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

An Electronic Health Record (EHR) is a healthcare digital product utilized to capture, store, and exchange patient data in a structured manner. It can be 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, immunization status, treatment flow, data concerning allergies, personal statistics, etc.

Physicians that apply to EHR use can manage different patient data, which is currently essential (e.g., chronic diseases, vaccines used, etc.). Moreover, the EHR system can be integrated with other platforms to engage patients better, so its capabilities can be 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. Digital information is always easy to read, unlike handwritten data, which 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 them 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, and 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 cannot be lost or damaged.

To engage patients to look after themselves and increase their health literacy, it may be possible to develop a patient portal and integrate your EHR system into it. Due to that, the patients will obtain the 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 an affluent patient experience. Our expertise in developing healthcare software helps us reduce software development time, leading to lower costs. But if you plan on creating a custom EHR software for your clinic or just building a startup, you should understand whether you need an electronic health record or an electronic medical record.

EHR is often confused with EMR, which is mistakable — both systems have their differences. So, let’s look at how to differentiate Electronic Health Record from Electronic Medical Record.

First, before talking about the EHR and EMR differences, 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.

What is the difference between EHR and EMR? Even though they seem identical at first glance, they have several significant distinctions.

• The EMR 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 development 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 — HL7 integration, or HFIR), while EMR mostly stores essential data.

Choosing between EMR software development and EHR, you should thoroughly analyze your current business situation to understand which of the two solutions is appropriate for your company. Thus, EMR would be ideal 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 to integrate with healthcare solutions that empower them.

If you wish to test your idea, you can create software with minimum features that’ll perform essential 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.

Mind that this EHR features list is approximate and may vary according to your needs. You must contact a software development company to develop a more detailed feature list.

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 improve 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 in automating 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 their well-being.

International Classification of Diseases

International Classification of Diseases (ICD) implemented into EHR helps doctors quickly discover the symptoms of various diseases and order more accurate medications.

Prescriptions management workflow

This feature for electronic health record development 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 integrating the solution with local drug stores and sending prescriptions to the pharmacy.

Clinical documentation

This feature streamlines healthcare professionals' recording and management of patient information in the EHR system, ensuring accurate and up-to-date records.

Integration with labs

This capability allows healthcare providers to communicate and exchange data with labs easily. They can order tests directly from the EHR, receive results electronically, and automatically add them to the patient's records.

Role-Based Access Control (RBAC)

It is a security feature that manages access to patient information in the EHR system. It assigns roles to users, such as doctors, nurses, and administrators, based on their job responsibilities. This helps maintain patient confidentiality and data integrity by only allowing authorized personnel to access the information.

Health information exchange (HIE)

This feature allows for the secure sharing of patient health information between various healthcare organizations or facilities. It enables the exchange of medical records, test results, treatment plans, and other important data, promoting effective collaboration among healthcare providers and improving the continuity of care for patients.

Security and privacy

Protecting patient information is crucial in healthcare EHR software. It includes encryption, user authentication, audit logs, and following regulations like HIPAA to keep data safe and maintain patient trust.

Here's also a list of advanced features you can add to your future EHR system:

• Customizable templates
• Clinical Decision Support (CDS)
• Artificial Intelligence (AI) and Machine Learning
• Data analytics and reporting
• Interdisciplinary collaboration
• Medication management
• Patient consent management
• Accessibility compliance

Note: The list of features is approximate. That’s why it’s recommendable to consult the healthcare software development provider as to the functionality essential for your particular EHR software.

Planning to build your EHR/EMR system, you probably want to see it in action to receive a sense of its capabilities. Our team has designed a demo version of the software, so you can see how the EHR/EMR system can look and work.

How to create an EHR system? We’ve created a list of technologies that professional EHR software developers use in their workflow. However, you should understand it's not the ultimate technology stack to consider. If you collaborate with an outsourcing software development vendor, they will help you define what instruments in particular are necessary to build EHR for your own medical establishment.

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

Based on our own experience of such solutions’ development, the EHR software development costs from $30,000 to $70,000+. Any IT company cannot define precisely the accurate product development price before they learn your requirements. So, the price definition depends on the following common factors:

• Complexity and the number of features. The complexity and range of features in the EHR software will impact the development cost. Advanced features like AI-driven analytics, telemedicine integration, and decision support tools raise costs.
• Scalability and customization. When considering customization and scalability, it is essential to note that a highly customizable and scalable EHR system tailored to the specific needs of different healthcare providers will likely have a higher development cost than a standardized solution.
• Integrations with third-party systems. Integrating the EHR software with other healthcare systems, medical devices, and third-party applications may increase the development cost, particularly if complex interfaces are necessary.
• UI/UX design. Creating an intuitive and user-friendly UI/UX design requires skilled designers and additional investment. A well-designed interface can enhance user adoption and satisfaction.
• Compliance. Implementing strong data security measures to comply with healthcare regulations such as HIPAA is necessary, but it may result in higher development costs. It is important to prioritize privacy and security standards in order to safeguard patient information.
• Tech stack. The choice of technology stack, programming languages, and frameworks can impact the development cost. Implementing advanced technologies may result in higher expenses but can also improve performance and scalability.

Thinking about creating such a system, it makes sense to address an outsourcing provider with experience in healthcare software development. Such a step offers numerous advantages: these vendors can build a robust EHR for you as they possess specialized expertise in the healthcare domain, having worked on similar projects before. Moreover, they understand the intricacies and regulatory requirements of the healthcare industry, ensuring compliance and security in handling sensitive patient data.

For example, you can pay attention to Estonia as one of the most preferable outsourcing destinations. It is right due to the following reasons:

• Estonia provides high-quality IT expertise, and software development costs are generally lower than in many Western countries. This cost-effectiveness can result in substantial savings for your EHR project budget.
• Estonia is recognized for its proficient IT professionals and developers. The country's education system emphasizes technology and computer sciences, leading to a workforce knowledgeable in advanced technologies and software development.
• English proficiency is widespread in Estonia, making communication with the development team smooth and efficient. This language proficiency contributes to avoiding misunderstandings and ensuring clear project requirements and updates.
• Estonia has implemented strong data protection laws and is recognized for its advanced e-government systems. The country prioritizes data security and privacy, ensuring confidence in handling sensitive healthcare information.
• Estonian IT companies prioritize adherence to industry best practices and quality standards, ensuring that your EHR software meets high-quality benchmarks.

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.

During the calculations, we took $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. Mind that QA and Project Management services are calculated separately, and we don’t include them in the total cost and the table 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 healthcare business analysts.

The complete EHR price will also depend on the vendor’s location. So, let’s see how will the specialists’ employment cost you due to a provider’s country.

Building an EHR is a complicated process, as there are a lot of technical moments to be considered. That's why you may need the assistance of a qualified software development vendor. We'll briefly enlighten you on the EHR development process and the things you should think out to have a robust and seamless medical software system and use it without the danger of being 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 and foremost, you may initiate the collaboration process by submitting an application on the vendor's website. There you should concisely but comprehensively outline your project concept. Once your application is received, our Business Delivery manager will promptly get in touch with you to engage in an in-depth discussion, ensuring all pertinent details are thoroughly addressed and clarified to pave the way for seamless progress.

Your given information concerning the project is researched and processed by the Solution Design team including notably, the Business Analysts (BAs), a Solution Architect (SA), and a designer. They will define your future product development business aims, concerns, quality attributes, and other essentials.

When they need more information, they will establish meetings with you to gather more information. As a result, you may have a rough estimate and a proposal.

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, deciding on how to create an EHR, they will discuss a number of complicated steps with you.

EHR system certification

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.

Compliance with international regulations

The EHR should necessarily comply with international regulations so as not to get fined for an improper health data security. How do 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.

Moreover, the designers start creating the interface of the future platform starting from prototypes. They will also prepare a UX map and a design concept in order to make the upcoming interface user-friendly and easy to navigate.

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 flawlessness by QA engineers. If they find bugs in the developed functionality, they will make bug report and hand it over to developers for hotfixes.

Moreover, developers integrate your EHR system with other essential solutions that you may need in your work and that were pre-discussed earlier on Discovery stage. Here are some examples of such systems that can be used:

• Health Information Exchange (HIE) Networks facilitate seamless sharing of patient information between healthcare providers and organizations.
• Integration with Laboratory Information Systems (LIS) empowers EHRs to store laboratory test results directly in patient records.
• Integrating Radiology Information Systems (RIS) and Picture Archiving and Communication Systems (PACS) within EHRs allows direct access to radiology reports and diagnostic images.
• EHR integration with Patient Portals and Personal Health Record (PHR) Systems empowers patients to access health records, test results, and communicate with healthcare providers conveniently.
• Integration with Billing and Revenue Cycle Management Systems streamlines financial workflows and automates billing processes, enhancing administrative efficiency.
• Integrating with Electronic Prescription Drug Monitoring Programs (PDMPs) aids in preventing prescription drug abuse and ensuring patient safety through data tracking.

After the functionality is developed, the QA team makes the final verifications, and the system is released by the software development staff. If you are satisfied with the outcome, the team gives you all the materials used during the EHR development.

However, the cooperation with the vendor is still not ended. The experts keep checking the platform's functionality for bugs that might arise and upgrade it based on the collected early customers’ feedback. This way, they ensure your EHR stays flawless in its functioning and up-to-date.

The EHR software development is destined to create a comprehensive and secure digital system to store the patient data and boost the personnel’s workflows.

Thinking out how the EHR development can better gain their aims, you should pay attention to the things given below.

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.

We want to share with you our experience in creating EHR/EMR platforms.

Our client is a rehab clinic from the USA that offers remote care and online consultation. Their current EMR system was inflexible, had partially odd functionality, and was distributed as a SaaS solution. So, they needed the healthcare software development vendor to:

• Change the excessive SaaS platform to a custom clinic management system with an EMR module, which will be more flexible and cost-effective
• Develop and offer a comfortable appointment management functionality for the client to boost time-saving during their common processes functioning
• Provide safe data migration with all user info to a new platform. Ensure the new system will be compliant with HIPAA regulations

During the work, we developed a custom EMR software to replace the outdated SaaS platform used by the client. The platform also has a solution for comfortable appointment management, and is aligned with a billing management functionality working as one digital ecosystem. It is also compliant to HIPAA, and user info data migration to a new platform passed successfully.

As a result, our client got a bespoke and robust clinic management system, with an EMR module in its core that can be used legally. Moreover, its use becomes more cost-effective for the clients’ budget, allowing them to allocate necessary resources to other business tasks. The system also plays a great role in time-saving, allowing the clinic to properly manage appointments and workflows preventing the schedule conflict.

Now, let us tell you about our company and the IT services we render for healthcare businesses.

Cleveroad is a healthcare outsourcing software development provider located in CEE region. With more than 11+ years of hands-on experience in developing medical solutions for clinics, hospitals, healthcare providers, and telehealth service vendors, we help our clients boost their activity and profit through top-quality digital solutions for their business.

Working with us, you will get:

• Experience in robust and secure healthcare solution development (e.g., EHR/EMR, patient portals, telemedicine platforms, etc.) compliant with specific industry regulations like GDPR, HIPAA, or PIPEDA
• In-depth consultation with our Healthcare Solution Architect or Project Manager concerning the development intricacies of your upcoming medical solution
• On-demand services: Building healthcare software from scratch, legacy systems modernization, IT consulting services, and so on
• A team of healthcare experts understanding the ins and outs of medical software development and capable of creating one enhancing patient care through the secure data management
• Full-scale software development services for different kinds of industry institutions (e.g., pharmaceutical companies, healthcare practitioners, or health insurance providers).

Our team is ready to create a modern EHR/EMR solution 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!