EHR Software Development: Ultimate Guide for 2025

Did you know, 9/10 hospitals and doctors have switched to EHRs and completely eliminated their dependency on paper records?

Over the last few years, Electronic Health Records (EHR) and Electronic Medical Records (EMR) systems have become the standardized systems for record-keeping in the healthcare industry. The rising popularity and widespread adoption have predicted the EHR system development market would hit the $40 billion mark by 2026, which was roughly $30 billion in 2020.

Furthermore, this trend of digital transformation in the healthcare industry is creating a win-win situation for both providers and patients. EHRs simplify the caregiving process by giving a comprehensive overview of health issues, medications, and past treatments.

Having said that, there are many EHR/EMR projects with the healthcare IT companies that continue to face challenges in development, leading to delays and even failures. The challenges span from user dissatisfaction, overlapping workflows, interoperability issues to high costs and system security.

Addressing these issues, this guide will help you in understanding the intricacies of EHR software development and everything that is involved in the entire process.

EHR Software Vs. EMR Software: The Fine Line Difference

There is a fine line difference between Electronic Health Records (EHRs) and Electronic Medical Records (EMRs), but unfortunately both these terms are interchangeably used, even by healthcare professionals. Since both are patient records at core their functionality and use defines the whole scope of your software. And for custom software development understanding this difference between them is necessary.

On that note, let’s first understand the core difference between EHR and EMR. And on the basis of that, let’s decide the system that you want to develop.

1. EHR (Electronic Health Records): EHRs are nothing but a comprehensive digital version of a patient’s health records that includes their complete history. It usually comprises the patient’s entire medical history, medications, allergies, immunizations, radiology images, treatment histories, etc.

2. EMR (Electronic Medical Records): While EHR compromises the entire health history of a patient, EMR on the other hand is also a digital version of a patient’s medical chart, but it is limited to the practice or provider or clinic only.

In a nutshell, EHR and EMR are both patient health records, where EMR is limited to a single practice, whereas EHR provides a broader view, encompassing the patient’s entire healthcare journey. EHRs integrate patient data from multiple sources and improve patient care access for healthcare providers.

On a base level this is the core difference between EHR and EMR. However, if you want to know the difference between them in detail, then here’s our detailed difference analysis between EHR and EMR.

Custom Vs. Off-the-Shelf EHR Solutions

By now, you must know if you need an EHR system or an EMR software system. And now that you hit the market in search of software solutions, then you probably encounter two solutions: Custom EHR software solutions and Off-the-Shelf software solutions.

Let’s understand both of them to make the choice clear for you and the facets that you must consider before making a clear decision.

1. Custom EHR Software Solutions: These EHR software solutions are built from scratch and are designed to meet the specific needs and requirements of the clinic, practice, or hospital. The major advantage of opting for custom EHR software development is its tailored features, flexibility, and ability to align with the specific workflow of the clinic.

2. Off-the-Shelf EHR Software Solutions: These EHR software solutions are predeveloped software solutions that can be directly implemented into your practice. They come with predefined functionality, and the major benefits they offer are quick implementation and lower upfront costs. However, if you are a specialized practice then its limited customization can be a major barrier for your practice.

Making the Right Choice

The choice between an off-the-shelf vs custom EHR solution can be daunting, as, on the bottom line, it offers almost similar features and functionality. Having said that, your choice of system should purely depend on factors such as scalability, customization, support, and the long-term goals of your practice.

To help you make the right choice in a more profound way, read our guide to making the right choice between off-the-shelf and custom EHR software systems.

Key Features to Have in Custom EHR Software

Features define functionality of any software and in custom EHR solutions, it all comes down to its features. These features define the scope of your software system and allows you to manage patient care and even other aspects of care and practice management.

Here are some of the key features that your custom EHR solution must have:

1. Appointment Scheduling: Starting with the very first step of care delivery, the appointment scheduling features are a must. It not only brings transparency in scheduling but streamlines the entire process and marks the roadmap for patient care journey. These features should allow patient appointments, send reminders and manage waitlists to streamline practice. One of the key integrations needed for this is with the calendar.

2. Patient Management: Coming to the core features, the software must have a comprehensive for patient data entry, its storage and retrieval on demand.

3. Electronic Health Records (EHR): Being a comprehensive health chart, the software should securely store patient medical histories, lab results, images, medication, etc. Furthermore, it should also allow patients and providers to access them.

4. Clinical Documentation: Another feature that your EHR software must have is clinical documentation. It should streamline the documentation process with templates, voice recognition, SOAP notes, and auto-population. This feature can be the backbone of your EHR system and it can simplify note taking and the entire documentation process, saving time and efforts, while bringing the attention back to patient care.

5. ePrescribing: Since we’ve moved to a digital healthcare landscape writing prescriptions can be too out-dated practice. However, with the ePrescription feature, providers can easily prescribe medication and reduce if not eliminate the chances of human errors in the process.

6. Billing and Coding: Billing and insurance are some of the most important aspects of care delivery. And the EHR software can be your savior as it makes the process smoother and improves accuracy in billing management, generating invoices and tracking payments. Furthermore, using tools for verifying patient insurance coverage and eligibility before appointment can further streamline the process and keep the entire finances of your practice in an organized and efficient manner.

7. Reporting and Analytics: Your EHR software will deal with data and generate more data on the basis of that. That is why your EHR software system should be able to generate customizable reports on patient demographics, care planning, goal achievements, and clinical financial performance. And since data is considered a new-age currency, let your practice leverage that to improve your practice.

8. Integration Capabilities: Healthcare delivery is a collaborative effort and the dependency on other healthcare professionals and disparate systems is high. With integration capabilities, your software seamlessly integrates with other healthcare systems, such as laboratories, pharmacies, etc., to ensure that care delivery is holistic and complete.

9. Patient Portal: Healthcare is all about empowering patients to manage their health and improve it. In achieving this, patient portal development can be the most effective way to do it. Through this the patient should be able to access health records, lab results, appointment scheduling and secure communication with providers.

10. Interoperability: Last but not least, your top priority during EHR software development should be to develop interoperable EHR systems . Meaning it should not only be able to share data across systems including disparate healthcare systems such as labs, pharmacies, specialists, etc., but also make sense of it.

Depending on the speciality you are serving, the features can change, but the features mentioned above are some of the most important features that your custom EHR software system must have. Or you can read our guide on the key features to develop in custom EHR software.

Advanced Features to Have in Custom EHR Software

The necessary features we just saw above are necessary for your practice for effective practice management, care planning, patient engagement, etc. However, technology is evolving with every passing day, and leveraging that for care delivery can radically transform your healthcare practice.

Here are some of the advanced features that you can incorporate into your software to leverage the full potential of your custom EHR software.

1. Patient Data Tracking: Patient health data forms the bedrock for providing care. With advanced integration with wearable devices of health apps, you can enable continuous monitoring. This way you can provide data-backed evidence based care with enhanced accuracy. Along with that, it also streamlines the follow-up process, allowing you to take a holistic approach to care delivery.

2. AI and Machine Learning: With AI and machine learning in EHR making headlines, leveraging them into your practice for predictive analytics can allow your providers to provide effective care by taking all the necessary preventive measures. Predictive analytics can help you analyze trends and patterns in patient health, which can form the basis for you to provide better preventive care and avoid any mishaps.

3. Clinical Decision Support (CDS): Real-time data analysis is one of the most sought our features of 2025. It equips healthcare providers with real-time data analysis of patient health and helps them in making better decisions, closing the gap between time to care.

4. Telemedicine Integration: Enable remote consultation and follow-ups for your EHR system with telemedicine integration. It will not only contribute to the user satisfaction but also save both time and money for everyone involved.

5. Advanced Data Analytics and Reporting: You can further enhance the care delivery process by using advanced tools for data analysis. It will help you in easy tracking of patient outcomes and improve decision-making backed by data.

6. Voice Recognition: During consultation note taking and documentation can stretch the entire care episode. However, with voice recognition with natural language processing capabilities, note taking can be faster and the documentation process can be automated. An important feature that can save time and improve clinical efficiency.

7. AI Claim Scrubbing: AI-powered EHR with the claim scrubbing process, can automatically verify diagnostic codes such as CPT codes or ICD codes. This can automate most of the manual process that goes in claims submission and enhance the overall efficiency for the practice.

8. Mass Communication: With robust and simple click communication features, you can easily communicate with all the patients, providers or everyone in your practice. One of the best use cases for this feature is to make any emergency announcements or communicate the unavailability of a provider for a particular day or date.

Jotting down to every aspect of care delivery and practice, the list of advanced features that can be integrated into your custom EHR solution can be never ending. However, if you want to know the necessary advanced features for your practice you can read this blog here.

Tech Stack for Building Custom EMR Software

Choosing the right technology stack for your custom electronic health record development is of equal importance as choosing the right features.

1. Backend Technologies: The performance of your EHR software will depend on the backend technology. With robust tools and technologies like Java, Python, Ruby on Rails, etc., you can not only enhance the performance of your software but also future-proof it.

2. Frontend Technologies: Users will be interacting with your software with the frontend technology, where it will work only when it is responsive. Choose the right frontend technologies like React and Angular to not only make the software responsive but also to give your users a seamless user experience.

3. Database Technologies: Choose a database that offers security and complies with HIPAA regulations. MySQL, PostgreSQL, and MongoDB are some of the technologies that are mostly used in healthcare software development.

4. Cloud Infrastructure: While choosing the technology stack, consider cloud infrastructure such as AWS, Azure, Google Cloud, etc., as they would make your software software scalable, remove the worries of storage, and improve overall security.

The technology stack is the core base of your digital healthcare practice. If you want to read more about it, then read our exclusive guide on choosing the right technology stack of your custom EHR solution.

EHR Software Development Process: Ultimate Guide for 2025

There is no doubt that the electronic health record development process is complex and consists of many facets that can define the success or failure of your custom EHR solution. Here’s your ultimate step-by-step guide to the EHR software development process.

1. Planning and Research: The first step is researching and planning your EHR software. In this step, you need to understand the clinical workflow, patient and provider needs, and understand regulatory requirements before moving ahead with anything. Furthermore, it is at this stage that you define all the necessary features and functionalities of your software.

2. Design and Prototyping: The next step is to design the software, with the major focus being on its user interface and user experience. Design your interface in such a way that it should allow easy navigation for the user. One of the best practices is to add patient-centered features and make it interactive. Moreover, before finalizing the design, create prototypes to ensure the design works flawlessly and allows users to easily interact with the software and its functionality.

3. Development and Coding: Once the design is finalized, it is time to code and develop your custom EHR software. During this stage, adopt the right methodology and ensure everything is done closely to ensure the development is going exactly the way you want.

4. Testing and Deployment: After the software is developed, it enters the testing phase. Here, rigorously test the software, concluding clinical trials, bug fixing, and creating a feedback loop for addressing issues after deployment. Once it is tested, the software will be deployed into practice.

5. Ongoing Support and Updates: Once the software is deployed, the real work starts. Here, to address any issues, support will be provided by the vendor, and updates will be provided to ensure the EHR software remains compliant, secure, and efficient.

Read in detail about the entire process of how to build an EHR system.

Challenges in EHR Software Development

If the EHR software development had been easy, there would hardly have been any delays or system failures. To help you avoid such things and prepare better, here are some of the challenges that you’ll most likely encounter during the EHR software development process:

1. Data Security: The major challenge is ensuring patient data security and implementing robust security measures such as role-based access control, encryptions, etc. One of the best to implement data security practices is to comply with HIPAA and other global regulations.

2. Interoperability Issues: Another challenge you’re likely to face is achieving interoperability. Data sharing between different EHR systems and healthcare systems can be challenging. The best way to overcome this is to follow standardized interoperability formats such as HL7 FHIR.

The challenges can be overwhelming at times and without proper guidance overcoming them can be an additional challenge. To simplify this for you, here’s our exclusive article on EHR development challenges and how to overcome them.

Third-Party Integration in Custom EHR Software Development

As discussed earlier, the healthcare industry is one of the most collaborative, as everything is interconnected and intertwined with every other aspect of care. To ensure this doesn’t become a problem in your care delivery, here are some of the third-party integrations you must have in your cloud-based EHR system:

1. Lab Systems: At times, you need to rely on the laboratory to get results and determine the disease the patient is suffering from. During this process, the frequency of test results can further stretch the consultation. However, by integrating your system with the laboratory system, that time can be saved, and test results can be directly reflected in your system.

2. Pharmacy: Since you will be handing out ePrescriptions with your EHR system, you can further streamline the medication process with pharmacy integrations.

3. Medical Device Integration: For remote monitoring of patients, you will most likely have to integrate your remote monitoring with your system. This will enable real-time patient data tracking and enhance virtual care delivery.

4. Billing and Payment Gateway Integration: With this integration, you can easily track your practice’s finances and improve the overall practice’s financial performance.

To know the right integrations that you need in your practice, read our complete guide on necessary custom EHR system integrations.

Security & Compliance Considerations in Custom EHR Software Development

Ensuring patient data security and compliance with regulatory bodies are some of those boxes that you must tick in your custom EHR software development. Here are some considerations for you to consider:

1. HIPAA Compliance: The Health Insurance Portability and Accountability Act is the governing body that ensures data safety and ethical use of data in healthcare software systems. Failing to comply with HIPAA’s regulations can lead to financial or legal penalties. That is why it is important to ensure that your EHR software system is fully compliant with HIPAA rules and regulations.

2. Data Encryption: During the transmission of data from your system to other systems or vice versa, there is a high chance of that data being stolen. That is, by robust data encryption, best practices must be implemented to ensure safe transfer and storage.

3. Access Controls: Patient data is sensitive in nature, and the EHR system at your practice will give access to almost everyone who uses it. However, by implementing role-based access control, you can add another layer of security for accessing patients’ protected health information.

4. Regular Audits: Another thing that you can include in your list is setting a time-frequency for conducting routine security audits. This is to identify and address security vulnerabilities in the system beforehand.

Know more about the security and compliance of EHR software in detail, in this complete guide here.

Cost of Custom EHR Development

The cost of custom EHR software development is crucial for many. And having an idea what the custom software is going to cost is making things much easier, right? To help you with that, here is a quick breakdown of custom EHR software development costs:

1. Initial Cost: Software development planning, designing, and development are the major facets that will cost you the most. Also, it is at the very first stage that you can get an idea about the cost of your custom EHR software. Discussing that with your custom EHR software development company can be the best way to get what your software is going to cost.

2. Ongoing Maintenance: Once the software is developed, frequent updates, technical support, and training will be required for user adoption. This will also incur a cost, which, again, discussing with the healthcare IT vendor would come in handy.

3. Return on Investment (ROI): The ROI of custom EHR software development is not necessarily monitory, and the secret to this lies in its effective implementation.

The secret to save on custom EHR software development is to know how to strike the right balance between the features and budget. Learn how to do that in our separate guide here.

Timeline of Custom EHR Development

Unlike off-the-shelf EHR software, custom EHR software needs to be developed from scratch. During the development process, knowing its timeline can give you an estimation of how long it will take for the software to be developed and deployed to your system.

The timeline consists of five phases known as Planning, Design, Development, Testing and Deployment. During this the factors that usually affect the project development timeline are complexity of features, integration requirements, regulatory approvals, etc.

Typically it takes around 6 months to a year for the entire development to be completed. However, it all depends on your needs and requirements. That is why discussing this with your healthcare IT vendor can be the best way to get an estimation for project completion. Learn in detail about the intricacies and other aspects of the custom EHR software development timeline.

How to Choose EHR Development Technology Partners?

Coming to the last aspects of this guide, understand that the success of your EHR software solution depends on your electronic health records development partner and the EHR implementation services they offer. That is why keen attention should be given to choosing the development partner and making the right choice. Here are some things that you need to consider while evaluating your electronic health record development technology partners:

1. Experience in Healthcare: Choose a partner who has a proven track record of developing robust healthcare software systems. Prioritize those who have already developed EHR systems, as they can minimize the timeline and know the intricacies that you might be looking for.

2. Reputation and Reference: Another way to assess your potential partners is through their reputation and references. The best way to get an idea of this is by reviewing their case studies, reviews, client testimonials, etc.

3. Support and Maintenance: You will be developing Custom EHR software for the long term, right? This is why ensuring that the partner offers long-term support and can effectively handle updates, troubleshooting, and scalability issues is important. Let this also be one of the checkboxes during development partner evaluation.

Your development partner is someone who defines the success arc of your custom EHR software. Know how to make the right choice and what are the checkboxes that you need to tick and ignore, in our latest blog here.

Frequently Asked Questions