Healthcare providers continuously innovate their clinical record systems to deliver better patient care experience. Managing patient admissions, treatments, post-surgery care, insurance claims, and more requires seamless medical data sharing among departments. EHR software development is instrumental to supporting such efforts. While off-the-shelf solutions may streamline medical record sharing to a certain degree, developing a custom-built EHR solution provides healthcare providers with more flexibility and control.
According to a study, EHR (electronic health records) can improve patient care by up to 78%, but only if the solution meets Meaningful Criteria. Meaningful Use are guidelines defined under an incentive program by the Centers for Medicare & Medicaid Services (CMS). It includes using appropriate EHR technologies to enable secure and transparent clinical data exchange and patient coordination.
Each medical institution has a unique workflow, technological infrastructure, and business requirements. This calls for EHR solutions tailored for the respective hospitals and clinics. As Uptech’s product manager, I’ve worked closely with healthcare clients to build solutions their customers love. I know the challenges, requirements, resources, and user sentiments when developing an EHR.
In this article, I’ll share how you can build an EHR solution that maximizes efficiency in patient care delivery.
What is an EHR system?
An EHR system is a digital solution that allows physicians, nurses, and medical staff to store, manage, and transfer patients’ medical data in a structured and secure environment. EHR, an acronym for electronic health records, consists of medical history, treatment records, prescriptions, lab results, and other healthcare information.
With an EHR system, healthcare providers can optimize data sharing amongst departments to enhance patient experience. EHR solutions are not only useful in enabling patients to receive prompt and accurate treatment but also assist in billing, reporting, insurance claims, and other administrative tasks. As of 2021, 96% of hospitals and 78% of private practitioners in the US have adopted EHR solutions. This marked the growing awareness and proven benefits EHR systems offer.
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Types of EHR Systems
When developing EHR systems, you can choose from physician-hosted or remotely-hosted architecture.
Physician-hosted EHR systems
These EHR solutions are installed on servers located at the practitioner’s establishment. This provides greater physical control and flexibility for hospitals, clinics, and private caregivers opting for this approach. However, hosting EHR systems on your own servers requires a substantial upfront cost to set up the computing infrastructure. Moreover, you’re responsible for maintaining the servers and upgrading the underlying software components.
Remote-hosted EHR systems
Remotely-hosted software is installed on servers owned and managed by an external vendor. Unlike locally hosted EHR solutions, you don’t need to pay for the computing infrastructure. Instead, you pay a smaller recurring fee to use the software, data storage, and computing resources. There are two options for implementing a remotely-hosted EHR system.
- Dedicated hosting. Your software is deployed on a third-party managed server that is not shared by others.
- Cloud hosting. You develop an EHR software that runs on AWS, Azure, or other cloud infrastructure. Other tenants may share the server that stores your medical data. You’ll need to thoroughly evaluate the cloud provider’s HIPAA policy for healthcare data and applications to protect patient’s privacy.
The Difference Between EHR for Practices and EHR for Hospitals
Both hospitals and private practices are major users of EHR solutions. Yet, each party has different needs that an EHR developer must address individually. It’s not viable to develop an EHR system for hospitals and market it to smaller practitioners or vice versa.
If you’re building an EHR system for hospitals, be mindful of these requirements.
- It allows seamless data exchange among multiple departments to enable informed medical decision-making.
- Patients can share medical data stored in the EHR system with specialists, consultants, and practitioners they visit.
- There is a sufficiently large capacity for data storage, which can be expanded as demand grows.
- The EHR solution augments other medical applications, including imaging, surgeries, and consultations.
Meanwhile, EHR solutions designed for practices share these characteristics.
- In consolidates medical histories for each patient registered with the practitioner.
- Patients can access their medical records conveniently with an app or website.
- The solution shall provide essential clinical features like appointment scheduling, e-prescription, and telemedicine.
- It assists doctors and staff with medical coding, invoicing, and other administrative tasks.
While EHR systems for hospitals and practices are vividly different, they substantially benefit the respective stakeholders.
- Solution providers can stay abreast of evolving healthcare requirements and digitalization by offering custom EHR systems for hospitals and clinics. They can uncover innovation opportunities and improve revenue growth with various monetization options.
- Medical institutions can avoid delays, human errors, and inefficiencies that affect patient satisfaction. EHR systems reduce operational expenses by digitalizing and automating medical workflows that were previously done manually. Moreover, healthcare providers enjoy better security with secure storage and highly available EHR solutions.
- Patients can retrieve medical records, test results, prescriptions, and other necessary healthcare information without visiting the care facility.
6 Steps to Build an EHR System
EHR development is a complicated process that involves balancing technical and regulatory requirements. Here’s how to start.
Step 1. Product Discovery
Studying the market in advance spares you from costly mistakes down the line. Whether developing an EHR for your healthcare institution or as a provider, it helps clearly define your target users and how an EHR solution can fit into their clinical workflow.
Then, compile a list of regulations you must comply with in your operating regions. For example, EHR systems marketed to US hospitals must comply with HIPAA, FDA, CMS, and ONC. Meanwhile, European healthcare systems must meet GPDR and MDR requirements.
Here’s how to comply with each regulation.
- HIPAA- enforce privacy, security, and breach notification rules on data storage the system uses.
- GDPR - be transparent about data usage and purposes. Collect minimal data and dispose of them when no longer required.
- ONC - ensure the EHR system meets Meaningful Use requirements when facilitating data exchange.
- CMS - provides accurate billing and coding features to support reimbursement.
- FDA - this is applicable if your EHR system is considered a medical device. In that case, read and adhere to the respective medical device regulations and Good Manufacturing Practices (GMPs)
- MDR - prepare comprehensive technical documentation, adopt a risk management system, and conduct post-market surveillance of the EHR system.
If you’re engaging an EHR software development company like Uptech, remember to sign the Business Associate Agreement (BAA) with them. BAA legally binds the EHR developer to HIPAA-covered entities, such as healthcare vendors or hospitals, to ensure the former takes appropriate steps to safeguard the personal health data they get access to. Work closely with the EHR developer to discover marketing ideas and evaluate the solution’s viability by comparing existing business case studies.
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Step 2. EHR Project Planning
Next, plan how to implement the entire EHR development. Work closely with software teams, medical experts, and business stakeholders to compile extensive software requirements specifications (SRS). SRS describes the EHR system’s purpose, features, and expectations of how it will operate in the actual environment. The development team will use the SRS blueprint to build the EHR software from scratch.
EHR developers then study the requirements and create an EHR design document. This document contains technical descriptions of software modules, architecture, and other technological components required to build the EHR solution. Besides technical considerations, the project team also assesses risks and challenges you might face throughout the development. They set reasonable milestones, budgets, and measurable goals while drafting backup plans to mitigate unforeseen events.
When marketing EHR solutions to specific regions, you must plan for certifications. For example, ONC certification is required when developing EHR systems for the US market. Meanwhile, EHR solutions classified as medical devices will require FDA 510(k) clearance, ISO 13485, and CE marking.
Here’s how to apply for the respective certifications.
- ONC. – Ensure the EHR system meets the stipulated functionality, security, and interoperability criteria. Work with an ONC-Authorized Certification Body to test and certify the system.
- FDA 510(k) clearance – Submit a 510 (k) application to the FDA detailing the system’s manufacturing process, purpose, and design. Wait for a clearance letter upon review.
- ISO 13485 – Reach out to an accredited certification body. Submit documentation related to your development process, quality management system, and risk management strategies.
- CE marking – Conduct a conformant assessment to ensure the EHR system meets the respective safety, health, and environmental requirements. Then, apply for the CE mark.
Step 3. UX & UI Design
Successful EHR implementation requires thoughtful considerations of user experience before development begins. This is essential to ensure that EHR users, including clinicians, patients, and medical staff, remain engaged throughout their interaction with the software. Each designated role uses the EHR software differently. They must be able to navigate through different features, pages, or tools to access the required information. To facilitate that, design unique user journeys to visualize how each user type interacts with the in-app elements to get what they need.
Augment storyboards with the best UX & UI practices to improve adaptability and acceptance. At Uptech, we create UX wireframes that show how different visual elements are positioned in the app. UX wireframes serve as a blueprint that ensures the functionalities we include are helpful to users. Then, we produce UI prototypes and survey different user groups for feedback before developing the solution. For example, we created this design concept to seek feedback for a healthcare mobile app.
Step 4. EHR System Development
With technical and UI/UX requirements in place, the EHR developers you engage commence the development works. EHR development involves creating custom software services that power users' frontend, backend, and mobile interfaces to store, manage, retrieve, and exchange patient information. It also includes integrating with data storage, cloud services, APIs, and other third-party managed services.
These are helpful tips that help you integrate different components more effortlessly.
- Use standard protocols to ensure the EHR solution is interoperable with existing medical systems. For example, many healthcare solutions structure and send clinical data with the HL7 standards.
- Ensure that all API, software components, and interdependencies are secure to prevent unauthorized access. This is important to ensure total compliance with HIPAA and related privacy acts.
- Thoroughly test all modules at every development stage. Conduct unit, functional, security, integration, and performance tests to identify possible issues that may impact the system in production.
EHR development is an iterative process that applies test results and feedback to refine codes, integrations, UI/UX designs, and other software components. Review test reports the QA team generates to ensure the EHR system passes compatibility, security, accessibility, and other criteria.
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Step 5. Pre-deployment assessment
Introducing a new EHR system requires ample preparation before launching. Clinicians and patients need assurance that the software is functional and their data is protected. Thus, it’s essential to get all necessary documentation and certifications updated and in place. For example, EHR developers ensure that ONC certification for the EHR system is promptly processed. More importantly, your EHR solution must be audited for HIPAA and GPDR, depending on the region it is marketed to.
Risks are involved in implementing EHR for a new facility or migrating legacy systems to a new one. Prepare risk assessment and steps to take in contingencies. Plan how to train and onboard medical staff, physicians, and patients. Conduct training programs and test run the software. Then, remediate issues that arise before releasing the software.
Step 6. EHR Launch and Maintenance
Deploying the EHR software in the production environment requires adjustment to the existing medical data infrastructure. Often, software teams must migrate medical records from legacy software to the new system. Plan how these phases will take place to prevent disrupting ongoing clinical workflow. As EHR deployment concludes, ensure that your software team is available to respond to issues that might arise. Continuously seek user feedback and analyze performance data to refine the software further.
Feature Set for an EHR System
EHR software is tailored to the specific requirements of each medical establishment. That said, there are common features in an EHR solution.
Core features
These mandatory features ensure an EHR solution is functional in most medical environments.
- Clinical records management. This allows clinicians and medical staff to capture, manage, and share patient information among relevant departments.
- Patient treatment scheduler. Medical staff use this functionality to plan and monitor treatments that patients undergo.
- Specialized features. Dermatologists, anesthesiologists, cardiologists, and other medical specialists prefer functionalities customized to their respective disciplines.
- Data security. Include security features like encryption, multi-factor authentication, and user access management to ensure cyber resilience and protect patient’s privacy.
- Functional UI/UX. Doctors and nurses expect the EHR software to be easily navigable.
- Platforms compatibility. Consider options for installing or accessing the EHR system from different devices, such as tablets, mobile devices, and computers.
Additional features
To prevent our clients from getting overwhelmed, we use different features prioritization frameworks. It lets us make data-driven decisions and ensures the product meets users' needs. These features may make your EHR system attractive to certain market segments.
- Voice assistance. Some patients prefer to navigate the EHR system guided by narrated instructions.
- Patient screening checklists. This is a form the software uses to collect medical histories, present illness, and other pre-screening information.
- E-prescription. This feature allows patients to receive medical prescriptions from the app.
- AI medical chatbot. A conversational chatbot powered by generative AI to answer patient’s queries, schedule appointments, review lab results, and more.
- Operational intelligence. Healthcare providers can generate reports on patient visits, admission rates, staff schedules, and other operation analytics.
- Financial analytics. Medical providers can access patient profitability, fraud risks, revenue growth, reimbursement, and other related reports.
- Billing analytics. This process gives insights into submission, wait time, approval, and other statistics of patient claims.
- PHI analytics. It provides patient insights that help medical providers improve patient care, reduce readmission, evaluate medication efficacies, and more.
- AI-assisted clinical features. This includes record summarization, medical imaging analysis, and other features that improve patient-doctor interactions.
- Remote monitoring. Integration with IoT and wearable devices that allow remote supervision by clinical providers.
Generative AI in EHR Software Development
EHR systems allow healthcare providers to consolidate disparate patient and medical information into easily accessible records. However, data processing remains challenging as EHR comprises data presented in various formats. For example, the EHR platform analyzes patient histories, lab results, current prognosis, and remote observations to recommend appropriate clinical suggestions. This process is time-consuming unless performed by generative AI models.
Generative AI is a powerful machine learning technology capable of quickly analyzing and identifying patterns in massive volumes of information. When applied in EHR software, generative AI can augment medical decision-making by discovering risk factors that humans may miss. For example, AI models can detect cancer biomarkers in much less time. This allows early intervention that better supports patient recovery.
Besides enabling early detection, generative AI can also help physicians devise personalized treatment plans. All patients are genetically unique, with differing diet requirements, treatment responses, medication allergies, and other traits. EHR software can feed an AI model with this information and generate several treatment options. Then, doctors review the possible care options and recommend the most appropriate one for the patient.
The Technology and Team Required for EHR Development
So, how do you create EHR software? Every EHR developer leverages different technological tacks to create the solution. Typically, they use programming languages, development environments, database management tools, APIs, and testing frameworks to build the EHR system. As the solution involves backend, frontend, and, in some cases, mobile app development – software teams may apply diverse tech stacks.
At Uptech, we use these technologies to develop EHR solutions.
Besides software development technologies, a team of skilled experts in different disciplines is also essential for EHR development. Here’s what a typical EHR development team consists of:
- Project managers.
- Frontend developers.
- Backend developers.
- Android/iOS developers.
- QA engineers.
- Clinical analysts.
- Machine learning engineers (for AI-powered EHR software).
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The Cost of EHR Software Development
EHR system development may cost anywhere from $50.000 to $500,000 or more. The cost of building an EHR system depends on several factors. Developing a complex EHR solution for a hospital or multiple medical facilities is more expensive than building a simpler solution for private practice. Likewise, compliance requirements, ongoing support, data security, integrations, and customization also influence the total cost of ownership (TCO) for EHR solutions.
You might also pay more to develop EHR software if you hire and manage your own software development team. This is particularly true if you’re based in major economies like the US and UK, where software developers charge more for the service they render. Some healthcare vendors outsource their EHR development needs to software developers in more affordable regions. Uptech, for example, is based in Eastern Europe and promises cost-friendly EHR development.
Check how much you'll need to invest in developing a custom app in our blog.
How Uptech can help
Developing EHR solutions is a challenging process not all healthcare providers and vendors can manage. Uptech is a development company you can rely on to build your EHR system. Over the years, our software team has helped numerous companies worldwide digitize their services with functional and engaging apps. More importantly, we have ample experience in the healthcare space.
Our recent works include a mental health app we built for the US market. With only a team of 4, we created an intuitive app that allows users to receive emotional support from selected practitioners. Users can schedule appointments on the app for consultations and receive continuous support. We also developed a backend panel that allows therapists to manage appointments, payments, and learning resources.
At Uptech, we believe that a successful project starts from understanding your users. When developing healthcare solutions, we analyze users' needs and design features aligned with their pain points. Besides adopting good UI/UX standards, we prioritize data security and patient privacy. We apply industry-recommended security practices to ensure the solutions we develop are HIPAA-compliant.
Summary
Developing EHR software allows healthcare providers to tailor features essential to their patient management workflows. Hospitals and private practitioners benefit from the flexibility of a custom EHR solution. An EHR system allows medical staff to manage and access protected health information to augment treatment decisions.
In this guide, I’ve underscored the general advantage of generative AI to EHR management. Also, I’ve shared how to create EHR software and the tech stack involved. While you can undertake the mammoth effort to build an EHR system, most healthcare providers outsource to a trustworthy EHR developer.
Let Uptech do the heavy lifting for you. Tell us about your project and we'll be hapy to help you.