How to Create EHR Software in 2023: Development Flow, Features, and More

First, we should define the difference between these two concepts. Even though they seem identical at first glance, they have several major distinctions.

• The EMR/EPR information about the patients is grouped to be used by physicians of one medical establishment
• EHR patient data can be spread among several healthcare facilities
• One of the major distinctions between EHR and EMR lies in their main functions: EHR is mostly intended to be integrated into the existing system and used with the integration to storage (with the help of the standards of interoperability like HL7 HFIR), while EMR mostly stores essential data.

Let’s take a closer look at both of these technologies.

What is EMR software? An Electronic medical record (EMR) is a digital record containing all the patient data necessary to be monitored by the physician (e.g., diagnosis, treatment, allergies). Such information is thoroughly and comprehensively provided by one medical establishment to coordinate the doctors, enhance their communication, and make their services better.

The major functionality EMR typically contains is the following:

• Detailed patient history
• Management of chronic diseases data
• Management of data connected to prescriptions
• Schedule for appointments along with reminders
• Assessment of medication effectiveness (analytical data collected)
• Support of clinic decisions
• Management of communication flows
• Opportunity to integrate with other solutions

Choosing between EMR and EHR, you should thoroughly analyze your current business situation to understand what of the two solutions is appropriate for your company. Thus, EMR would be an ideal option if you plan to operate with information only in your medical establishment for internal use.

However, in this article we'll dive deeper into the peculiarities of EHR software, as it is often used in integration with different healthcare solutions empowering them.

What is an EHR system? Electronic Health Record (EHR) is the patient information stored online and shared among various healthcare facilities through enterprise data systems, or network connected ones to be used or researched by different medical teams. EHRs may contain a pile of data including but not limited to patient history, status of immunization, treatment flow, data concerning allergies, personal statistics, etc.

EHR digital solutions typically include the following functionality:

• Tracking and management of chronic disease data along with International Classification of Diseases (ICD)
• In-depth patient history
• Vaccination monitoring
• Management of prescription information
• Electronic forms/templates easily customized to current needs of their users
• Management of communication flows
• Medical analytics, etc.

This way, you can see that physicians that use EHR can manage different patient data which is currently essential (e.g., chronic diseases, vaccines used, etc.). Moreover, the EHR system can be integrated with different other platforms to better engage with patients, so its capabilities can be really borderless.

When you require complete control over your EHR software features, such as user-friendly design, to expand your system as your organization grows, or to enter a market with a new EHR system, creating EHR software from scratch appears to be the only one that is readily available. With your own bespoke EHR, you are shielded from transferring or changing EHR systems since you won't have to pay license costs or adhere to "per provider" access limits, which is relevant for healthcare providers.

Qualitative and thoroughly developed EHR from a reliable vendor will give you a lot of benefits for your business. Let's discuss the most common of them.

Such a system is helpful and reliable for physicians because of:

• Reliability. All files can be restored, and it’s hardly possible to lose them.
• Regular updates. Electronic charts are always updated according to the preventive care guidelines they are connected with.
• Reduction of possible mistakes . The digital information is always easy-to-read, unlike handwritten data that is often unclear.
• History. Patients’ treatment and disease history is stored in one file.
• Marking. Doctors can mark drugs that should be added or removed from a treatment process right from the EHR.
• Group management. Physicians can create groups of patients in one practice, manage them, and customize according to their needs.

Connecting to EHR, the patients can also obtain the following:

• Timely care. Authorized doctors may help their patients at any time.
• Appointment management. All appointments with doctors can be managed and scheduled via EHR software.
• Medical data tracking. Patients may track all lab results, doctors‘ notes, prescriptions, with the help of EHR (and EMR) software.
• Integrated communication. Patients can communicate with doctors when they need help.
• Card scanning. Patients can quickly scan their insurance cards via EHR software, and then all the cards are stored in the system.
• Reminders. Reminders about bills or appointments can be sent automatically when a user makes custom EMR or EHR adjustments.
• Cloud hosting. All medical files are stored in the cloud, and they cannot be lost or damaged.

In order to engage patients to look after themselves and increase their health literacy, there may be a sense to develop a patient portal and integrate your EHR system into it. Due to that the patients will obtain opportunity to access different features (like patient education on health issues, different types of customer reporting, and so on).

However, the patient portal is not the only healthcare solution EHR can be integrated with. Depending on the needs of the patients or healthcare institutions that are owners of such a solution, the electronic health records can be implemented into:

• CRMs for medical purposes
• Telemedicine software
• Digital products for laboratory management
• Insurance management platforms, etc.

This way, you'll be able to deliver affluent patient experience. Our expertise in the development of healthcare software helps us reduce software development time, which leads to lower costs. But if you’re planning on creating a custom EHR software for your clinic or just building a startup, what things should be carefully thought out? Let's find it out.

If you wish to test your idea, there’s no need to integrate a bunch of complicated and expensive features into your project. Instead, you can create software with a minimum set of features that’ll perform basic functions. Later on, if your idea appears successful, you can add advanced features in further updates. Now, let’s go through some of the must-have features for EHR software development.

• Complete medical history. Paper records with patient data are being replaced with electronic ones. Due to this reason, physicians can have rapid access to all the patient's allergies data, medications, etc., enhancing health care and support.

• Chronic disease management. EHR systems can enhance chronic illness management to provide improved patient health outcomes and, in the long term, lessen the workload for physicians.

• Vaccination tracker. Unvaccinated patients can get SMS reminders until the specifics of the vaccination proof have been verified thanks to the vaccine monitoring. Additionally, it includes all the information on how and when vaccinations were created.

• Customizable e-forms and templates . Clinicians may quickly add templates —customizable forms to their notes to assist automate the insertion of duplicate narratives and let them enter just the patient's unique variable data. In this manner, the practitioner may spend less time clicking and typing and more time concentrating on the patient and his or her wellbeing.

• International Classification of Diseases (ICD). This classification implemented into EHR helps doctors quicker find out the sympthoms of various diseases and order more accurate medications.

• Prescriptions management workflow. This EHR feature lets physicians prescribe drugs remotely. Patients won’t waste their time in lines just to get their medicines. In addition, they’ll always be informed about the side effects and doses. The next step is to integrate the solution with local drug stores and send prescriptions right to the pharmacy.

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.

Typically the specialists advice to start EHR creation from developing an MVP. However, in some cases it may be required or optional to have a patient portal as part of EHR. MVP can be started without it, but should be added gradually.

With Interactive Patient Portals the patients' engagement is much higher, patients and healthcare providers have access to personal patient profile/doctor profile, appointments scheduling, history & details, and other commodities.

Let’s study EHR integration 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 ranges between $36,700 - $59,000 for web and $25,900 - $65,800 for one mobile platform. Mind that QA and Project Management services are calculated separately, and we don’t include them in the total cost and the table below.

We take $50 as an average hourly development rate. To estimate an EHR system's average cost for two mobile platforms, multiply the design cost by two. Backend development is created for both platforms, so it won’t cause new expenses. You can find rough estimates for web and mobile in the tables below.

It’s impossible to accurately indicate an EHR software development cost because everything depends on specific requirements and platforms (web, mobile). To get a detailed estimate, you may contact our business analysts.

How to create an EHR system? We’ve created a list of technologies that professional EHR software developers use in their workflow.

Here’s an approximate team composition that you’ll need to build an EHR software:

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

Building EHR is a complicated process, as there are a lot of technical moments to be considered. That's why the you may need an assistance of the qualified software development vendor. We'll briefly enlighten the EHR development process as well as the things you should think out to have a powerful and seamless medical software system, and use it without a danger to be fined.

Typically, the EHR development process is performed according to several steps. We put them down on the example of the Cleveroad software creation flow:

• First contact. You leave an application on the vendor's site, briefly mentioning your project concept. The managers will contact you to clarify the details.

• Solution Design Workshop. Your given information concerning the project is researched and processed by the Solution Design team (particularly, the business analysts (BAs), a solution architect (SA), a designer).

• Discovery phase. The specialists continue to think your information out, defining what systems your EHR can be integrated with, the detailed feature list to include, and so on. Moreover, the designers start creating the interface of the future platform.

• Development and Quality Assurance. After the design is ready, the project is handed over the developers, who begin bringing the system's functionality into life. The development process is performed by sprints, and each of the sprints is aimed to be finished with a ready-made part of the functionality or a whole full-fledged platform. Each feature is checked for bugs by QA engineers.

• Release. After the functionality is developed, the QA team makes the final verifications, and the system is released by the software development staff.

• Support and maintenance. After the system is launched, cooperation with the vendor is not ended up. The experts still check the platform's functionality for bugs that might arise, and upgrade it.

While thinking about how to create an EHR, you should keep in mind that the process includes a number of complicated steps. First off, you have to think about HIPAA/GDPR compliance.

Compliance with international regulations

The EHR should necessarily comply with the international regulations for not to get fined for an improper health data security. How the companies deal with it? For instance, Cleveroad provides solutions that adhere to GDPR, HIPAA, PIPEDA - depending upon the customer's country location, and other laws and standards guaranteeing all pertinent health information is fully protected (PHI for HIPAA). In practice this means you have to implement data encryption at rest and on client devices, support HL7 standard, HTTPS or encrypted WebRTC. In addition to the necessary functional aspects, we focus on access control, data storage, and transmission.

Control accessing implies that we care about Multi-Factor Authentication (MFA) and automatic logouts. Data storage is also precisely secured in our solutions - we orient on the best industry standards for data encryption to protect it from any inproper intentions of unauthorized access. HTTPS or HL7 standards are intended to enhance the info transmission security. These are some of the ways how we create the cutting-edge software matching the highest expectations of our clients.

EHR system certification

Certification is a must-have stage for the Electronic Health Record solution distribution after EHR software development completion. Users should have no doubts that your software is legal and is safe to use.

EHR system development 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 be confident in your product because the software meets all the standards. In the EU, you’ll need to go through EuroRec certification. It has the same purpose as ONC-ATCB but is made for European Union.

Without certification, it’s illegal to distribute EHR software.

You should also remember that in order to comply with the requirements of the Promoting Interoperability Act, starting in 2019, all qualified professionals and hospitals in the USA must adopt CEHRT, 2015 edition certified electronic health record technology.

Data transferring

It’s required to migrate data from old-school records to the new EHR software. Clinic owners can hire employees that will assist them in this routine task. Also, it is also recommended to hire an admin that will manage EHR software and upload the medication histories of patients.

Principle of mobile friendliness

Primarily, custom EHR software should have a web version since there are many features and particularities that are better used as a web application. However, the EHR system should have a mobile version since it improves patient-physician communication.

Besides that, mobile EHRs mean portability. Users and patients may solve many important issues on the go. Mobile EHRs engage patients in the treatment process. And to make sure that your custom EHR system covers as much audience as possible, take care of iOS and Android operating systems while building an EHR system.

Custom EHR software performance

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

• ROI calculations to assess profitability
• Throughput of records to understand the efficiency
• Quality of care that requires collecting feedback from patients
• Physicians’ satisfaction
• Monitoring data error rates to assess and improve the software quality

Synchronization With Apple Health Records

Also, we can’t ignore the Health app made by Apple that makes it possible for iPhone users to visualize and store all their health records securely in one place. It’s available for all US-based healthcare organizations at the moment and nice-to-have in your platform.

One of the benefits of EHR systems is the synchronization with the Health app. All US clinics may self-register on Apple's website and connect their compatible EHRs with the Apple Health Records system. It lets all patients and doctors aggregate health records from different clinics in one place, download all medication history on iPhone, and keep track of it.

These things considered will help you create a high-quality product and not to miss something important during EHR development stages.

While you are creating medical software, there are a lot of things to consider for that. In such a situation you can apply to a software development vendor, experienced in medical solutions creation (such as EHR), and Cleveroad is such a vendor capable to help you. Let us introduce this company.

Cleveroad is an outsourcing software development provider located in CEE region helping startups, SMBs and large corporations to boost their activity and profit through top-quality digital solutions for their business.

At Cleveroad, we know how to create an EHR system that’ll be highly efficient for healthcare providers and convenient for patients. We have deep expertise in the niche, and we’ve worked on several healthcare projects. Our track record includes healthcare SaaS solutions and complex solutions for hospitals.

We’ve also developed software for smaller healthcare practices. One of them is the telemedicine platform for appointments management called TapGP. Such a system is a cross-platform one, available both for iOS and Android. It offers day and night access to remote medical services from the UK-accredited healthcare specialists. Due to this app the patients are capable to get healthcare services distantly as soon as possible, as well as qualitative consultations as to the matter.

We're ready to create a modern digital solution also for your healthcare organization. So, to boost your activity and enhance the lives and well-being of your patients, you need to contact us and start your medical business solution development right now!