Building an EHR system: Definition, benefits, problems, and examples

They also:

• Require a lot of physical storage space
• Don’t show the entire patient journey in one go
• Are impossible to recover if lost
• Can’t be in two places at once, so they aren’t always accessible to the staff who requires them
• Have limited security
• Are prone to errors
• Are usually incomplete

Source: dribbble.com by Dorota Pęczek 

These problems with paper medical records are why many clinics are adopting their digital alternative ― electronic health record (EHR) software that stores and centralizes patients’ charts. 

If you came here to learn about EHR software development, you’re in the right place. In this post, we talk about how doctors feel about electronic health records and what it takes to create a successful EHR system. We also lay out the differences between EHRs, EMRs, and PHRs, show examples of the best EHRs, and go deep into key features of an EHR system. 

What is an EHR system? And what about EMR and PHR?

EHRs, EMRs, and PHRs all perform similar functions, which is why many people mix them up. To remove the confusion, let’s figure out what’s what.

Electronic medical records (EMRs)

An electronic medical record, or simply an  EMR, is a digital replacement for a patient’s paper chart. It includes a patient’s medical history and key clinical data and can be accessed by one practice. 

Note: EMRs aren’t designed to be shared with other practices, pharmacies, hospitals, etc. That’s why they don’t usually travel outside the medical office. But when they do, a provider needs to print them out and mail them to another provider.

Source: dribbble.com by RD UX/UI

EMR software allows practitioners to:

• Streamline charting
• Track patient data over time
• Quickly access patients’ vitals and accurately diagnose patients
• Decrease paperwork and improve productivity
• Reduce medical errors
• Keep patient information private and secure
• Get a clear and accurate overview of a patient’s health

Electronic health records (EHRs)

EHRs take things a step further. They focus on the total health of the patient and thus provide a more comprehensive overview of a patient’s medical history. The primary benefit of an EHR is its collaborative nature. It’s designed to be shared across healthcare providers, allowing patients to move records with them from one practice to another (including to labs, emergency rooms, and pharmacies).

Source: practicefusion.com

In addition to the benefits provided by EMRs, EHRs:

• Reduce duplicate testing
• Facilitate information access
• Make prescribing medications safer and more reliable
• Promote patient participation in healthcare decisions
• Improve coordination between care providers

Personal health records (PHRs)

The patient is responsible for managing and updating their own personal health records. With PHRs, patients can collect all information related to their health including lab results, exercise sheets, and even life insurance documents. Additionally, PHRs can contain information such as a doctor’s name and phone numbers, medications with doses, allergies, chronic health issues, illnesses and surgeries with dates, vaccination records, advance healthcare directives, and family histories. The goal is to let patients self-manage their medical records and have everything stored in a single place. 

Source: pagedesignshop.com

Personal health records allow patients to:

• Become more informed about and involved in their care so they can make positive choices to maintain good health
• Monitor and assess their health
• Upload and evaluate data from health devices
• Quickly give first responders vital data in an emergency
• Keep all of their vital information in one place 
• Get organized by tracking medications, appointments, and vaccinations
• Better coordinate with physicians and other care providers

Putting it all together: EHR vs EMR vs PHR

To make it even easier to understand the differences, we’ve created an EHR vs EMR vs PHR comparison table. Enjoy!

How doctors feel about EHRs, or what doctors want from EHR software

EHRs are meant to increase physician efficiency. But unfortunately, most doctors (56%) say EHRs do the opposite according to a 2018 Survey of America’s Physicians by the Physicians Foundation. The same survey states that doctors do see value in EHRs, yet they want significant improvements. What do doctors want from EHR software? Let’s find out. But before we go into detail about creating a successful EHR that addresses doctors’ needs, let’s look at the major barriers to physicians’ use of EHRs.

Key barriers to adopting electronic health records

A study by AAFP shows that the use of EHRs greatly contributes to doctor burnout, stress, and frustration. Additionally, doctors report spending quite a lot of time working on EHRs at home. Other research from Stanford Medicine shows that only one in five doctors are very satisfied with their current EHR software. EHR systems require some changes. 

Data source: med.stanford.edu 

Below, we lay out common EHR challenges doctors face and offer possible solutions.

#1 Doctors spend up to three times as long on EHRs as they do caring for patients

According to the Annals of Internal Medicine, physicians typically spend 16 minutes per visit using an EHR. A survey by the Physicians Foundation states that practitioners spend 19 minutes in an EHR out of 31 minutes on behalf of each patient: 8 minutes during the visit and 11 minutes outside the visit. First-year doctors spend up to 43% of their working time interacting with EHR software. It shouldn’t take that long.

What can be done? An EHR should offer a frustration-free user experience. When designing your platform, make sure it:

• Solves users’ problems. Your system should perform all the functions required to get the job done.
• Is easy to learn. A new user should be able to learn your platform easily and quickly.
• Is straightforward and not overly complicated. An EHR should provide quick access to common commands.
• Is consistent. Your EHR should always behave the same, meaning a user shouldn’t have to find a new way to do what they need to each time they take a similar action. 

Also, medical staff needs training to switch from paper to digital health records. Provide useful learning and training resources so doctors can be taught the optimal way to use the system. Offer step-by-step instructions, pre-recorded videos, pictures, and tutorials to make the learning process easier.

#2 Doctors don’t consider an EHR a powerful clinical tool

Among primary care physicians, 44% say an EHR acts as data storage, not a clinical tool, and only 8% consider an EHR to be clinically important according to Stanford Medicine.

What can be done? EHR software should evolve beyond data storage into a solution that provides clinically important yet necessary functionality. Include features like flexible charting, built-in billing, e-prescribing, mobile access, patient management and scheduling, reporting, and order management.

#3 A poor user interface contributes to EHR inefficiencies and more screen time

Poorly designed user interfaces cause inefficiencies and increase screen time. Stanford Medicine reports that 72% of physicians want to improve EHR user interfaces to address common challenges.

What can be done? To craft a good design, pay close attention to colors, typography, icons, and images. Your design should be minimalist, consistent, clear, and relevant. Be very careful about what elements you include and what elements you don’t. Also, don’t forget to ask for user feedback. This will help you improve your design and the product itself.

#4 EHR interoperability is a mess 

67% of doctors say solving interoperability problems should be a key focus for EHRs in the coming years. Doctors should be able to easily share data with providers across the care continuum. (Source: med.stanford.edu)

What can be done? Make it easy for doctors to share medical records with lab providers, emergency rooms, pharmacies, and other entities. 

In addition to the above, we suggest you:

• Take security measures from the very beginning
• Design your system so it can scale
• Talk with doctors, patients, nurses, and other potential users to find their needs and focus your EHR development in the right direction
• Define user roles and permission levels to cover multiple functions and address the needs of all groups within your practice

Examples of the best EHR software

Real-life EHR apps are the perfect place to get inspired with ideas for your own EHR software. Using examples from the best EHR vendors, we can draw up a list of features and key elements to consider adding to your EHR. 

NextGen Healthcare

• Years on the market: 48
• Employees: 2,800+
• Providers using NextGen: 155,000
• Company type: Public
• Area served: US
• Website: www.nextgen.com

Source: www.nextgen.com

NextGen Healthcare is a US technology company that builds and sells EHR and medical practice management software. NextGen Healthcare also offers solutions for clinic management, billing and revenue management, and population health. 

Initially, NextGen software was aimed at dental practices. Yet about 20 years after going live, they switched to electronic health records. Today, NextGen Healthcare is one of the leading EHR software vendors. The company has won many awards including the 2018 White Coat Award, 2018 most improved vendor for EHR by KLAS, 2019 North American ambulatory revenue cycle management enabling technology leader, the best practice management solution by 2020 best in KLAS, and number one in client satisfaction for integrated ambulatory EHR by Black Book Research.

Major NextGen EHR modules/features:

• Data sharing across systems via NextGen Share, whose directory contains over 1.2 million providers and organizations.
• Immunization, radiology, and lab interfaces where doctors can check a patient’s test results.
• Health maintenance reminders. Physicians can set notifications unique to their specialty or practice, enable reminders for past due health maintenance, and adjust alerts at the patient level.
• Referrals. Doctors can send referrals and track information over time.
• Reporting. Practices can dive deep into the patient flow through every part of their visit. With such reports and data, organizations can see where time issues are, evaluate the performance of a particular physician, and know if patients receive timely attention.
• Workflow screens. Providers can check the appointment queue, clinical tasks, and clinical appointments.
• Clinical tasking. Users can create, reassign, and update tasks.
• Clinical quality measure reporting. This module allows clinics to generate reports to measure progress against work objectives. 
• Population health. With the population health management module, clinics can access  population demographics, disease registry information, and analysis of gaps in care based on an organization’s clinical quality measures.
• Mobile access. Physicians can check a patient’s vitals and labs anywhere at any time.

Also, NextGen EHR is connected with the patient portal. This helps patients proactively participate in their care by checking their recent information and visit activity, getting lab results, ordering prescription refills when needed, and scheduling appointments. When a patient can’t make it to a physical visit, they have the option to schedule a virtual appointment. 

NextGen clients include Planned Parenthood, Appriss Health, Cherokee Health Systems, First Care Clinics, Texas Health Resources, CalvertHealth, Eye Specialty Group, Preferred Family Healthcare, and Grace Health.

Kareo

• Years on the market: 18
• Employees: 1,000
• Providers using Kareo: 107,000+
• Company type: Private
• Area served: US
• Website: www.kareo.com 

Source: www.kareo.com/ehr 

Kareo is an American healthcare IT provider that creates SaaS solutions for independent medical practices. Their EHR software is a modular platform allowing healthcare providers to use one or all modules: EHR and practice management along with telemedicine and patient payment processing. 

The Kareo EHR can be used across over 45 medical specialties including family medicine, mental health, cardiology, pediatrics, podiatry, and chiropractic, and is mainly used among small practices and billing providers. Kareo is a subscription-based EHR that offers different subscription options. Based on our research, implementation costs start at $300 and the monthly user fee starts at $160. We suggest you contact a Kareo sales representative to get a better understanding of their pricing.

Major Kareo EHR modules/features:

• The Dashboard provides healthcare providers with an overview of their day. Doctors can view and manage patient appointments and access high-priority tasks like prescription refills, lab results, messages, and open notes.
• The Calendar allows the front office and doctors to easily manage appointments, see patient alerts, view details on patient eligibility, and see and print credits, outstanding balances, and copays.
• e-Prescribing. Doctors can quickly and easily send prescriptions directly to a pharmacy or print them out. This can be done during any part of the patient encounter. Also, doctors are allowed to search for a medication from Kareo’s comprehensive library using automatically suggested recommendations. Or they can choose a medication from their frequently prescribed list. 
• Patient portal. The Kareo EHR is integrated with the patient portal so doctors can easily connect with patients online by exchanging messages instantly and sharing lab results, medications, allergies, diagnoses, immunizations, histories, and clinical summaries in a secure environment. Plus, if a doctor uses Kareo practice management software, patients can see and pay bills.

Kareo’s clients include Medcor, SAI Systems, Able Rehabilitation Equipment, Advantage Physician Billing and Consulting, Physical Medicine & Chiropractic Centers, Alli Center, Billing Advantage, and Elite Medical Revenue Solutions.

Key features of an EHR

Based on the examples we’ve just shown you, let’s outline the features that these top EHR vendors have in common.

The last word: It’s time for a change in health IT

An EHR is a great way for clinics to provide a better patient experience coupled with a more efficient practice. A well-designed EHR system allows healthcare providers to concentrate on patients without getting bogged down in administrative work or documentation, maximize reimbursements, and stay compliant. 

We hope our guide has given you a better understanding of how to create a successful EHR system that provides great value to doctors. Check out our custom healthcare software development offer to learn about our expertise in the industry.