How to Build an EHR System: A Complete Guide

EHR system development can significantly enhance patient care and optimize workflow within your organization, addressing various issues, from automation of routine tasks to medical data loss. An electronic health record (EHR) is a fully digitalized software that efficiently stores, manages, and shares patient medical information with labs and other healthcare providers.

The Global Electronic Health Records (EHR) market is experiencing explosive growth at a 9.3% CAGR and is expected to hit $52.98 billion by 2027 . Over the last decade, we have built and implemented custom EHR and EMR systems, such as a lab web portal and patient feedback software , that have helped our clients optimize clinical productivity.

In this guide, we will uncover how to build an EHR system, highlighting all the factors to consider and the tech challenges to overcome. You will learn about EHR system architecture, its key features, team composition, the step-by-step development process, best practices from our experts, and estimated costs. So, let’s delve into all the ins and outs of EHR software solution development.

EHR System Architecture

Architecture is the foundation of your EHR system that determines its portability, maintainability, usefulness, efficiency, and reliability. A robust, well-planned architecture results in a more secure and adaptable operating environment, increased scalability, and intuitive usability. The overall EHR architecture design defines the hardware and software used and how they are integrated and set up to function as a system.

In the EHR software architecture, healthcare personas like physicians, nurses, patients, and laboratory technicians interact with the system through the user interface (UI). A user interface (UI) can be a web portal, a mobile application, or both.

A typical EHR system architecture comprises the following components:

• Databases: They keep track of patient data, such as medical history, test results, prescriptions, and treatments
• User interfaces: Allow healthcare providers and patients access relevant medical information
• Workflow tools: Medical professionals use them to control the gathering, distributing, and utilizing of patient data
• Integrations with other medical systems: Enables healthcare providers to access external information, such as laboratory data with lims applications.

These components work together to create a system that facilitates the gathering, organizing, and sharing patient medical information to enhance patient care.

Key Features of EHR Software

How to develop EHR functionality? While each EHR system is designed to meet the unique functionalities and needs of the healthcare facility, certain functionalities and requirements are universal to all EHR system development processes. Here is a short list of the main features an EHR software should have.

Patient Records Management

This essential functionality of the EHR system handles most administrative duties, including new patient registration, admission, facility transfer, and discharge. When a patient registers with the hospital for the first time, the admission desk has to know all the details. Once registration is complete, each patient is assigned a unique ID on the system, also called a medical record number. This number keeps track of all further communications with the patient.

This feature allows for adding and managing clinical records, enhancing patient management competency. Clinicians can collect and document patient interactions, including surgery notes, physical examination results, and patient histories. Nursing and pharmaceutical information can be stored in patient records management.

Appointment Scheduling

Real-time appointment scheduling between patients and doctors is one of the must-have features of electronic health record software. This functionality also enables sending automatic reminders to reduce the number of no-shows. Online scheduling provides insightful performance suggestions based on available data, helping to maximize healthcare providers' output and raising patient satisfaction levels.

Some EHR systems allow for customized appointment scheduling based on specific requirements. In your EHR scheduling system, you can specify default lengths for each appointment type, such as initial consultation, follow-up visit, and physical exam. This guarantees providers adequate time for each visit and facilitates more precise scheduling.

Billing and Invoicing

Any healthcare institution involved with paid or private operations deals with billing, denials, claims, and other related paperwork. While building an EHR system, you need to think about automating all of these procedures with the billing feature of the EHR software. It will significantly streamline the work of finance departments. Some EHR systems also allow patients to pay directly for the services they utilize through payment features.

The billing feature can include financial dashboards for monitoring key performance indicators and other analytical reports. It continuously collects data from many sources across the medical facilities to help the finance department track historical revenue, department-specific invoicing, expenses, and possible areas for development.

Prescription and Order Entry

The e-prescribing feature allows physicians to prescribe medications remotely while checking their medical records. It helps to avoid medication incompatibilities and increase patient health visibility. The feature records the history of the patient’s medications, conditions, and therapies, flagging any potential contradictions. It aids medical professionals in developing and making wise decisions while choosing the most suitable and safe treatments.

Computerized order entry allows practitioners to create and send medical orders and treatment prescriptions using an EHR rather than paper. It removes the need for manual data entry, saving time and increasing accuracy. Pharmacies can get e-prescriptions directly from the doctors. On the other hand, patients can also monitor the history of their medications.

Decision Support System

An electronic health record's decision support system allows for sending preventative health reminders, screening for drug selection, dosage, and interactions, and alerts and reminders to help diagnose patients. This feature comprises a knowledge base, an inference engine, and a communications mechanism.

A knowledge database houses clinical expertise created by domain experts, an inference engine processes the knowledge artifacts, and a communications mechanism receives user input and returns the results of the inference engine to the user. All these components work together to execute decision-support logic.

EHR System Development Team Formation

Now that you know the main features of an EHR system, it’s time to think about your development team. Building an EHR software is complex, so assembling a team with the necessary skills and experience is critical. Let’s look at the list of the team members and their responsibilities.

EHR System Development Process

How to create EHR software? As a seasoned provider of healthcare development services, Exoft has a broad understanding of the technological solutions needed for efficient full-cycle EHR software development and integration. Our services ensure your platform's scalability, safe patient data handling, and, ultimately, HIPAA compliance. The following steps comprise our EHR system development process:

• Discovery
• Development
• Compliance and Certification
• Deployment and Go-Live
• Maintenance and Updates

Discovery

Once you initiate the collaboration process, our EHR system development consultant will contact you to address and clarify all relevant details of your project idea. Then, the Exoft solution design team will outline critical requirements for your EHR system, select the required tech stack, and discuss healthcare-related procedures, such as system certification and international regulatory compliance.

Our software engineers use this tech stack to create high-quality EHR systems:

• Back-end: .NET, Java
• Front-end: Angular, React.JS, Vue.js, Node.js
• Mobile: Android, iOS, Xamarin
• Databases: MySQL, MongoDB, Redis
• Cloud services and API: AWS, VULTR

Our knowledgeable specialists can implement EHR software on the most appropriate private, public, or hybrid cloud platforms.

Development

At this stage, our Exoft EHR development team turns the product's initial idea into a full-fledged solution with all the required features and capabilities. This is when our EHR software development experts do the following tasks:

• Determine the project scope and budget for developing an EHR system.
• Build a custom EHR software tailored to your unique requirements.
• Integrate medical equipment or third-party solutions with your organization's software, such as patient portals or remote patient monitoring applications.
• Offer comprehensive quality assurance (QA) with continuous testing.

Compliance and Certification

Preparing for certifications and compliance is critical when you create EHR software. Depending on the region, HIPAA, GDPR, CCD, HL7 compliances, and certifications like ONC-ATCB and EuroRec must be engineered into an EHR system. If these regulations are not followed, it may lead to expensive fees and the vulnerability of the EHR software to security breaches.

Exoft always considers regulatory standards when developing healthcare software solutions for our clients. The certification of your EHR system will refer to HIPAA regulations if your organization operates in North America. Exoft's experts can also build GDPR-compliant EHR software for healthcare providers in the European Union.

Deployment and Go-Live

We prepare the deployment environment during this phase and develop data migration strategies on this stage. Then, we integrate your custom EHR software into your organization’s ecosystem. If needed, our experts can also execute patient data transfers and train end-users like doctors, nurses, and administrative staff.

Once we ensure everything is ready to go live, we launch your custom EHR software either by adding it to the current system or by releasing a new one entirely once the EHR system. Our deployment specialists facilitate a smooth launch process.

Maintenance and Updates

After deployment, our EHR software development company provides all necessary support. Ongoing EHR system maintenance will help your organization enhance patient management, promote engagement, and improve healthcare quality.

The Exoft support team will provide performance enhancements, bug fixes, and regular updates and add new functionality as needed.

Best Practices for Developing EHR Systems

Based on Exoft’s 10+ years of experience in EHR system development, we want to share valuable insights, highlighting best practices in building user-friendly, secure, and compliant healthcare software.

Developing Mobile-Friendly EHR Software

Custom EHR systems should primarily have a web version since many functionalities run best in web applications. However, creating mobile versions of EHR software allows you to connect patients with doctors on the go or access quick solutions for urgent issues. Moreover, the mobile EHR keeps patients more engaged in their treatment course. To ensure your mobile EHR software is accessible to all users, take care of the iOS and Android operating systems. Learn more about healthcare app trends in our blog.

Adopt a Systematic Approach to Data Migration and Transferring

When switching to a new EHR software, it is vital to migrate critical patient data from the previous EHR system or old-school records. We recommend developing data migration strategies and following a milestones approach to ensure a seamless transition. It is also a good idea to have an admin oversee the EHR system and upload patients’ medical records.

Track Your EHR System Performance

Establish and monitor metrics to estimate your custom EHR system efficiency and profitability. You can track the following indicators to assess and improve software quality:

• ROI calculations
• Ease of use and user satisfaction
• Care quality based on patients’ feedback
• Data error rates

How Much Does EHR System Development Cost?

Now that you have a solid understanding of how to build an EHR software for your healthcare organization let's discuss how much it may cost to develop an EHR system. The feature list, team size, and location are just a few variables that affect the total cost of electronic health record development. While these differ from project to project, certain expenses can be estimated.

You can calculate the total EHR development cost by breaking down each task or item's expenses. The table below provides estimated ranges for each cost component, briefly describing what is included.

Build EHR Software with Exoft

Exoft is an EHR software development company with 10+ years of experience creating and deploying custom EHR and EMR solutions to help healthcare providers maximize productivity. Our team has successfully completed numerous healthcare projects. We possess the knowledge and expertise to create medical software that best meets your requirements.

We know how to create EMR software and EHR systems to enhance communication between physicians and patients and resolve urgent issues on the go. Our development team not only creates EMR and EHR systems but also offers integration services. We can assist with installing software development solutions and configuring the required EMR or EHR implementation:

• Health information exchanges (HIE)
• Communication tools
• Hospital management systems
• Document management software
• Third-party billing services
• Insurance databases.

We take a holistic approach to EMR and EHR solutions development to establish ourselves as a reliable technical partner for your healthcare organization. Here is why choose Exoft as your EHR and EMR development partner.

• Strong expertise in medical software development
• Industry knowledge
• Wide range of services
• Participation in HIPAA-compliant projects
• Superb price-quality ratio
• Client orientation.

Let’s look at some of our successful cases of EHR system development.

Lab Web Portal

Our client, a medical facility that treats sarcomas and other oncology conditions and is one of our clients wanted to simplify lab administration tasks. Their CTO requested that the Exoft team develop an intuitive web system to make it easier for medical personnel to obtain and oversee patient lab tests. The client also wanted a desktop application for administrative functions.

Our team has built a comprehensive laboratory ordering web system and user-friendly desktop application to satisfy the client's needs. As a result of our joint efforts, the client received the following outcomes:

• Streamlined data entry and other technical processes
• Error-free lab ordering and patient information processing
• Easy lab results monitoring
• Favorable work conditions for clinicians through a manageable workload

Patient Feedback Software

Our client is a digital startup based in Western Europe specializing in creating medical software for healthcare professionals. Its team wanted to develop a web-based tool that would make it simple for behavioral health therapists to ask patients for feedback and record their scores on the Outcome Rating Scale (ORS) and Session Rating Scale (SRS).

The client was impressed with our proposal and knowledge of developing solutions for healthcare organizations and has selected Exoft as their medical software development partner. We developed an end-to-end web platform for gathering patient feedback , which allowed our client to achieve astonishing outcomes:

• 1.2x productivity boost thanks to automatic patient feedback collection
• Saving $240M by integrating a patient feedback solution with existing medical software systems
• Over 1,000 positive feedbacks from patients
• Enhanced communication with patients that reduced the no-show and dropout rates and increased patient satisfaction
• Personalization of treatment approaches
• Faster complaint resolution through immediate interventions
• Operational improvement thanks to advanced analytics with critical recommendations

The Bottom Line

A fully digitalized electronic health record (EHR) software effectively saves, organizes, and exchanges patient medical data with labs and other healthcare providers. With a reliable EHR software development partner like Exoft, your healthcare organization can expedite clinical procedures and enhance doctor-patient communication.

With over ten years of experience developing and implementing custom EHR and EMR solutions, Exoft can build a custom EHR system to help maximize your organization’s productivity. Our team has the skills and experience to develop and integrate medical software that best satisfies your needs.