Building A Custom EHR System: Practical Examples, Cost, Compliance, And Features

07 May 2019
17 min
author avatar
Sergey L.
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Stanislav K.
Business analyst

Healthcare field is the one that is also digitized and all patient-physician interactions move to a new level. Electronic health records mean a lot in this process and EHR software helps both parties improve their interaction and reduce paperwork. To create EHR, you should know all the benefits of this software for patients and physicians, tips to keep up with to create it right, basic features, cost, tech stack, and how to choose reliable custom software development services. Read this article - you will find answers here.

What’s The Difference Between EHR And EMR Software

For a start, we should define the difference between these 2 notions. They may seem totally identical, but in fact, EHR and EMR have some distinctions. So EHR vs EMR - what are they?

Electronic medical record (EMR) is a digital chart of a patient that is stored in a database of a hospital. EMR software is created separately for each disease by a doctor. It means one EMR is created for one practice. EMR replaces paper records and it has a few obvious advantages like the following:

  • Tracking data over time
  • Physicians always receive notifications with reminders that that or another patient should undergo a planned check-up or screening
  • Also, physicians can quickly check test results like a blood test or MRT
  • Monitor how good treatment is, what improvements are there. If something goes wrong, the treatment process may be revised.

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However, as it was mentioned above, EMR is used only for one practice. So it is not convenient to have plenty of EMRs if other physicians need to observe you. So EMR is not an ideal option.

What is electronic health records (EHR)? It is also a digital chart but it has much more functions and capabilities. EHR not only store information about a patient in one practice. EHRs are used to share information between different doctors and healthcare providers like laboratories, so all information can be stored in one file. Thus, EHR can be managed by various healthcare specialists that may even work in various cities and countries.

That is the main difference between EHR and EMR. In fact, timely shared medical information may even save lives, so EHRs are very important in today’s world. And in order to deal with EHRs more effectively, it is better to create special electronic health records software that will be handy both for doctors and patients. Now let’s proceed to the main benefits EHRs have and how EHR can be used successfully.

Benefits Of EHR Software

Before you make a decision to build EHR software for your business, you should understand all strong sides EHR software may bring. We will divide benefits into 2 categories - for physicians and patients.

Benefits of EHR systems for physicians and healthcare providers

benefits of ehr systems

Advantages of EHR

  • Reliability. EHRs can be found easily from any point of the world and they have backups in case of any system failures. It means that all files can be restored and it is impossible to lose them.
  • Permanent updates. Electronic charts are always updated according to preventive care guidelines they are connected with. Besides that, all updates are performed instantly and all users will be notified about it.
Success story

Dr. Hugh Bonner and his team from St. Francis Medical Center in the US-based Wilmington, DE has noted that EHR integration into their practice helped them not only optimize and simplify record keeping but also increase patients engagement in the treatment process. The team has integrated existing professional guidelines into their EHR and all this information can be quickly called up if it is necessary to discuss something with a patient. Thus, doctors don’t need to explain something in simple terms, they have all the required materials. And physicians have more arguments to prove how preventive measures are important.

  • Reduction of possible mistakes. Digital information is always easy-to-read, unlike handwritten data that is often unclear. That is why one physician will always know what prescriptions are indicated there written by other specialists.
  • History. All history about patient’s diseases is stored in one file that which is very convenient.
  • Marking. Physicians may mark in patient’s chart information that one or another drug should be recalled.
Success story

Recently we have developed EHR software for one clinic from Southborough, MA, and staff of the clinic has started using EHR systems for working with diabetics. Doctors are monitoring how regular their patients do blood tests, see test results, and remind patients to do tests if they forgot about it. Also, if patients miss an appointment, EHR system can automatically send a message to patients they need to visit a doctor as soon as possible. In addition, patients with high blood pressure, plug their blood pressure monitors directly into their home PC and all readings can be sent to EHR system, and a doctor will be notified about it at once. The clinic pushes forward its diabetes management program where EHR plays one of the most important roles.

  • Group management. A physician can create groups of patients in one practice, manage them and customize according to their needs.

Advantages of electronic health records for patients

Benefits of EHR for patients

Advantages of EHR software for patients

  • Timely care. Authorized specialists have 24/7 access to EHR from any point of the world. Hence doctors may help their patient quickly and timely at any time.
Success story

South Cove Community Health Center in Boston, MA, improve health care and control costs due to EHR software. In 2009, South Cove successfully switched to the electronic system using their EHR and they departed from paper records. Due to EHR feature that provides with analysis, specialists of center noted the increase in the number of colorectal screenings, and they started to input all this information in EHR and worked on it. As a result, if something goes wrong, the software marks screening as “Abnormal” in the lab section, and physicians can communicate with patients and start treatment quickly. So EHR allows healthcare providers to improve workflow and give higher quality care to their patients. And reduce costs as well.

  • Appointments management. All appointments with doctors can be managed and scheduled via EHR software. Also, it is possible to set up a notification about these appointments not to miss anything.
  • Medical data tracking. Patients may track all lab results, notes of doctors, prescriptions and so on at any time.
  • Integrated communication. Of course, any software becomes better when it allows its users to chat with each other. Patients can communicate with doctors when they need help.
  • Cards scanning. Patients can scan their insurance cards quickly via EHR software and then all the cards are stored in the system.
  • Reminders. Reminders about bills or about appointments can be sent automatically when a user makes custom settings.
  • Cloud hosting. As it was mentioned in the advantages of EHR for physicians, all medical files are stored in the cloud and they cannot be lost or damaged. Especially if blockchain services are used for storage.

In fact, EHR system is a patient portal that also contains educational materials for patients and they can always increase their level of engagement. So it is beneficial for both parties. Our experience in the development of healthcare software helps us reduce software development time which leads to lower costs. But if you plan to create a custom EHR software for your clinic or just make it your startup, what should you start with? There are several important steps you should know about for building an EHR system, see them below.

How To Start Your Custom EHR Software Right

First, you should start your way with HIPAA/GDPR compliance.

Stages for EHR software launch

Important stages to keep up with when building EHR software

HIPAA/GDPR compliance

Let’s consider it in details.

When you create EHR software for the USA, you should make sure that your app is HIPAA compliant since EHR software processes and stores personal health information. HIPAA stands for Health Insurance Portability Accountability Act. HIPAA contains many rules and regulations your app should comply with. Technical issues of EHR software development are covered in paragraph 164.312. By the way, we have built GDPR compliance checklist which may help you verify how your website or mobile app is GDPR-compliant. Feel free to use it.

HIPAA guidelines require your EHR system to provide the confidentiality and security of protected health information of users.


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As for GDPR compliance, this new law that came into effect last year on May,25 was elaborated for EU. It means that all businesses that include processing and storing of personal data of EU citizens should comply with GDPR and provide individuals with a high level of security. As healthcare providers work with patients’ personal data, they need to notify patients that processing of their data meets all GDPR requirements. You can read our detailed article concerning GDPR compliance.

Make sure your EHR software is mobile-friendly

On the whole, custom EHR software should be built for web first since there are many features and particularities that are better used as a web application. However, EHR system in mobile is also should be available since it helps improve patient-physician communication and, also, a patient may increase their education in the medical area.

Besides that, mobile EHRs mean portability. Users and patients may solve many important issues right on the go. Mobile EHRs facilitates a better involvement of patients in the treatment process. And to make sure that your custom EHR system will be met by new users warmly, build mobile app both for iOS and Android operating systems.

EHR system certification

It is a must-have stage and custom EHR system should be certified officially. Users should be aware that your software is legal and won’t be malicious.

  • Thus, EHR system for the US-based citizens will require ONC-ATCB certification ( Office of the National Coordinator - Authorized Testing and Certification Bodies). After certification, healthcare providers and patients may feel the confidence to your product and that software meets all required standards.
  • On EU territory, you will need to undergo EuroRec certification. It performs the same functions as ONC-ATCB but only in the European Union.

Without certification, you will have no right to distribute your app, and you will gain nothing.

Standards and protocols compliance

There are a few standards that are used for healthcare information exchange. These standards are CCD, CCR, HL7, CCA, etc. It is impossible to predict what standard you will use, everything depends on the particularities of EHR software you need to create and what country you create it for. Our specialists will advise you what standard should be adopted.

Don’t forget to transfer all the necessary data

It is required to migrate data from old-school records to new EHR software. Clinic owners can hire employees that will help them perform this routine job. Also, it is also recommended to hire admin that will manage EHR software and upload medication histories of patients.

Track the performance of your custom EHR software

To understand how popular and profitable your EHR software is, you should monitor some important metrics like:

  • ROI calculations to assess the profitability of software
  • Throughput of records to understand the efficiency
  • Quality of care which requires the collection of patients’ feedbacks
  • Physicians’ satisfaction with the help of their feedback as well
  • Quality of functionality monitoring data error rates

Synchronization to Apple Health Records

Also, we cannot ignore Health app made by Apple that makes it possible for iPhone users to visualize and store securely all their health records in one place. It is available for all US-based healthcare organization at the moment.

The point is that all US clinics may self-register on Apple's website and connect their compatible EHRs with Apple Health Records system. It allows all patients and doctors aggregate all health records from different clinics in one place, download all medication history on iPhone and keep track of it.

Thus, if you are a caregiver organization from USA, our development team will build your EHR systems considering compatibility with Apple Health Records. It can be much more convenient for your patients to monitor everything locally, without the necessity to use a few different EHR systems. So we always move with the times and create your software taking into account all innovations in digital world.

All these steps will help you create a high-quality product and not to miss something important during EHR development stages. Now it is the time to speak about minimum viable product development and what basic features it should include.

Essential Features For Custom EHR Development

Any EHR software should be built with the following feature list that makes a skeleton of the service:

Note: As we have large experience both of healthcare software development and other types of software, we have created a kit of basic features that are often integrated into healthcare app. This kit helps us integrate features twice faster, so we can build your project faster, and deployment time is also reduced. We call this kit BasicProject or Starter. For example, if charting feature implementation took 80 hours before, we can build it for 40 hours now.

Electronic document management

Doctors should have a good opportunity to manage patients’ history, lab results, and other reports to understand the whole situation concerning treatment and health condition of the patient.

Task management

Advanced task management allows doctors to work on their productivity and optimize it. As a result, they will spend less time on the routine job and focus on the treatment process.

Task management in EHR software

Task management in EHR software

Patient page/profile

As it is clear, this page should contain information about patient and personal data like age, location, disease history, and any other info about the overall condition of the patient.

User profile in EHR software

User profile in EHR software


Using this feature, physicians can send prescriptions right to the drug store. Thus, patients will get their medicines on time. Also, doctors can note in prescription all possible side effects and doses.

List of prescribed medicines

List of prescribed medicines


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Distributed access control

It means that both physician, hospital admin, and nurses will have their own access level only to the information they are responsible for. Therefore, the security level is much higher.

Integration with labs

It helps doctors and patients get all results immediately directly from labs and start treatment quickly, and it can save precious time.


Customizable chart templates become a real magic wand for doctors and nurses. With this feature, staff can spend less time filling charts of patients, and machine learning algorithms may analyze and memorize standard data, so it will be added to the chart by default then.

charting ehr

Charting feature in EHR software

Integrated chat

Doctors and patients may communicate and speak about all related issues in real-time mode. This feature is one of the most frequently used in almost all types of apps. 3 years ago we have released an on-demand app for finding doctors in UK where this feature was one of the most important.

ehr communication

Communication between doctor-patient

Clinical dashboard

It shows the results of treatment and the whole treatment processes that were applied for a specific patient. Diagrams with results and pie charts help doctors see the general statistics.

EHR dashboard

Dashboard to monitor the results of treatment


Doctors may set an appointment with patients and notifications are sent to patients’ smartphones with a precise time of appointment. It ensures that the visit won’t be ignored.


Reports about drug interaction, billing reports, diagnosis information - everything can be found in the reporting section.

Reports in EHR

Reports about drugs taken and other medical information

Cloud hosting

All personal info should be stored in the cloud, and in case of any failures or damages quick recovery will be available at a few clicks. It ensures higher security level.

Also, keep in mind that a custom EHR software should have an intuitive user interface that is simple but attractive. Mind to add drag-and-drop capabilities to your software, columns, tables, and so on. That is what EHR software features should look like.

In addition, your app should be available 24/7 since patients and doctors may need to access medical information at any time of day and night.

How Much Does EHR Software Cost?

Let’s study EHR implementation cost breakdown. UI/UX design cost will be approximately $4,000 - $5,000 for web and $5,000 - $7,500 for one mobile platform. Average cost of EHR implementation will be min $36,700 - max $59,000 for web, and min $25,900 - max $65,800 for one mobile platform.

We take $50 as an average hourly development rate. To estimate the average cost of EHR system for two mobile platforms, just multiply this cost by two. You can find an estimation for web and mobile in PDF with each feature clicking this link.

As you probably know, it is impossible to indicate a custom EHR software cost accurately, because everything depends on specific requirements and the number of platforms (web, mobile), so we have provided you with a rough estimation of an EHR system.

Tech Stack For Building EHR System

To build EHR system, the following tech stack can be used:

  • Languages: Java, Python, Swift, Kotlin, JavaScript, PHP
  • Frameworks and libraries: Angular, jQuery, Django, Node.js, Bootstrap
  • Databases: MySQL, PostgreSQL
  • Analytics: Amazon EMR, Google Analytics, Optimizely
  • Web server: Apache HTTP Server, nginx
  • Utilities: Cloudflare, Microsoft Azure, Amazon S3
  • Payment gateway: Braintree, PayPal, Stripe
tech stack EHR

Possible tech stack to create EHR software

A team required to build a custom EHR software

  • 3 web developers (1 back-end developer, 2 front-end developers)
  • 1 Android developer
  • 1 iOS developer
  • 2 QA engineers
  • 1 Project manager

How Cleveroad Can Assist You In Healthcare Software Sector

If you need to build a software related to the healthcare area, you should find a reliable software development team. To save on development costs, you’d better outsource the development to another country where the hourly rate is not very high. Eastern Europe is the region where the average hourly rate is $35 - $50.


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Cleveroad is a healthcare software development company with experience in medical and healthcare solutions of different complexity level. For example, at the moment our team works on the on-demand mobile app to find and call a doctor in a certain region. It is like Uber for doctors. So our developers can build a custom EHR software according to your requirements and needs. Just contact our requirements managers and they will provide you with all the information you need. We think that this guide was helpful and now you can make the right decision on what EHR software you need. So be clever, and follow the right road!

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