June 18, 2024

The Journey of EMR Software Development — How To Guide

Elena Pashkovskaya

Technical copywriter


EMR Software Development: How to Guide

Elena Pashkovskaya

Technical copywriter


EMR Software Development: How to Guide

Medical records have a long history, from the ancient world through medieval times to formal medical records of the 19th century. All that time, the idea that information about a patient's health is important and can improve diagnostics and treatment was in the air. 20th-century technological advancements have shifted how medical records are created, stored, and used — that is how electronic medical records development emerged.

In this article, you'll learn and understand the value of EMR for healthcare, how it differs from EHR, its advantages, challenges, and development steps.

Key Takeaways

  • EMR differs from EHR by the scope of use and interoperability. EMR is used within one healthcare provider and contains less data than EHR, which can be used by multiple care providers who can contribute to patient records and keep them updated.
  • By type, EMRs can be web or mobile, cloud or on-premise, custom or ready-made. Additionally, personal health records help patients track their health information, control medication appointments, and store test results.
  • EMP benefits healthcare organizations by increasing care quality and facilitating patient data management. The main challenge of EMR software development is the inability to create one-size-fits-all solutions due to the variety of healthcare providers and their different needs.
  • If you want to develop a custom EMR solution that will perfectly reflect your organization's workflow, you will need a reliable EMR software development company. Consider NEKLO to achieve the highest level of industry compliance and top usability.

How does EMR differ from EHR?

Electronic medical records (EMR) and electronic health records (EHR) sound quite familiar and for a good reason. The core idea is the same: collecting and storing patients' electronic health data, such as lab test results, prescriptions, and diagnoses, in one place. The modern no-paper patient's chart, putting it simple.

At the same time, the difference between them lies in the scope of use. EMR software is mostly used by a single healthcare organization or practice, meaning the data cannot be electronically transferred to another care provider. EHR systems allow this interoperability, enabling different healthcare providers to access a patient's history. They also contain more information, which may include billing and insurance data.

Nowadays, the terms EMR and EHR are often used interchangeably. Despite some differences, they both play an important role in healthcare. EMR or EHR software development optimizes workflow, facilitates data management, and access for doctors and other authorized healthcare personnel.

EMR Types

Let's examine the most common classifications of EMR software to better understand their functioning and distinctions.

EMR software development types of apps

Web-based vs Mobile

Web-based EMRs are convenient to use from the desktop, but thanks to their responsiveness, they are also available from browsers on mobile devices. While mobile apps often display less due to screen size and ease of use, web-based EMRs are more convenient for complex data input.

Web EMR software development is more cost-effective and faster than mobile EMR apps. Nevertheless, EMRs tailored for smartphones and tablets do not bind professionals to the desktop and are available on the go.

With the growing popularity of mobile use, the common sense is to develop web-based apps or combine them with mobile EMR app development.

Cloud vs On-Premise

Cloud EMR means that all patient data is stored and managed on a remote server via an Internet connection. This approach allows easy data access from any location, no need for an advanced on-premise environment, and automatic updates.

On the other hand, cloud solutions mean a certain level of dependency on the cloud server provider's work and Internet connection quality — you can lose access to the data if issues with cloud servers emerge. Security is another concern for cloud storage.

On-premise EMR servers are placed directly in healthcare organizations, ensuring you have complete control over the software and hardware.

Custom VS Off-the-Shelf EMR Software

The EMR software market offers ready-made solutions for every practice size and budget. It might be suitable for many healthcare organizations, but careful consideration is required.

Off-the-shelf EMR software can sometimes be hard to customize, and the features and workflows included cannot be changed from your side. The good thing is that the provider is responsible for the product's maintenance and support.

Custom EMR software development requires significant initial investments but pays its own way in the long run. Custom EMR is a product that is tailored to your healthcare organization's needs and is in your full control. There are no extra features or monthly payments — only tailored functionality, seamless integrations, and personalization. Nevertheless, the product's support and security updates become your responsibility, and it is better to have a professional team to cope with it.

Benefits of EMR Software Development

Custom EMR software development can be rewarding in many ways. From removing the need for physical storage of patient charts to significantly reducing medical errors, there are a whole host of reasons for accolades.

Increased efficiency

There is no longer a need to turn over the pages of a patient's medical chart. Electronic records provide doctors with full patient information and include navigation and search options, saving time for better treatment. Moreover, EMRs eliminate the possibility of misreading handwritten notes or misplaced paper charts.

Better patient's care

EMR improves records accuracy, data accessibility, and healthcare statistics, allowing healthcare organizations to provide better care for patients. With a comprehensive medical history, doctors can identify patterns and trends that might not be obvious from paper records.

Optimized cost

Keeping records in one place reduces operational costs caused by overtime labor and medical transcription services. EMRs can also automate many billing and coding tasks, prevent duplicate services, and free up valuable time for doctors and nurses, allowing them to see more patients.

Untroubled data transfer between departments

EMR increases collaboration between departments through seamless workflow and shared medical data. Additionally, EMR software allows for reminders and alerts, meaning no issue is ignored or missed. That leads to better decision-making and improved diagnosis.

Conflicting treatment prevention

Keeping all patients' medical records in one place helps prevent conflicting treatment and extra tests. Data entry standardization, system alerts, and user-friendly design also contribute to identifying contradictions.

Patients' benefits are also quite shiny:

  • Faster information exchange
  • Access to their medical records
  • Keeping track of medical history
  • Improved diagnosis and treatment
  • Faster decision-making
  • Enhanced patient data security

Challenges of Modern EMRs

With the first EMR developed in 1972, the world is still far from creating a single perfect solution. That justifies the diversity of EMR software on the market and the lasting demand for custom EMR software development. Let's look at the common pitfalls of EMRs and take a lesson from others' experiences.

Undermining of traditional patient-doctor interaction

Replacing patient-doctor interactions with patient-doctor-computer ones. This checkbox-based approach disrupts communication between patient and doctor, and instead of facilitating logical thinking, human narrative, and clinical reasoning, it makes doctor's appointments less patient-centered.

Increased work burden

Working with EMR can lead to personnel burnout. It sounds contradictory after you've read about automation and workflow improvement, right? The truth is that bad EMR design zeroes out all potential benefits, sentencing hospital personnel to hours of constant clicking instead of seeing patients. One emergency room professional can make 4,000 clicks for a 10-hour shift, spending 40% of their time on that.

Still no clear understanding of the patient's journey

EMRs often present information in a siloed way, focusing on individual encounters rather than the bigger picture. This makes it difficult to understand the course of illness or how past events might influence current treatment decisions. Patient portal integration, which allows patients to share information, such as medication logs and self-monitoring data, directly with their providers, might clarify the issue.

How to Create EMR Software?

EMR software development involves thorough planning and consultations with management, stakeholders, and the development team. While technically rather complex, we'll briefly outline the main stages of EMR development here.

EMR software development steps

1. Define the concept of your EMR

As a primary step, define your project's goals and needs and make an initial cost and ROI return analysis. The other major step is to determine the project's timeline, deadlines, QA, and success evaluation criteria.

At this step, you should also launch a survey to reveal the main features of your future EMR. Ask medical personnel about the desired features and the most daunting tasks that need automation, as your healthcare organization's staff knows best what they need in their daily activities.

Create a project description — an outline of future EMR. This will become a good basis for formulating project requirements and will help the EMR software development company create the exact product you want.

2. Define user roles

Always focus on the people who will use the system and make everything possible to make the product comfortable for different sorts of users. Each group of users will have a different EMR software interface, meaning different access levels to certain functions and data.

In general, the main types of healthcare organization users are:

  • Doctors
  • Nurses
  • Front-office workers
  • Administrators
  • Management

Defining user roles is also important for data security and access management. The Access Controls Standard is one of the basic PHI protection regulations outlined in HIPAA. So, define user roles, consider data access for each category, and apply limitations to data use and sharing.

3. Select features and integrations

If you don't know where to start planning EMR software development, start from the basics. There is a standard must-have set of features for EMR that include:

  • Thought-out and user-friendly interface
  • Charting with customization options optimized for mobile devices
  • E-prescriptions for easy medication management and quick refilling requests
  • Lab integration to receive, save, and analyze test results
  • Appointment reminders for timely doctor visits
  • Access control for enhanced patient data safety

In light of this EMR basis, you can add the features your organization needs exactly. Analyze the survey results and determine your organization's workflow bottlenecks and the most desired features your EMR system must have.

At this step, you also consider the necessary integrations of your EMR software development. The list depends on your healthcare institution's current work environment, including the software used.

The main EMR Integrations:

  • Healthcare CRM
  • Analytics tools
  • Patient Portal
  • Billing service
  • Hospital management software
  • Pharmacy management software

4. Choose tech stack

The choice of the right tech stack depends on project scope and features, scalability needs, and security and compliance requirements. You can consult experienced EMR developers to determine the most fitting technology stack for your project.

Front-End Development

  • Languages: CSS3, JS, HTML 5.
  • Libraries/frameworks: React, Vue.js, or Angular. These offer efficient UI development and interactivity.

Back-End Development

  • Languages: Python is popular due to its readability, extensive healthcare libraries, and strong focus on data security. Java is another strong contender for its scalability and large developer community.
  • Frameworks: Frameworks like Django for Python or Spring for Java can streamline EMR development and offer pre-built functionalities for data management and security.


  • Relational Databases: SQL databases like PostgreSQL or MySQL are commonly used for structured data storage and retrieval in EMR systems.
  • NoSQL Databases: For specific use cases, NoSQL databases like MongoDB or Redis might be considered for handling large volumes of unstructured data (e.g., medical images).

Other Important Technologies

  • API Gateways: Tools like API Gateway can manage API interactions between the EMR system and external applications.
  • Cloud Platforms: Cloud platforms like AWS, Microsoft Azure, or Google Cloud Platform (GCP) offer scalable infrastructure, data storage options, and security features for EMR development.

Remember that the proper use of these technologies can be achieved by experienced developers. Find a dedicated development team that shares your views and aspirations regarding EMR and has extensive expertise in healthcare software development.

5. Create MVP

MVP is the point where real coding starts. Its development helps prove your idea, test the product at the initial stage, and make necessary design/feature changes. At the MVP creation stage, focus on features that address critical workflows and offer significant improvements over existing systems. You can build both low-fidelity and high-fidelity MVPs to test their functionality and user-friendliness and receive feedback.

6. Launch agile team

Among many other software development methodologies, agile EMR development is widely popular due to its iterative nature, open collaboration, and open communication within the development team.

To begin your full-scale EMR software development, first agree on the development team size, composition, and level of seniority with your software development provider. The classic team includes:

  • 3-5 developers
  • 2 QA engineers
  • 1 UX/UI designer
  • 1 product manager
  • 1 project manager

Team size and composition might vary according to the project's scale and complexity. The team may also include a full-stack back-end developer, database administrator, IT architect, and API developer.

The team proceeds with the development of the following components:

Features: creation of basic and advanced features according to the specification and checking their smooth run;

APIs: special software that connects your EMR with existing solutions (CRM) and third-party services, allowing you to send, receive, and process data in required formats;

Data migration: as your organization probably already uses an electronic data management system, placing it in your EMR without losses is essential.

7. Security and compliance

The first and most important thing to figure out in the compliance domain is the HIPAA regulations and standards. This Act safeguards patients' medical information, preventing unauthorized access and distribution. HIPAA compliance includes rules for data storage, sharing and processing, standards for data encryption, urge to launch regular security audits, and strict access control.

EMR standards and protocols:

  1. Health Level Seven (HL7): international clinical data transfer standard. Facilitates information exchange between different healthcare systems;
  2. International classification of diseases (ICD-10): the medical classification of diseases includes codes, signs, and symptoms. In EMR, classification is used for health data standardization;
  3. Fast Healthcare Interoperability Resources (FHIR): electronic healthcare data exchange standard. Supports RESTful architectures, facilitating records search and retrieval.

There are also other standards and legal acts that regulate EMR development, such as GDPR, HITECH and more. Consult your development team how to approach compliance in the best possible way. 

8. QA and testing

Testing determines whether the EMR software development process is completed and the product is ready for launch. It also checks whether it meets the initial requirements. Software testing engineers scrutinize every piece of code, looking at functions, integrations, design, and security. Testing starts at the planning phase and goes through the whole development process, showing at every iteration in the form of manual and automated tests. The results of the final acceptance testing will give you the green light for system implementation.

9. User onboarding and training

Now, you must introduce new software to the medical and administrative staff and help them acquire technical competence with the new EMR. Launch on-site training and online workshops, and ask your EMR software development company to create comprehensive FAQs and explanatory documentation beforehand. The typical staff training plan looks like this:

  • Creation of EMR training timeline
  • Training needs assessment
  • Choosing the right curriculum
  • Assembling training team
  • Real-time hands-on training

Additional tips: train users only in the area of your EMR that they are going to actually use, and conduct post-implementation sessions where professionals can share feedback on using new solutions. Remember that effective staff training helps overcome potential user resistance to the new EMR system, increase staff productivity, and provide outstanding patient care.

10. Maintenance and support

Maintenance and support are based on fixing current issues when they arise, developing new features and functionalities, and keeping the EMR system up-to-date. The core EMR software optimization activities include fixing bugs and minor errors, making upgrades and patches, automation, backup and disaster recovery, and adaptation of EMR to the changing environment (e.g., regulatory requirements change or introduction of new company policies).

The Cost of EMR Software Development

EMR is a complex product, meaning its development will require considerable resources. The average time for custom EMR software development is 12-18 months, and half of that time is spent building an MVP. The cost can range from $20,000 for basic EMR system to $150,000 for advanced one.

The cost depends on factors such as project scope, technology stack, and system complexity. The location of the development team is also important. In some regions, such as North America or Central Europe, the price can be significantly higher than in other regions.

Why NEKLO for EMR Development

  • 15+ years of excellent healthcare software development experience, focusing on security and compliance. Our team is well has strong knowledge of the latest compliance standards and regulations for patient data protection;
  • Successful EMR system development cases. We built web and mobile EMR apps for our client, a private hospital network, set up cloud-based data storage, and provided quality technical support.
  • Developers with industry-specific expertise. Our team delivers healthcare software with the highest security, interoperability, compliance, and outstanding user experience.

Our EMR software development services go far beyond coding. NEKLO prioritized open and genuine communication with the customer. If we see the opportunity to reduce cost or increase usability, we'll inform you and get it done.

Get in touch to discuss your EMR project!