Scalability Considerations for Custom EHR Solutions


META-15-1024x597 Scalability Considerations for Custom EHR Solutions

Amidst the rapid adoption rate of electronic health records software, custom-built EHR software has also marked its market presence. In the United States alone, almost 4 out of 5 office-based physicians have adopted electronic health records software systems.

EHRs are at the helm of the digital drive in the healthcare sector, and they are slowly entering the mainstream healthcare workflow worldwide. While most of the healthcare institutions and practices have made it evident that EHRs are beneficial for their practice, the fact is that, along with technology, healthcare practices are also evolving.

This is where the question, ‘Is my custom EHR software scalable?’ becomes crucial for healthcare practice. It is natural that Electronic Health Records are making up a larger portion of the digital healthcare infrastructure. Your healthcare practices depend heavily on it, connecting every other aspect of healthcare delivery with your practice.

And this is where most healthcare professionals who are trying to shift to digital care delivery miss the mark. The foundation of scalable custom EHR software is set during the development phase of the EHR software.

EHR scalability is crucial because, over the course of time, your practice will scale, and the software should be able to handle the significant amount of load while allowing multiple users to work on it efficiently.

In this blog, let’s see how to develop a future-proof EHR by enabling EHR scalability and what factors you should keep in mind during the custom EHR software development.

Understanding Scalability in Custom EHR Software Solution

Before diving deep into the core aspects of developing a scalable custom EHR software, let’s first understand what scalability refers to in EHR software systems.

In a nutshell, the scalability of the EHR software is the software’s ability to handle the increasing workload without compromising the performance of the software system.

Here, the increasing workload refers to the growing patient population, which is fairly natural as your patient population is bound to increase as your healthcare practice is sustained. With an increase in the patient population comes more users and the need to add new features and applications.

Custom EHR development performance can be truly scalable when its software is able to withstand the increasing workload and keep the system intact and running by avoiding system crashes and enabling smooth data flow.

But as discussed earlier, the foundation of scalable custom EHR software is laid during the development phase. What really are the considerations that we should take to achieve EHR scalability?

Well, find out more details below.

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Key Scalability Considerations in Custom EHR Solutions

Key-Scalability-Considerations-in-Custom-EHR-Solutions-1024x576 Scalability Considerations for Custom EHR Solutions

1. User Growth

To understand this aspect of healthcare practice better, let’s assume that you’ve started a specialty clinic and have developed a custom EHR software for the same. Now, since there will be less inflow of patients, the software will be easily compatible with the data flow. However, as your practice grows, the number of patients and providers using the same EHR software will increase.

To ensure that your software is able to accommodate the growth in users, building a multi-tenant architecture can come in handy. This way, you can enable multiple users to access one instance of the application at the same time. Along with that, enabling role-based access control will help you in safeguarding the information and efficiently managing patient data for holistic healthcare delivery.

Furthermore, if you need the system to accommodate new specialities and departments, then the software needs to be flexible enough to give you enough room to add additional features and handle traffic as well.

2. Data Storage & Management

The inclusion of technology has provided us with crucial data on almost everything that we do on the internet. The same is the case in the healthcare industry; it is predicted that by the end of 2025, healthcare data will increase by 36%.

Some of the major contributors to this healthcare data will be from genomics, wearables, and the usage of IoT devices. This will provide you with new challenges with data volume and storage capacity.

One of the best practices for scalable EHR in terms of data storage and management is to leverage cloud-based storage like AWS or Azure. These cloud-based storage solutions offer you unlimited capacity and can be scaled to meet your needs and requirements. Along with that, implement data compression practices so that data integrity is maintained and you have enough room to store data for a prolonged period.

Another best practice for scalable EHR in terms of data storage is to archive the older data, as it offers an economic solution with regard to the cost of scalable EHR development.

3. Performance & Integration

The only reason why technology has entered and sustained the healthcare industry is because of its time-saving capabilities. The factor of instant results has played a crucial role in hastening healthcare delivery. Furthermore, once the patients and providers get used to a certain performance, even a slight delay in functionality can cause frustration.

Furthermore, as the number of users increases, so does the healthcare data. That is why it is important for you to keep the performance of your custom EHR software in check. For this reason, you should be careful when choosing the scalable hardware and software infrastructure for your custom EHR software development. Ensure that the software is compatible with the servers and databases so that there is no latency in the software’s performance.

Apart from performance, integrations with other technologies also play a huge part in scaling and make your EHR software system reliable. Since it will be the connection to every aspect of a patient’s healthcare journey, it must have robust APIs.

Along with that, as advanced technologies become more prominent, many healthcare processes will probably become much more sophisticated and streamlined. Integration of AI, ML and blockchain technology should be considered.

4. Security & Compliance

In an attempt to make the software system more scalable the security and compliance standards followed are at risk. This can pose serious challenges in the healthcare delivery process and compromise the trust and integrity of the patients.

However, with robust data encryption standards, it can not only eliminate the factor of unauthorized access but also help in the scalability of the software significantly. Along with this, comply with the standards set by the regulatory bodies like HIPAA, HITECH, GDPR, etc., as it will not only help you in developing a safe healthcare ecosystem but also keep you out of legal troubles.

Leverage Cloud-Based Infrastructure

The success of your custom EHR software system majorly depends on the infrastructure you choose. If you hit the market, you are basically provided with two choices: on-premise infrastructure and cloud-based infrastructure.

Now, the problem with on-premise infrastructure is that it requires a significant upfront investment in hardware such as servers, networking, and storage. And when you want to increase its load capacity, you again have to make a significant investment in new hardware. This is not only a costly but also time-consuming process.

Whereas, when you opt for a cloud-based infrastructure, it offers elasticity, and resources can be scaled up or down almost instantly, that too on demand. Moreover, there are many players that offer cloud-based services. Here’s a brief overview of the major cloud-based service providers that you can use for your custom EHR.

Cloud ServiceUse CaseScalability FeaturesHealthcare Fit
AWS RDSManaged SQL databases (MySQL, PostgreSQL, etc.)Read replicas, Multi-AZ, automatic backupsStructured EHR data like appointments, billing, and clinical records
Azure Cosmos DBNoSQL database for unstructured/JSON dataAuto-scaling throughput, global distribution, and multi-region replicationReal-time data, clinical dashboards, wearable data
Google Healthcare API + BigQueryFHIR/HL7/DICOM data storage & analyticsPetabyte-scale analytics, real-time querying via BigQueryAdvanced analytics combining structured records with imaging/telemetry
Amazon HealthLakeFHIR-based healthcare data platformPetabyte-scale ingestion, indexing, and natural language processingAI/ML for population health, clinical insights, predictive care
Azure SQL Managed InstanceFully managed SQL Server in AzureElastic pools, auto-scale, geo-replicationCore EHR systems, migrations from on-prem SQL databases

Benefits of Scalable Custom EHR Solutions

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Choosing a scalable custom EHR software is beneficial for your growing practice, but what exactly are the benefits of choosing a scalable custom EHR or migrating data to a scalable EHR?

Well, here are a few of the many benefits of scalable EHR software apart from the ability to handle increased users and higher workloads:

Improved System Performance: Since you’re choosing custom EHR software, it will be dedicated to your specialty, which will enhance the efficiency of your growing practice. Along with that, the flexibility of the system will improve the overall performance of the software system, making it ideal for your practice.

Cost-effectiveness in the Long Run: For a growing practice, as time goes by, the practice grows. By choosing a custom scalable EHR software, you don’t have to migrate data from one system to another, and you can be comfortable using the existing system.

Flexible for the Future: Growing practices are flexible, and they need a system that is flexible enough to accommodate and adapt to their needs and requirements. A scalable custom EHR solution is a perfect solution for them.

Enhanced User Satisfaction: Since scalable custom EHR software is flexible in nature, it enhances user experience with improved speed and workflow. Apart from that, access to features and other functionalities of the software also contributes to user satisfaction.

Challenges in Scaling EHR Solutions

Scaling EHR solutions might come with challenges such as interoperability, data security concerns, and varying standards across healthcare systems, along with integration complexities and the system’s resistance to change.

Overcoming these challenges requires implementing standardized data formats, and achieving interoperability through industry collaboration, and prioritizing robust cybersecurity measures. Flexible and modular EHR designs, coupled with user-friendly interfaces, facilitate smoother adoption. Additionally, promoting a culture of adaptability and providing comprehensive training are essential strategies to address resistance and ensure the successful scalability of EHR solutions.

Best Practices in Developing Scalable Custom EHR Solutions

 Scalability Considerations for Custom EHR Solutions

Collaboration between developers and healthcare professionals: Effective collaboration between developers and healthcare professionals ensures optimal EHR solutions by combining technical expertise with real-world medical insights. Continuous communication helps address evolving clinical needs, ensuring user-friendly interfaces, data security, and scalability. This partnership ensures that custom EHR solutions align with industry standards and best practices, ultimately improving patient care and healthcare workflows.

Regular updates and maintenance for ongoing scalability: Regular updates and maintenance in developing scalable custom EHR solutions involve continuous monitoring, performance optimization, and addressing emerging needs. Adhering to best practices ensures system resilience, security, and adaptability to evolving healthcare standards. This iterative approach enhances scalability, enabling the EHR system to seamlessly accommodate growing data volumes and user demands while maintaining efficiency and compliance.

Future Trends in EHR Scalability: Emerging technologies such as blockchain and AI are shaping the future of EHR scalability, enabling efficient data management and interoperability.

The Role of Performance Testing & Scalability Monitoring

Scalability and performance of your software go hand in hand. This is because the scalability can directly impact the performance of your custom EHR software. That’s why the role of performance testing complements the scalability monitoring process. Let’s first look at the different aspects of performance testing and later at the aspects you need to consider in scalability monitoring.

1. Importance of Performance Monitoring: When you conduct performance testing to check the scalability side of your custom EHR software, ensure that your system can handle growth without degrading user experience or risking patient safety. For instance, it validates your system’s behaviour under load and helps you identify bottlenecks, such as slow database queries, memory leaks, etc. Along with that, this test also ensures the responsiveness of your software, checks where the scalability supports regulatory compliance, and reduces the risk of downtime.

2. Scalability Monitoring: The key areas you need to focus on when monitoring the scalability in custom EHR are performance metrics (CPU usage, memory usage, response time, data query, etc), load testing, database scalability (where the database is accommodating increasing load), autoscaling and infrastructure monitoring with tools and user experience feedback.

Conclusion

As healthcare data continues to burgeon, the ability of EHR systems to seamlessly adapt, expand, and integrate is paramount. From user growth considerations to data storage, performance optimization, and security, the blog underscores the critical role scalability plays in the future of healthcare organizations. Choosing scalable custom EHR solutions not only ensures improved system performance, cost-effectiveness, and flexibility for future growth but also enhances user satisfaction. The challenges in scaling EHR solutions are acknowledged, and best practices emphasize collaboration, regular updates, and maintenance.

Comprehensive Guide to Scale Your EHR Software Solutions
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Frequently Asked Questions

1. How can I ensure my custom EHR is scalable for future growth?

Design your custom EHR with a scalable architecture, prioritize modular components, leverage cloud services, implement efficient data storage, plan for increase user load, and regularly update technology to accommodate future growth.

2. What are the technical aspects of building a scalable EHR system?

Building a scalable EHR system involves considerations like distributed architecture, data interoperability, robust security measures, cloud infrastructure, efficient data indexing, and adherence to healthcare standards. Ensuring scalability requires modular design, load balancing, and performance optimization.

3. What are the costs associated with building a scalable EHR?

Costs for building a scalable EHR include software development, infrastructure, security measures, regulatory compliance, user training, and ongoing maintenance. Integration with existing systems and data migration may incur additional expenses.

4. Can my existing data be migrated to a scalable EHR?

Yes, existing data can be migrated to a scalable EHR system, ensuring seamless integration and improved healthcare data management.

5. What are common challenges in scaling custom EHR solutions, and how can they be addressed?

There are several challenges in scaling custom EHR solutions, which are below:-

  • Interoperability: Ensure seamless data exchange with other systems.
  • Scalability: Design infrastructure to handle growing data and user loads.
  • Security: Implement robust measures to protect sensitive health information.
  • User Adoption: Provide user-friendly interfaces and comprehensive training.
  • Regulatory Compliance: Stay updated on healthcare regulations for legal adherence.

Ganesh Varahade

Founder & CEO of Thinkitive Technologies.

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