET. Server-side scripting languages like PHP or Node.js may be used for dynamic web page generation.
  • Mobile EHR App: Standard mobile app technologies like Swift (iOS), Kotlin (Android), React Native, or Flutter for frontend development. Backend technologies may resemble web-based EHRs but are optimized for mobile platforms.
  • Simple EHR Development utilizes standard frontend frameworks like Bootstrap or UIKit. Backend technologies may include Express.js (Node.js) or Spring Boot (Java).
  • Complex EHR Development requires an extensive technology stack to support advanced features. They may involve additional components like message brokers (e.g., RabbitMQ, Kafka), data warehouses (e.g., Amazon Redshift, Google BigQuery), and advanced security measures.

In addition, you may consider third-party integrations to enhance your EHR system/app's functionality. Developing it from scratch is like reinventing the wheel so you can power your software by integrating other ready-made systems. Third-party Integrations 

  • LIS Integration to receive and store lab results directly.
  • RIS Integration to access radiology reports and images.
  • Billing System Integration to capture patient encounters for accurate billing.
  • HIE Integration to exchange patient records across healthcare networks.
  • Medical Device Integration to receive data from monitoring devices for remote tracking.

Development Team StructureA well-rounded team is crucial if you’re considering a software development project for healthcare. Here's a breakdown of the common roles and responsibilities within the team, along with the approximate number of specialists needed for each role:

  • Project Manager (1): This person oversees the entire EHR software development project, plans, schedules, and budget resources and is the primary contact between stakeholders and the development team.
  • Business Analyst (1): This person gathers requirements from stakeholders and translates them into functional specifications.
  • Software Architects (1-2): Design the overall architecture and technical solutions for the EHR software.
  • Backend Developers (2-4): Develop server-side logic, databases, and APIs.
  • Frontend Developers (2-4): Design and develop the user interface and user experience of the EHR software.
  • Database Administrators (1-2): Manage the database infrastructure, including design, optimization, and security.
  • QA Engineers (2-3): Test the EHR software to identify defects and usability issues. Develop test cases and perform manual and automated testing.
  • DevOps Engineer (1): Implement and maintain the CI/CD pipeline for the EHR development.
  • Security Specialists (1-2): Assess and mitigate security risks in the EHR software. Implement security controls and compliance measures.
  • UX, UI Designers (1-2): Design intuitive and user-friendly interfaces for the EHR software. Create wireframes and prototypes.
  • Technical Writers (1): Create documentation, user manuals, and training materials for the EHR software.

The number of specialists needed for each role may vary based on factors such as the size and complexity of the EHR software project, organizational requirements, and project priorities. Some of these roles are optional and can be blended if you start with a simple EHR app or its MVP.

The EHR software development team includes specialists such as front-end and back-end developers, designers, project managers, product owners, integration specialists, and QA engineers.

EHR Custom Software Development Cost

The cost for an EHR software solution depends on the development destination, the feature set, complexity, platform choice, and other requirements. Development rates in the chosen outsourcing destination is a primary factor determining the final cost. While Eastern Europe typically offers lower development rates than Western Europe, both regions have highly skilled developers capable of delivering quality EHR solutions. 

Basic EHR Solution Example

Basic EHR system development for a small clinic with a mobile app for appointment scheduling, patient records access and medication reminders. Developing this app in Eastern Europe may cost from $60,000 to $90,000, while in Western Europe, it could be from $90,000 to $120,000. 

Advanced EHR Solution Example

Suppose you’re considering a complex solution, like an enterprise-level EHR system with advanced functionalities like real-time patient monitoring or integration with medical devices. In that case, the development cost will increase respectively. It may cost around $250,000 to $350,000 in Eastern Europe, while in Western Europe, it could range from $400,000 to $500,000.

Cost Breakdown

Different components of the EHR system development generally compound the core budget or may be outsourced to multiple vendors to reduce the overall project cost. 

  • Project management: core budget/client’s side
  • Development (Web): core budget
  • Development (Mobile App): estimated separately
  • Testing/QA (Web and Mobile App): core budget / may be outsourced to reduce cost
  • Deployment and Initial Setup: core budget
  • Design (Web and Mobile App): may be outsourced to reduce cost 

Final Thoughts

EHR software development is a journey filled with challenges and opportunities. You can unlock success in this rapidly evolving landscape by prioritizing compliance and security, embracing interoperability, crafting exceptional user experiences, and future-proofing your solution. 

EHR software digitizes clinical workflows, simplifying charting, documentation, and prescription management tasks. This automation not only reduces paperwork but also boosts efficiency, allowing healthcare providers to focus on what truly matters — delivering top-notch patient care.

FAQ

What are the most critical stages in EHR development?

The most critical stages in EHR development are the first stages of planning, requirement analysis and team assemblement. These early stages lay the foundation for the entire EHR development process. Consider choosing a reliable EHR Software Development Company to start your project and lead it to success.

What laws regulate electronic health record systems?

In the US, electronic health record system development is regulated by laws such as the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act. In Europe, regulations like the General Data Protection Regulation (GDPR) and the European Union's Medical Device Regulation (MDR) govern EHR system development.

What are the types of electronic health records software?

Among the types of electronic health records software, you can consider web-based EHR systems, mobile EHR apps, simple EHR and enterprise solutions.

  • Web-based EHR can be accessed from any internet-enabled device.
  • Mobile EHR apps cater to the increasing demand for on-the-go access, allowing healthcare professionals to access patient information from their smartphones or tablets.
  • Simple EHR systems are designed for smaller practices or organizations with basic requirements.
  • Complex EHR systems are equipped with advanced functionalities and capabilities, suitable for larger healthcare facilities or institutions with intricate workflows.

What is the difference between EHR and EMR?

Electronic Health Records (EHR) encompass comprehensive patient health information from multiple healthcare providers, whereas Electronic Medical Records (EMR) contain records from a single healthcare provider's practice.