How to Build an EHR System [IT Experts Opinion]

Even though over 96% of non-federal acute care hospitals have adopted an electronic health record system, there is still a high demand for quality EHRs. Many health providers look for custom EHR software tailored to their operational needs. Their motives are clear – only custom EHR development can ensure maximum optimization and automation of internal processes.

Yet custom EHR software development is a large-scale project that requires lots of financial and human resources. When building an EHR system, you may need to engage a healthcare development company like Binariks to get the necessary expertise.

This guide shares some of our knowledge on how to create an EHR. Keep reading for more details on developing EHR systems.

Some benefits of EHR systems

Before discussing how to create an EHR system, let's discuss why you need it. EHR system development benefits every party, from software providers to patients. Here are the main advantages for each group:

• For software providers. Companies that create EHR software enter the field with continuous demand for innovative systems. The electronic health market is steadily growing at a CAGR of 3.30% to reach 33.69 Billion by 2030. Thus, a reliable multi-functional EMR/EHR system will always find its users.
• For hospitals. Hospitals using electronic health records optimize many processes through automation and enhanced data management. Regulatory reporting also becomes easier as transparency increases.
• For medical teams. Doctors have all data about patients collected in one dashboard. It allows them to make informed treatment decisions and collaborate with other medical teams. Besides, many latest EHR systems leverage predictive analytics to support diagnostics.
• For patients. Patients get more influence over the treatment process thanks to easy access to their records. Most importantly, building a custom EHR system enhances the overall quality of healthcare services, which directly benefits those who use them.
• For governmental agencies. The government has encouraged EHR adoption by all means since it makes the healthcare industry more centralized. All interactions between healthcare providers, patients, and other parties involved are recorded.
• For researchers. Transition to electronic systems supplies researchers with large volumes of data they can use to estimate different treatment approaches and outcomes.

It's worth noting that the benefits of custom EHR system adoption and off-the-shelf solutions differ. Both provide revenue cycle management, interoperability, mobile access, artificial intelligence, and telemedicine EHR software development to reduce expenses. Custom platforms are generally more effective since they are designed specifically for your organization. It means they have only the necessary functionality, smoothly integrate with the services you currently use, and have the required level of scalability. Even though ready-made solutions cover the standard needs of a healthcare organization, you will face limitations when using them long-term. Off-the-shelf products won't ensure enough flexibility to modify your electronic medical record system as your needs change over time.

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Typical EHR system architecture

Architecture is one of the primary things to map out when building an EHR system. It defines the functionality, usability, efficiency, and portability of the software. Hence, it's life-critical to do everything right at this stage.

Check out the main components and structure of an EHR architecture below:

User interface

UI is a fundamental component of almost any clinical application, including EHRs. Its primary task is displaying and entering patient health records. The user interface also provides inputs to the clinical decision support system (e.g., records a recommended treatment) and displays notifications or clinical guidelines to users on behalf of the CDSS.

Record services

Record services are responsible for managing patient health records. They interact with the UI and CDSS components to enable data entering, health records search and retrieval, data extraction, and exchanging records with other systems and applications.

Terminology services

Terminology services represent events that happen in the real world by managing the database. It's called semantic interoperability and implies using clinical terminology codes to exchange information between multiple systems. Terminology services interact with CDSS and perform processes like installing or updating SNOMED CT from release files or querying concepts.

CDSS (Clinical Decision Support System)

The clinical decision support system encompasses multiple tools that provide clinicians, staff, patients, and other entitled parties with relevant information (output). The CDSS interacts with all main EHR components to execute the decision support logic.

CDSS (Clinical Decision Support System)

As you can see from the image above, the EMR user interface interacts with the record services to enter and store health data. It also provides input to the clinical decision support system and displays alerts based on the CDSS output. The CDSS processes the input from terminology and record services to identify whether the CDS conditions are met, and the response (alerts or knowledge resources) can be delivered back to the user interface.

Must-have features for EHR systems

Functionality is another critical aspect of this "How to develop an EHR system" guide. Although custom EHR software development implies you can add whatever feature you want, some functions are essential. So make sure to focus on them when you build an EHR system.

Intuitive user interface

EHR systems connect multiple users with different levels of computer proficiency. Therefore, they must be simple to use. Always create software with standard UI logic, intuitive navigation, and clear design.

Electronic document management

Convenient document management is the primary task of any EHR system. When you start to create your own custom EHR, be sure it reads multiple document formats and automates routine document management.

Informative profiles

Provide healthcare teams with all-in-one patient profiles where they can view detailed information about a specific person. Such profiles usually include demographic data (name, age, sex), medical information, lab tests, medication, treatment plan, insurance, and other info. Patient profiles allow everyone who provides health services to the patient to stay on the same page and synchronize their efforts.

Task management

Build EHR software using algorithms that enable manual and automated task distribution. It will allow you to organize the work of everyone using the system and optimize their performance. Clinicians will engage with patients instead of doing administrative tasks.

E-prescribing

Add a section that contains all prescriptions to increase the visibility of the patient's health. It must also enable physicians to prescribe drugs remotely and forward this information to drug stores. The e-prescribing portal may include information about side effects and doses to help medical teams with decisions.

Patient portals

Give patients access to their treatment details and personal information to keep them updated. Some electronic health record systems enable patients to message clinicians or arrange a direct video call for consulting.

Charting and documentation

The healthcare industry is strictly regulated and requires lots of documentation to prove compliance. Documents are also necessary for insurance claim processing and patient management. Thus, you must be able to generate detailed documentation and charts for each patient's case automatically based on the data that enters the system.

Instant messaging

Messaging capabilities allow medical team members to communicate more efficiently within the system. You may even integrate an online chat option to connect patients and clinicians directly. This feature will considerably simplify communications and information exchange.

Appointment scheduling

An in-app calendar enables patients and administrators to schedule meetings with physicians based on available slots. The system automatically records these meetings to organize the work of medical teams. Read also: EMR appointment scheduling .

Comprehensive reports

Implement tailored reports to cover the most common cases when patients or clinicians may request information. PDF format is the industry standard for reporting, so you may need HTML to PDF conversion for implementation.

Integration with labs

Integrate your system with associated labs to instantly upload test results and start treatment as soon as possible. It will speed up the treatment cycle and benefit the quality of care.

Access control

How to develop an EHR system that is secure? Create software with granular user permissions to control who can access data and under what conditions. It will also allow you to redistribute tasks among various teams to avoid confusion.

Additional requirements and modules for EHR system development

There are several additional requirements and services to implement besides the listed functionality. Security is the first one. Every quality EHR system has multiple security measures, including automated session termination, data encryption, data signatures, and multi-factor authentication. They minimize the risk of data breaches and ensure that only authorized users access records.

As to additional modules to use with an EHR system, we recommend implementing the following solutions:

Medical billing module

Connect your EHR with a billing solution to efficiently handle payments and reimbursements. It will enable you to generate invoices, track payments, compose and send claims to insurance providers, view claim status, automatically code patient information, verify eligibility, and optimize finance and insurance management operations in many other ways.

Telemedicine module

Integrate your system with telemedicine software to offer patients high-quality video and audio consulting. They will be able to talk to a doctor right from their account to discuss treatment options and other concerns. For ultimate convenience, the telemedicine module should also support screen sharing, consultation notes, and scheduling.

Voice recognition capabilities

A speech recognition system integrated with an EHR allows information input through voice instructions. It also enables medical teams to navigate electronic health records using voice commands. Note that such a solution may require using headsets to improve voice recognition accuracy.

With additional modules, you can expand the functionality of your system and adapt it to the needs of end users. They are usually not included in the core functionality as not every healthcare provider wants such features.

Technology stack for an EHR system

The tech stack to build your own EHR product will depend on what capabilities you want. Still, there are some common choices for frontend, backend, and integrations Binariks uses for our customers. They are necessary to implement the core functionality of electronic health record systems.

Backend development

Backend engineering involves building the database layer of the EMR system where the most critical data processing operations happen. Laravel and Ruby are the top choices for backend mechanics, among other technologies: