Realistic Timeline to Build an EHR System

The accessibility of off-the-shelf EHR systems has really blurred the timeline of EHR development. You see, most of the healthcare practices that have adopted EHR systems have adopted off-the-shelf systems, as they offer instant setup at a fraction of their development costs.

So, when these healthcare providers naturally move out to seek an EHR system that actually supports their needs, developing their own systems becomes a sensible option. And when you ask, ‘How long to build EHR?’ The EHR project timeline seems to take everyone by surprise.

Many healthcare practices still underestimate the EHR development timelines, and given the growing complexity of interoperability, compliance, AI-based integration, and scalability, the timeline only seems to extend.

Having developed more than 50 EHR systems across ambulatory care, hospitals, and specialty care practices, we have curated a time breakdown for custom medical software engineering.

On that note, let’s try to understand the key factors that influence the EHR development lifecycle and give you a near-perfect EHR project timeline that can be implemented in your EHR development lifecycle, to know the realistic timeline to build your EHR system.

So without further ado, let’s get started!

Understanding a Realistic EHR Project Timeline

When you want a realistic timeline to build an EHR system, you need to understand what kind of EHR system we are trying to build. You see, depending on this, the timeline can hugely vary.

For instance, you just have to develop a basic MVP product, then the timeline can span from 5 months to a year, depending on your needs and requirements. On the other hand, when it comes to building an enterprise healthcare platform, the development phase, or where you actually code the software, takes around 6 months to 1 year minimum.

This difference in the EHR project timeline is dependent on feature complexity, integrations required, and compliance requirements. Since MVP EHR would naturally need fewer features, integrations, and compliance adherence, the timeline shortens. On the contrary, for an enterprise EHR system, not only does the feature complexity increase, but also the integration landscape can be complicated as the system itself.

This is the reason why to find a realistic timeline for building an EHR system, you need to know the feature complexity, integrations, and compliance requirements clearly. On that note, here are some of the common factors that extend or delay the healthcare software delivery schedules:

• Changing requirements during development
• Complex clinical workflows
• EHR and third-party integrations
• HIPAA and compliance requirements
• Poor requirement gathering
• Stakeholder approval delays
• Data migration complexity
• Extensive QA and testing
• Scope creep
• Unrealistic delivery expectations

Here is a clear table that would help you understand why EHR project timelines are long, with a comparison between MVP EHR and enterprise EHR:

Discovery, Planning & UI/UX Design Phase

The realistic timeline to build an EHR system can be easily found in the discovery and UI/UX design phase. That is why it is considered the most important phase in the EHR development lifecycle, placing it higher than the coding or development phase.

Additionally, it is this phase that clearly gives you a near-perfect EHR project timeline. On that note, let’s try to find out why this phase is so important when it comes to the timeline.

• Defining Workflows, Goals & Compliance Requirements: The very first activity that you do in the discovery phase is defining the clinical and administrative workflows. This is not only crucial for managing the day-to-day operations of your practice, but also defines what features you need. Apart from that, you also have to align the development as per your business goals and compliance requirements.

• Gathering Input from Stakeholders: Since you will not be the primary user or the only user using this software, you need to gather crucial inputs from clinicians, administrators, and technical stakeholders. This is the only way to curate software that actually addresses the problems faced by them while using it and makes it more usable.

• Designing Clinician-Friendly Workflows & Healthcare Interfaces: Designing wireframes, workflows that are friendly to all your staff, and the interfaces of your software is where the look and feel of the software is determined. And bringing this to reality can again be time-consuming, which can be estimated at this stage.

• Planning Infrastructure, Interoperability & Cloud Architecture Early: During the discovery phase, only you will have a clear understanding of the infrastructure you will be needing, the interoperability requirements, and the need for cloud architecture. This will allow you to plan early and can prove to be crucial for shortening the timeline by a significant margin.

Understanding these aspects early can help you make quick decisions and not only give you a realistic timeline to build your EHR system but also open the door to different possibilities by which you can reduce the development time.

Core EHR Development & Engineering Phase

After the discovery and design phase, the most important phase in the EHR development lifecycle starts. This is where you actually code your software and bring it to life. So, here are a few things that you need to know about this phase and the role it plays in influencing the timeline, and why this phase is marked as a major healthcare software project milestone.

• Developing Administrative Modules: First things that are developed in this phase are the administrative modules that enable you to conduct day-to-day clinical and administrative tasks. Some of the core tasks included in this are patient records, scheduling modules, billing screens, and system and clinical documentation modules.

• Building Clinical Modules: Once the administrative modules are developed, the next step in development is the clinical modules. Some of the prominent modules that are developed here are ePrescription, telehealth platforms, and care coordination functionalities that bind the entire practice together. Moreover, with intricacies and feature complexity, this phase can take the most time to develop.

• Integrating HL7, FHIR, APIs & Interoperability Capabilities: After both clinical and administrative modules are developed, your EHR development lifecycle moves to the integration phase. Here, you integrate your system with the necessary systems using HL7 FHIR standards and APIs.

• Structuring Modular Healthcare Systems for Scalability & Expansion: After integration and making your system interoperable, you structure your modular healthcare system with respect to the scalability prospects and future expansion.

This is the longest phase of your EHR development lifecycle, and managing it is one of the most important healthcare software project milestones. This is where it becomes quite clear when the software will be completely developed and ready for deployment.

However, the situation doesn’t play out exactly like you would expect in the real world. For instance, healthcare practices decide to launch an MVP EHR platform in the first six months. This gives them a head start in developing and getting started with using the software. However, the part of the development phase is spent on expanding the same MVP EHR into a full enterprise-grade EHR system.

Testing, Compliance Validation & Deployment Phase

Once the core development phase is completed, the next phase that your system enters is the testing, compliance, and deployment phase, and this is by far the most critical stage of your EHR development lifecycle.

The reason why this phase is important is that it ensures that the custom platform you are developing is secure, reliable, compliant, and ready for real-world clinical use. Moreover, rigorous validation and testing are required here as even a minor issue can impact patient care, data security, and operational workflows of your practice.

Some of the key things done in this phase are:

• Functional testing to validate system behavior
• Usability testing for clinicians and staff
• Performance testing for scalability and reliability
• Interoperability testing for the connected healthcare ecosystem

Along with that, some of the compliance validations that you need to align your platform with are HIPAA, HITECH, ONC compliance, and local regulations. A few activities included in this are role-based access control, audit log verification, encryption testing, data protection reviews, cybersecurity, and penetration testing.

Other than all these aspects, you must also participate in User Acceptance Testing (UAT), where physicians, administrators, and the operational team validate the workflows in your EHR system with real clinical settings.

After this is completed, you enter the deployment phase, which typically includes:

• Cloud infrastructure setup
• Production environment validation
• Monitoring configuration
• Backup and disaster recovery setup
• Go-live readiness checks
• Performance optimization

Now, the impact it can have on your EHR project timeline can be huge. You see, for an enterprise EHR project, this phase can take several months to complete, given the complexity of compliance, security, and operational validation requirements.

Time Breakdown for Custom Medical Software Engineering

If you have made it this far, then I can assume that you know about the EHR development lifecycle well. On the basis of that, let’s try a time breakdown for custom medical software engineering.

First things first, engineering time is distributed across the EHR development lifecycle. This means that the moment you give a green light to the discovery, the time is distributed till the deployment.

Given the time-sensitive nature of each phase, it can be fair to say that discovery and design take the least amount of time, varying from 10-15% of the total time allocated to these phases, respectively. And the most time-consuming phase is obviously the development phase.

During this entire EHR development lifecycle, you have to balance architecture design, interoperability implementation, and compliance validation. These things can be time-consuming.

Also, during development, you might have to make a few changes in the design or development, which also need to be made. However, a core aspect that you need to focus on is post-launch optimization, staff training, and maintenance activities. And these aspects cannot be ignored as they determine the success and usability aspects of your software.

Here is a timeline distribution table for you to briefly know about the development timeline:

Factors that Can Delay EHR Development Timelines

Even if you try to define a foolproof development plan for your EHR system, the timeline is bound to be influenced by the factors that only make your system better. Here are some of the factors that are most likely to impact your EHR project timeline:

• Expanding Project Scope: It is a very common scenario where, during development, you try to expand the scope of your project. This is a recurring pattern across development projects, and this is one of the leading factors that influences the EHR development timeline.

• Delays Due to Interoperability & Legacy System Challenges: Making your EHR software interoperable is a challenge, and it can be even more difficult if you have a legacy system on the other end. This is another factor that influences the EHR project timeline by a margin.

• Compliance Review & Certification Bottlenecks: You are bound to get certified by ONC. Now, this process can be a time-consuming process, and it mainly depends on the other systems.

• Resource Limitation & Stakeholder Approval Delays: Development being stopped or delayed due to limited resources available for your project is also one of the most common factors in delays. Other than that, stakeholders’ approval for designs, workflows, etc., is also a contributing factor to delays in EHR development projects.

Every other day, AI is making headlines in some sector or another. Having said that, if you are looking to include AI-assisted workflows and automation features in your EHR software, then it can not only increase the development complexity but also increase the timeline by a significant margin. Also, it is best practice to plan for it from the start, as it can require making major changes to your software workflow, infrastructure, etc.

How to Reduce Delays & Improve Delivery Speed

At the start, I told you about finding a way to help you reduce the delivery time or speed up the development process. On that note, let’s see how you can reduce delays and improve the speed of your EHR project.

First things first, start with a clear project requirement and realistic milestones. This is the cornerstone of any project that you will undertake. With a clear project requirement, achieving them becomes easier, and the risk of unexpected factors coming in between can be reduced.

Other than that, use agile healthcare development methodology, as it develops the software in phases, and in case you forget anything in the earlier stages of development, it can be easily covered or included in the later development stages.

Apart from that, try to prioritize MVP-based implementation strategies. This will help you in reducing the timeline by a huge margin so that your day-to-day activities won’t stop.

The key to quick development is seamless collaboration and coordination between clinical staff, operational staff, and engineering stakeholders. This makes things much clearer and sets the pace of development.

Frequently Asked Questions