Development Phase – Custom EHR Software Development

One of the major challenges that healthcare practices is related to managing patient data. Indeed, data-driven care delivery has improved the quality of healthcare services, but managing that healthcare data has been a problem in recent years.

Manual data entry accounts for as many as 40% of the medical errors, a study by the American Medical Association found in 2018. Though this number has improved greatly even since the rise in adoption of healthcare software systems and especially electronic health records systems.

But some of the problems still persist, like incomplete patient records often leads to delays in care along with increasing the cost to care. And the healthcare industry being highly prone to cyberattacks costs the healthcare industry almost $10.1 million.

Having said that, humans have always found a way around their problems, and healthcare professionals found a solution for this problem as well. Rather than sticking to the healthcare IT solutions provided by healthcare software development companies, they are opting for unconventional methods of custom medical software development.

That is why a surge in custom EHR software development has been observed lately. Electronic health record systems can be considered the backbone of any healthcare practice, and with a custom approach, every need can be achieved effectively and efficiently.

However, many healthcare providers get started by hiring EHR developers for development of custom EHR software, but by the prolonged development phase, the problems start piling up, leading to the failure of the system as a whole. That is why a keen attention must be given to the development phase of the custom EHR software development.

Because in the development phase you actually bring your ideation of the electronic health record system to life, it demands attention. In this blog, let’s explore the key steps involved in the development phase of the custom EHR software development.

Step 1: Requirement Gathering & Analysis

Generally the development phase spans from three to four months, however one of the most important things to note here is that, depending on the complexity of the software, the timeline can even extend.

Moving on, let’s get started with the first step of the development phase, which is gathering and identifying all the necessary things that you require for your custom EHR software development. This includes both clinical and non-clinical or administrative needs. Here is a simplified way for you to know what you require:

1. Identification of Core Functionalities: With EHR software development, you will be taking the first step to making your healthcare practice digital. It will require you to identify all the core aspects of care and the features that you need to include in the software before hiring EHR developers. Some of the most important features that you must include are dashboards for patient demographics, medical history, appointment scheduling, electronic prescriptions, and billing. In this case, some electronic prescriptions and billing will require integration with other systems. These integration requirements must also be outlined to ensure no leaf is left unturned.

2. Regulatory Compliance: Given the sensitive and confidential nature of the patient data you deal with, some rules have been put down by the regulatory bodies to ensure its safety and integrity. The necessary compliances that you need to adhere to for this are HIPAA, HITECH, GDPR, FDA, etc. Along with these compliance requirements, you also need to outline the data privacy and security measures that will ensure the security and integrity of your health information and practice integrity.

3. User Experience (UX) Design: The usability of your custom EHR software directly depends on the user-friendly nature of the software. That is the reason why designing an intuitive user interface for both patients and providers must be considered along with its alignment with your clinical workflow. Study your diverse user groups and curate the design in such a way that is accessible and usable for everyone. Adopting patient-centric EHR design practice can be the best way to ensure the software is more usable.

Step 2: System Design & Architecture

Remember, the custom EHR software development phase works like a chain reaction, where one thing will set the base for the next thing. Once you have gathered everything, the next step is to design your system. Here are some of the things that you must consider:

1. Database Design: Create a robust database to store patient information like medical records and all the other data that your custom EHR software will be generating. While creating the database design, implement best practices like data normalization and optimization for efficient data retrieval and storage.

2. Software Architecture: Outline and design the system architecture so that your front-end, back-end, and database layers align with each other. This cannot be ignored and should be done rightly to ensure the desired result is derived from the software. In this, your choice of the right technology stack plays a crucial role. That is why you sit down with your healthcare software engineering team and choose the programming languages, frameworks, and databases that meet your needs.

3. Security and Privacy: Consider all the security and privacy measures to protect patient data. Some of the best practices are implementing robust encryptions, role-based access controls, and conducting regular security audits. Along with that, outline and plan for developing a HIPAA-compliant EHR software.

Step 3: Development & Implementation

Now that you have all the plans ready, it’s time you actually develop or code the software. Here is a brief overview of everything that goes on at this stage:

1. Front-end Development: Front-end development is basically the development of all the systems that you see on the screen of the software. The first step involves building the user interface, which will include forms, customized dashboards, and reports. One of the major challenges that your EHR developers most likely encounter here is making the interface responsive and compatible for different devices and operating systems. Discussing this beforehand with the healthcare software engineering team can come in handy for this.

2. Back-end Development: Apart from the front-end development, there is also a back-end development where everything that is not seen takes place. Consider this as a guy behind the screen. To do this, your EMR developers first need to develop the server-side logic, data access layer, and code API integrations. Only after this will everything on the front end work effectively and exactly the way you want it to. Implement efficient data processing and handling practices to ensure the data moves to a decided framework.

3. Testing and Quality Assurance: Once the front end and the back end of the software are developed, the testing phase begins. In this stage, your EMR software developers must conduct thorough and different types of testing, such as unit testing, integration testing, and user acceptance testing. This is to ensure the quality of the software, identify any pre-existing bugs in the system, and fix them before the software is deployed in your practice.

4. Deployment: After your EHR developers test the software completely, your custom electronic health record systems enter the deployment phase, where the system is deployed to production servers for the users to use. Some of the things that you should overcheck before pushing the deployment button are the scalability of the software, security, and performance.

Step 4: Integration & Customization

Integration and customization are two other aspects of medical software development. While one allows you to share information with other disparate healthcare systems, the other allows you to align your software with the clinical and administrative workflows of your practices. Here are some intricacies that you must know:

1. Third-party Integrations: Apart from the systems in your ecosystem, your system needs to share data with other systems outside your specific ecosystem as well. This is where you identify such systems and integrate your system with them. Some of the most common third-party integrations that you need are LIS, pharmacy, and imaging systems. These systems can change depending on your specific needs and the specialty you are serving. Following the interoperability standards such as HL7 FHIR for seamless data exchange is a must for developing an interoperable customizable EHR.

2. Customization: Your practice works in a specific way, and your custom EHR software needs to align with it for effectiveness and efficiency. This is where customization comes into the picture to address the specific workflows and preferences of healthcare providers. To bring the factor of flexibility and scalability due to the evolving nature of the healthcare landscape, consider developing a cloud-based EHR solution.

3. Data Migration: Migrate existing patient data from the legacy systems into your new EHR to ensure the completeness of the data. Some of the best practices that you need to practice for efficient data migration are data validation and cleansing for data accuracy.

Step 5: Training & Support

After everything is said and done, here comes the last stage of your custom EHR software development, which has nothing to do with development but training the users on the developed system. Here are some things that you must consider before rolling out the system for use:

1. User Training: Create comprehensive training for all your user groups on how to effectively use the electronic health record system. Along with that, curate training material such as user manuals and online tutorials, apart from the hands-on training sessions.

2. Technical Support: Once the software is in use, there is a chance that the users might face any issues. Offering ongoing technical support comes in handy to address those in real time.

Frequently Asked Questions