The EHR Software Development Handbook

The federal government has taken the initiative to offer more than $4.4 billion in electronic health records (EHR) incentive programs. Developing a custom EHR software may be the missing ingredient to increase operational provider efficiencies and save costs.

While EHR has become a must-have tool to manage patient data in the medical industry, it is also known to be a cause of stress and burnout. The latest study by the University of New Mexico found that EHR can be the leading cause of exhaustion in physicians.

As many healthcare organizations have already switched to custom EHR solutions and mobile EHR app development is also upcoming, it is crucial to learn the lay of the land.

Custom EHR Software Development – What it isn’t

Before we move on to find the answers to what EHRs are and how they work, it’s important to understand what EHR software development is NOT.

Difference Between EHR, EMR, and Practice Management Software

EHR (electronic health record) and EMR (electronic medical records) are closely related terms. However, it is not right to use these medical terms interchangeably. However EHR and EMR software are not the same.

EHR is typically associated with the statement “performing functions related to medical records.” It is all about storing and normalizing the information related to the patients’ medical history. EHR is extensive and can show broader functionality, accuracy, and usability.

Many people confuse EHRs with practice management software. Because of the purpose of medical software, its use remains unchanged in health organizations. Most of them streamline operations and patient data to improve the healthcare practice.

While EHRs or EMR handle the clinical side of the medical facility, practice management software manages the operation, and it may include scheduling, claim to process, and billing. Electronic health records and electronic medical records are automated versions of patients’ medical history and health records.

The software collects, accesses, stores, and forwards the complete health information of patients via secure servers. In fact, EMR is like a summary or snapshot of the patients’ medical history and information. It can include an overview of diagnosis, treatment history, and past visits.

EHR typically provides more extensive and comprehensive patient data. The software allows sharing of data with important stakeholders. The Healthcare Information and Management System Society defines EHRs as:

“Longitudinal electronic record of patients’ health information produced by one or multiple encounters in healthcare organizations or delivery settings. The information is comprehensive and includes everything from medical problems, progress notes, and demographics, to past medical history, immunization, vital signs, radiology reports, and lab data of the patients.”  

In short, EHRs are designed to automate, organize, and streamline the workflow of healthcare professionals and clinicians. EHR software can generate a detailed and thorough report of a patient’s clinical treatments. It includes quality management, outcome reporting, and evidence-based decision support.

The software comes with unique features of generating a complete record of patients’ clinical encounters and other care-related activities that can impact the treatment directly or indirectly.

Benefits for Custom EHR software development for medical practices

EHR software offer threefold benefits to the medical practitioners. It provides business benefits for the medical practice itself, operational benefits for the medical providers and also benefits the patients at the same time.

Whether you are an entrepreneur looking to get custom EHR software developed or are a medical practitioner looking at custom EHR software development for your own practice, let us break up the benefits of EHR software development.

Business Benefits of Developing a Custom EHR Software

1. Thrust towards digitalization

With more and more medical practitioners making the move towards telemedicine and digital innovation, the demand for EHR software is going to continue rising steeply. Despite the surge in technological adoption, millions of healthcare practitioners worldwide are yet to digitalize their operations completely, making scope for custom EHR development boundless.

2. Market capitalization

Despite a number of EHR system vendors in the market, the need for custom EHR solution for the target market still persists. This is because the existence of a EHR system that meets the user requirements perfectly doesn’t exist. Developing a custom EHR software that can have added integrations based on user requirements and offering unique capabilities based on the region, market and target audience served with always give you a business advantage.

3. Software monetization

Just like any other software solution, EHR software also comes with plethora of monetization options including advertising, paid add on features (freemium model) etc. which make it a lucrative option for entrepreneurs looking to get into custom EHR software development.

Medical Benefits of Custom EHR Software Development

1. Improved efficiency

Custom EHR software development takes the pressure off the staff by improving process efficiency and automating routine tasks. With all information available at the fingertips, medical staff no longer have to browse through thick files of data to obtain the necessary information. Custom EHR software can be streamlined according to your practice’s unique workflow which makes it possible to reap the most benefit in terms of efficiency.

2. Greater interoperability

Custom developed EHR software enables quick and seamless interaction between the different hospital departments, promoting interoperability. Since the data input does not have to be done at every touchpoint over and over again, it not only saves the time, it also reduces the potential data entry errors and allows for all the facility departments to work towards a unified end goal – patient care.

3. Lowered risk of medical errors

EHR software development allows for early detection of errors reducing possible risk of malpractice. The software is able to analyze the available data and point of the red flags if any. Clear formatting and structuring of data within the custom developed EHR also allows the healthcare providers to scrutinize data more effectively and identify any errors early on.

4. Enhanced security and regulatory compliance

By engaging in custom EHR software development, healthcare providers can ensure that only the authorized personnel can get the access to the sensitive patient data which is one of the basic tenets of regulatory compliance like HIPAA. Custom development of your EHR software ensures that security best practices such as encryption, digital signatures, access control, data backups and recovery, automated session termination, multi-tier access, etc. are practiced. This considerably reduces the chances of non compliance with security and regulatory laws.

5. Reduction in costs

Custom EHR software development is an investment rather than an expense. One that pays off multifold in the years to come.  Overall, it may cost to develop and maintain EHR software, however, from the day of software implementation within your practice, it helps save cost associated with non clinical labor. With overall consumption of resources minimized, EHR software development can help practices save on the transcription costs, result in fewer expenditures on physical chart storage, simplified coding, and claims management.

6. Streamlining of patient provider interactions

The biggest benefit of custom EHR software development is laying down the foundation for fostering better provider-patient communication. EHR development acts as an empowering tool for the patients turning them from silent spectators into active collaborators in their healthcare regimen.

By having access their health records and health education tools, patients are able to track progress of the healthcare regimen being followed and  can even read the clinicians’ notes which can greatly amp up the levels of patient engagement and result in better patient outcomes.

Types of EHR Software

Depending on where the software is hosted and records are kept, EHR software can be classified as the following.

1. Locally Hosted EHR Software

In this type of EHRs, the electronic health records are hosted physically in the local server at the provider’s office. The responsibility of implementing the EHR system, ensuring regular maintenance, data back-ups and updates, and ensuring security and regulatory compliance falls on the head on the providers or the healthcare organization themselves. Locally hosted EHRs are thus less desirable since they come with a larger set of responsibilities for the healthcare facility.

2. Cloud hosted EHR software

Cloud hosted electronic health records are a scalable and cost effective solution. The cloud hosted data is more secure and the providers don’t need to worry about maintenance and upgrades of the EMR EHR software. The medical practitioners thus have to only focus on patient interactions and entering the data into the electronic health records. They do not have to worry about managing the IT system. This makes cloud hosted EHR system a more popular choice.

How To Approach Developing a Custom EHR Software

You may find plenty of ready-to-use EHRs in the market, including commercially licensed and open-sourced software. However, not all of these options are affordable. Developing EHR software with all the necessary features is not always cost-effective.

This is when you need the right approach to help you develop a custom EHR software suitable to your needs and preferences. How about taking an MVP approach? MVP approach is a “minimum viable product” containing fewer must-have features you need when developing medical software.

The MVP development will work as an EHR prototype that you can use as a proof of concept for an EHR system. Once you include all the necessary features in the initial phase of your medical software development, you can incorporate advanced features in further iterations.

The development approach may seem slow, but it is cost-effective. Plus, it is an easy way to develop a scalable prototype and enables you to add other features at any developmental stage, leading to an improved software product.

Stages of Custom EHR Software Development

The EHR software development process can be divided into the following stages.

• Discovery stage
• Development stage
• Testing and compliance stage
• Implementation stage
• Evaluation stage

The discovery stage of EHR development comprises the goal-setting phase for the EHR system. It includes a short listing of the features and add-ons you will use during the first iteration of EHR software.

The next stage is for EHR development that includes a user interface, design experience, and upgrading the ideas into codes.

The third stage of EHR software development involves assessment and compliance that focuses on the privacy and security of patients’ medical data. It further ensures data compliance and adherence to standard regulatory requirements.

The fourth stage is how you implement and execute EHR software in clinical settings. The fifth stage is typically related to the last stage and evaluates how EHR works and streamlines the process.

Only in-depth planning, impeccable execution, and thorough evaluation of electronic health record software during different stages can ensure that it achieves clinical efficiency. Following strategic EHR implementation is important during the developmental stages to add value to the current workflow.

Must Have Features When Developing A Custom EHR Software

Following are the features that EHR systems must have to improve the efficiency of a healthcare system.

1. Easy-to-Use

Ease of use is the most important EHR software features you need to consider when developing the EHR system. The EHR system should not only be user-friendly but also offer an engaging experience to users.

It should be valuable to your existing healthcare workflow instead of burdening clinicians, nurses, and physicians.

2. Computerized Charting

EHR systems must streamline automation and clinical management via tailor-made chart templates that suit your clinical practice requirements. One way to do that is to leverage artificial intelligence and other advanced features, like machine learning, in your EHR software iterations.

It allows clinicians to streamline and update data entry and lessen the charting burden on physicians and clinicians.

3. Thorough Patient Records

Electronic document management is the primary feature that an EHR system should have.

As it digitizes everything, it must eliminate extensive documentation and paperwork while saving the time admin staff spends on their duties.

4. Electronic Prescriptions and Medicine History

Physicians and doctors should be able to access the information of all medicines prescribed to patients who are under treatment. Plus, the EHR system should include ePrescribing as it helps clinicians develop a better understanding of the medicines prescribed and administered to the patients. It is a great way to minimize risks due to illegible handwriting.

Electronic prescription allows doctors and physicians to send the details directly to the pharmacy in future EHR software development.

5. Patient Portal

The patient portal is also an essential feature the EHR system must have to enable patients to access their medical data and information. It can improve user engagement in the healthcare industry while improving overall outcomes.

6. Interoperability

Healthcare organizations use different software, such as scheduling, claim processing, and billing. It is important for the EHR systems you develop to be interoperable with other software.

EHR software has a diverse range of integrations and functions that need to work together to maximize the overall benefits.

7. Integration with Laboratory

Healthcare organizations need to exchange data instantly and require seamless collaboration with technicians and lab assistance services. Therefore, EHR software should create opportunities to streamline treatments. It should process the data and instantly introduce the review of the laboratory results.

8. Clinical Dashboard

Ideally, EHR software should assist physicians and clinicians in understanding patients in a better way. The automated system includes the treatment results and data of various treatment processes associated with the specific medical history of the patients.

In many cases, the software produces results in the form of various diagrams to help doctors obtain statistical data and insights.

9. Scheduling

The option is for streamlining appointments, meet-ups, and follow-ups that EHR software must be able to do. This feature of EHR software manages the workflow and saves a lot of time for administration staff.

Electronic scheduling through EHR software provides system flexibility, along with the reliable storage of time entries. With relevant data entry, electronic scheduling is a critical medical record feature.

10. Cloud Hosting

Well-designed software is maintainable on the cloud. It provides healthcare providers with an adequate and secure EHR software maintenance method and reduces issues with EHR software hosting.

11. Role-based Access Control

EHR software must enable distributed access to data for better security. That means the clinic admins and physicians obtain customizable access to patients’ data. Plus, it should provide relevant temporal and spatial capabilities according to the specific needs of patients.

As EHR software can develop privacy awareness, it should provide dynamic interaction to manage workflow.

12. 24/7 Constant Support Access

To achieve user satisfaction in service delivery, the EHR system should have constant support access. It is one of the key functionalities that considerably contribute to software’s conformity to usage and streamlined healthcare service provision.

Cost Of Custom EHR Software Development

The estimated costs and timeline of development depends upon the features that you plan to include in the EHR software.

A feature rich software which requires multiple API integrations will take much longer and cost much higher than an EHR software that is developed taking the MVP approach.

The cost and development timeline also depend on the device type that you are developing the EHR software for. If it is going to be a desktop-only software, the timelines would be shorter but if you plan on including a mobile version for your EHR (which you should), the development time and costs associated with it would rise.

Even with mobile EHR solutions, you can choose to develop native apps for both Android and iOS devices or you can go for cross-platform development using hybrid programming languages like React Native and Flutter.

When developing native apps, the code for the software has to be written individually for each operating system whereas in cross-platform development, since the codebase is shared, development only takes half the time and effort.

Another cost-effective and customized way for EHR software development is opting for a headless EHR. Here, EHR is developed by keeping APIs in mind. It’s a cost-effective way to build a customized EHR software. It’s long-term costs are lower than the off-the-shelf EHRs.

Because of high variation in the features and associated timelines, the best way to get accurate EHR software development cost is to obtain a custom quote based on your unique requirements.

Choose The Right Partner For Developing EHR Software

Software development in the field of healthcare is tricky. Along with the security requirements for ensuring the safety of sensitive patient data, there are also legal and regulatory requirements like HITRUST and HIPAA guidelines that medical software has to comply with.

Partnering with an experienced healthcare software development company can amplify the chances of your success when developing an EHR software for your practice.

Specializing in the healthcare niche and having worked for clients ranging from established practices to up-and-coming healthcare startups, Arkenea is a trusted company in the field of healthcare software development.

With more than 13 years of experience, a team of expert developers and a number of success stories in our portfolio, we can help take your project to the next level.

Whether you are transitioning from a legacy paper based system to an EHR or or looking for a much-needed upgrade, our team would be happy to help you and solve any other queries that you may have.

Main Challenges in EHR Software Development

Some of the major challenges in developing and integrating EHR software in the medical facility include:

1. GDPR Compliance

GDPR compliance regarding patients’ rights protection comprises consistent guidelines for the privacy of patient data. The regulations manage the collection of personal data of the residents. The compliance requirements apply to all kinds of information, including residency, names, contact details, addresses, and demographic entries.

2. HIPAA Compliance

HIPAA rules are mandatory for all private or public healthcare providers functioning in the US. That means all medical practitioners must create a verified and flexible EHR system that meets the defined requirements related to technical and administrative safeguards of security, integrity, and confidentiality of the patient’s information.

3. EHR Software Certification

Any custom EHR software must have a certification from the office of the National Coordinator for Health Information Technology. It is an authorized and official certification that ensures that EHR software meets all the standards for security and functionality.

In particular, the EHR system needs to offer structured data. Also, it must have reliable patient-specific options that can ensure secure, fast, and efficient data sharing. It is worth mentioning that the EHR system for any US-based resident must have an official certificate from ONC-ATCB.

For EU-based entities, citizens need the EuroRec certification. It is the certification criteria that are similar to the ONC-ATCB.

4. Significant Use Criteria System

The Use Criteria System refers to incentive payments to different vendors and suppliers who can provide functions that meet the requirements in the strategic documents. These documents establish the main rules for using EHR systems in three stages.

In stages 1 and 2, the lawmakers have expanded the criteria for specialized systems in terms:

• Requirements for the digitizing or capturing of clinical data electronically
• Care-coordination rules
• Patient data-sharing
• Rules for primary patient engagement

Stage 3 introduces regulations concerning standards to structure data and important measures to improve patient engagement and provide coordinated care. Any medical facility that breaches or ignores these regulatory requirements may be prosecuted, leading to termination of their activity.

One security measure that prevents the worst-case scenario is addressing the issues before EHR deployment with a trusted medical software development company.

5. UI/UX

EHR systems have the basic purpose of introducing an intuitive and effective user interface. If you don’t give enough thought to selecting the optimal and most effective EHR software design, it may result in technical difficulties and data mismanagement for medical staff.

It is important to consider the main criteria about important elements when designing an EHR system. Also, ensure clarity in terms, and choose colors that support your users in operating the software.

Summing Up

EHR system is a great technology in the field of healthcare. However, you must find a reliable technology partner with in-depth experience and who understands the challenges and issues of healthcare practices.