Introduction

Electronic Health Record (EHR) systems represent a complete, real paper chart, providing all the benefits of information that is instantly and securely available to authorized users – at access points all over the health facility, in different and remote care providers’ locations, and sometimes outside the health organization, such as the patient’s home. Ideally, an EHR will contain and share information from all patient-care providers that might impact a patient’s care. This enables a distributed view of a patient’s care over time, with the end goal of providing the best quality of care for the patient by ensuring appropriate and accurate patient data at all the points in the record from the time of the patient’s care, past, present and future. EHRs can provide the patient’s medical history and diagnoses, medications and treatment plans, immunization dates, allergies, radiology images, laboratory test results, and more.
Customization is one of the most important non-functional requirements that must be taken into account in healthcare software product development. Generic EHR systems offer huge benefits since they have been widely used in many different environments and, as such, most problems have been identified and addressed (or workarounds are common practice). However, they might not fit some specialties and healthcare organizations. Workflows and practices are different between organizations, sometimes even departments within them. Customization to the organization’s specific workflows, practices, and regulatory requirements can improve the facility's efficiency in terms of the number of patient visits, error reduction, and patient outcomes, among others. Customization might be the key to making EHR systems work seamlessly as part of an integrated technological infrastructure within hospitals if integrated with other technologies.
The advantages of having a custom EHR system are too many to count: better patient care, faster workflow, improved data security and regulatory compliance, easy Single Sign-On, etc. Custom EHR can reduce the time clinicians spend on administrative work, which, in turn, can improve patient care as they have more time to spend with patients. For clinicians who spend most of their energy on paperwork and data entry, custom EHR can create a hospital environment where physicians have more time to spend with their patients. Custom EHR also helps generate tailored reports to aid in making both clinical and business decisions. With custom EHR, organizations and physicians can also use the system to improve care coordination and collaboration among people working on a patient’s medical condition or holding responsibilities in that patient’s care.

Understanding custom EHR systems

Electronic Health Record (EHR) systems can be defined as digital repositories for information on an individual’s health history, proving a safer and more effective way of collecting, storing and managing patient’s health and care information while eliminating the use of paper records. EHR systems provide secure access to patient data in real-time by approved permitted staff and professionals. Electronic Health Records (EHR) contain a variety of components, including the patient’s medical history, diagnostic test results, allergies, immunization dates, medications, treatment plans, lab results, radiology images, and past surgeries. EHR systems were established with the purpose of improving patient care and outcomes by providing accurate and complete information about the patient’s history to fellow healthcare providers while granting access to this information in rapid manner and when needed.

Difference between off-the-shelf and custom EHR systems

Off-the-shelf EHR systems - Off-the-shelf EHR systems are so-called ready-made solutions that fulfill the requirements of typical healthcare providers. It is a system comprised of one or many pre-built EHR core components, which cover many popular features and functionalities required by many other healthcare providers. The core advantage of off-the-shelf EHR systems is primarily economic – lower upfront costs, shorter time-to-market (implementation), and well-proven products due to the previous deployment in many other practices. The most common disadvantage of such ready-made EHR systems is a lack of flexibility and appropriateness for a particular practice or workflow, lack of customization, and potential inefficiencies in usage due to the mismatch between the system and the practice or between different layers within the same system.

Custom EHR systems - Unlike a generic off-the-shelf EHR, custom EHR systems are crafted to the specific needs of a specific practice. Instead of forcing a practice’s workflows, procedures, and regulatory requirements into the rigid structure of an out-of-the-box system, custom strategies work with the organization to craft an EHR that’s designed around existing workflows and technologies. Custom EHR systems lend themselves more readily to integrating with legacy technologies since they can be adapted to the vessels in which they’ll need to flow. That said, developing and implementing a custom EHR system can take more time and expenditure than a generic system. However, the gain in return is often worth the initial costs of custom healthcare software solutions. A custom system makes the user’s job more efficient, accurate, and pleasurable by seamlessly integrating existing workflows and technologies.

Why customization is crucial for healthcare providers

Customization in EHR systems is essential for several reasons:

1. Alignment with specific workflows - Every healthcare facility has a different type of workflow matched to the nature of the work, which is in turn related to facility type, size and type of patient population, and level of specialty. By developing a custom EHR, the system can conform to this workflow, making it as efficient as possible by supporting the real-life workflow rather than hindering it. This adaptation reduces disruption to normal operations, reduces the staff learning curve, and enhances efficiency.
2. Enhanced patient care - Implementing a custom-crafted patient EHR can ensure that physicians have all pertinent patient information readily available to them in the right format. Custom software development for healthcare can offer practice-specific templates, alerts, and reminders that aid clinical decision-making and patient improvements.
3. Improved data integration - Better data sharing Improved data integration: In theory, EHRs could be developed to work in tandem with other systems and software that providers use, such as laboratory information systems, radiology systems, practice management/billing software, and more. The workflow would be more efficient since providers would not have to re-enter the data in several separate places manually; they would enter it once and have a seamless way to see it in all those other systems.
4. Compliance with regulatory requirements - When it comes to healthcare providers, certain areas must comply with federal, state, or local laws in how they operate. EHR in healthcare custom software development would be designed to support the specific regulations where the healthcare provider’s office is located or specializes. Creating custom EHR would help providers reduce the chances of legal action or penalties.
5. Scalability and future-proofing - A custom EHR will make it easier and more cost-effective to incorporate new features and functionalities as your organization’s requirements change, thereby preserving the system’s long-term relevance and efficacy.

Key benefits of custom EHR systems

Enhanced patient care

• Improved accuracy and accessibility of patient records - EHRs that are custom-built for a practice ensure that the patient record is accurate, robust, and easily available. The data is pulled from various sources (physical exam notes, lab results, images, specialist records, etc.) and placed in one concise record, giving a complete and current picture of the patient history. Fast access to correct information ensures correct diagnosis and formulation of a care plan, leading to better patient care. A custom EHR can have templates and fields designed for the specialty of the practice, ensuring that all information pertaining to that practice is captured and displayed as required.
• Streamlined communication between healthcare providers - When using the same system, sharing information becomes easier. Trying to arrange lab tests, referrals, and discussions with other doctors to make a diagnosis and plan patient-centered treatment can be a strenuous task. This interoperability stems from healthcare mobile app development and ensures that all care team members have access to the same information, reducing the risk of errors and ensuring continuity of care. Custom EHRs can also integrate tools such as secure messaging, automated alerts, and reminders, and such features can easily integrate multiple teams to streamline coordination and collaboration.

Increased efficiency

• Automation of administrative tasks - Administrative tasks such as appointment scheduling, billing, and refilling prescriptions can be automated within a custom EHR, improving patient care immensely. To illustrate, patient record systems can be automated so that the doctor or nurse simply requests what appointment times fit the availability of both the patient and the provider, and the automated system in the EHR fills in the time details based on the responses. When an automatically generated entry later turns out to be incorrect, correcting it with a couple of clicks is easy.
• Reduction in paperwork and manual entry - Shifting information from traditional paper to digital EHR systems eliminates paperwork that physicians, nurses, and other healthcare administrators have to keep in hand. Efficient custom EHR systems offer easy-to-learn interfaces and superior workflow patterns to urge their users to make minimal effort in data entry. This helps them to reduce paperwork, which in turn eliminates wasting time, reduces storage cost overhead, and reduces the probability of losing a significant document. Additionally, a search on electronic records is faster, more effective, and more efficient.

Better compliance and security

• Custom security features to protect patient data - Security and privacy are paramount, and custom EHR systems can be developed to include advanced security measures to protect patient information. While choosing custom healthcare software development services, go for EHR systems that include advanced encryption, multi-factor authentication, and audit trails to monitor access and activity. Custom security options for EHRs help guarantee the protection of sensitive patient details by safeguarding against unauthorized access, breaches, and other forms of cyber attacks and give both providers and patients assurance.
• Compliance with healthcare regulations - The implementation of healthcare regulations like the Health Insurance Portability and Accountability Act (HIPAA) helps guarantee that patients are not victimised for personal data by law enforcement or private firms, and that lawsuits for mishandling data are avoided. Custom EHR systems can be built to cater to any specific regulatory components, taking into account all required restrictions and protocols, thus minimizing the risk of finances and penalties from third parties.

Scalability and flexibility

• Adapting to the specific needs of the healthcare facility - To make it more tailored to the needs of the facility, every healthcare provider's operations are different and have unique workflow needs, which can be handled with custom EHR systems. Whether the facility is a clinic or a hospital, the GHXD expert's custom EHRs can be designed to help facilitate how the facility operates. Custom EHRs will ensure that daily operations are enhanced and do not hinder workflow efficiency, leading to better patient care.
• Future-proofing for technological advancements - Technology in healthcare is evolving all the time. New technologies are discovered and the ways of using and implementing them are regularly updated. The ability of a custom EHR to adapt to these changes in technologies is a huge advantage that can help you keep up with the health sector. Continually introducing new feature sets and functions enables a custom EHR to grow and evolve according to the mutual needs of the healthcare provider and the patient. This feature assists in keeping the EHR relevant and effective for the ever-changing needs of the health sector and is able to incorporate new technologies and practices.

The implementation process of custom EHR systems

Initial assessment and requirement gathering

• Identifying the unique needs of the healthcare provider - Before undertaking a custom EHR build, the provider and team conduct a complete assessment of the company’s needs and requirements by evaluating current workflows, identifying challenges faced by staff, and detailing effective features and functionalities to overcome those challenges. Extensive interviews and observations often help to determine the company’s daily processes in detail and all the pain points they need to alleviate.
• Stakeholder involvement and feedback - Stakeholders like physicians, nurses, admin staff, and IT personnel are involved in getting their input and feedback. Their perspectives should be the primary source for putting emphasis on the right design or functionality of the custom EHR system. Meetings or workshops with the stakeholders keep track of the requirements collected from them and represent their needs and expectations.

Designing the custom EHR system

• User-centric design principles - Producing a bespoke or custom-built EHR employs user-centered design approaches to ensure that the system is ergonomic, efficient, and easy to use. Features such as an intuitive design framework, smooth navigation flow, and workflow that matches how the user naturally approaches their job all boil down to reducing the number of clicks or interactions needed to efficiently conduct a large portion of the providers’ clinical day. In other words, we intend to make the system as easy, efficient, and satisfying for a clinician to use as possible.
• Integration with existing systems and workflows - One of the most crucial design tasks is to ensure that the custom EHR system can integrate with its existing systems and workflows. It should be compatible with other software programs, medical equipment, and data management platforms used by the healthcare provider organization. Effective integration will make data exchange easier, thereby minimizing redundancies and enhancing operations efficiency.

Development and testing

• Agile development approach - Adopting an agile development methodology will allow the development of the custom EHR system to adhere to iterative processes that enable continuous feedback and improvements as the system develops. Agile includes dividing the project into small, approachable pieces to accommodate feedback and teachability. To this end, seek a developer with custom healthcare mobile app development services who offers regular iterations and reviews, testing the system as it’s developed so that it continues to get better and ultimately works the way the healthcare provider believes it should.
• Comprehensive testing for functionality and security - The custom EHR system needs to be fully tested to be sure it functions according to specifications, that it is secure, and that patients' confidential health information remains safe. To do this, thorough functional, usability, performance, and data integrity testing must be done. Only after conducting extensive security testing can the medical office be sure that the system really works to their specifications, that there are no vulnerabilities that would allow hackers to access it, and that patients' critical health information will remain safe.

Training and support

• Training programs for healthcare staff - An important element of a successful full-scale implementation of an EHR with custom features is the availability of appropriate training programs with different levels of proficiency for all groups of users in the health organization, such as physicians, nurses, office staff, and IT personnel. All system features and functions, from the basics like navigation to advanced modules like medication history and documentation, should be included in training programs. The use of hands-on training sessions, user manuals, and online help resources can help maintain staff competency and comfort in using a custom EHR.
• Ongoing support and maintenance - The given vendor must be able to provide maintenance and support for the long run of the system. This may include providing technical support whenever the user encounters a certain issue, performing diagnostics from the backend, and creating bug fixes and contingencies if there are other problems when the EHR system is already in implementation. Maintenance and support work hand in hand with regular updates in EHR to make newer features and security patches available for managing store data. This is an advantage for companies and establishments that must keep their patients' information secure. With a constant stream of feedback, the system may be improved and polished over time.

Conclusion

A properly designed and supported custom EHR system can empower healthcare providers to provide better care for their patients, become more operationally efficient, and increase regulatory compliance. By tailoring the EHR system to fit the often-complex workflows, regulatory requirements, and cultures of the organization providing care, providers can achieve exponential gains in accuracy, availability, usability, and comprehensiveness while decreasing cost, improving patient outcomes, and reducing physician and nursing burnout. The implementation of a well-planned, carefully considered and properly equipped custom EHR is complex, time-intensive and costly, but is a worthwhile investment. Like medical care itself, a custom EHR system is not a simple product or service; it requires planning, discussion, design, testing, and delivery, followed by training, support, and modification over many years after implementation. EHRs will continue to evolve at an ever-increasing pace, reflecting and amplifying the dynamic and complex changes within the rest of the healthcare system. As these changes continue, the rigidity of off-the-shelf systems (OTS) will remain a major barrier to providing high-quality, patient-centered medical care in the years to come. Custom EHR systems will be essential not only to meet these challenges but also to thrive in this evolving landscape.

People Also Ask (PAA) questions

1. What are the benefits of a custom EHR system?
   A custom EHR system, specially built to fit the workflows of a given healthcare provider, will help streamline workflows, improve patient care, and streamline operations by integrating with the existing EHR while avoiding unnecessary work. It will be more flexible, scalable, and designed to suit specific regulatory and operational needs.
2. How do you implement an EHR system?
   Setting up an EHR system involved planning and analyzing the appropriate features of the system, which included selecting or developing the system, integrating it with the existing system, training the staff involved, and testing to ensure that the system fits the healthcare provider’s needs and is compliant with the regulations.
3. What is the difference between a custom and off-the-shelf EHR system?
   On the other hand, a custom EHR system (such as one we built at the Texas Biomedical Research Institute) truly suits the needs of the provider in question: it can be designed from the ground up. Custom-built IT systems are likely to be a better fit than off-the-shelf EHR systems, which come with pre-defined lists of features – only sometimes aligned with actual requirements or workflows.
4. How does a custom EHR system improve patient care?
   A bespoke EHR system provides improved patient care through features that streamline clinical workflows, improve data accuracy, and facilitate more effective coordination of care between care providers. It offers patient care that is more targeted and tailored to their needs through better patient information management and other custom-fit workflow solutions.
5. What are the steps involved in the EHR implementation process?
   A due-diligence process must follow: assess the needs, select/develop and test the system, integrate it with existing technology, train the users, test, go live, support, and maintain/update.
6. How long does it take to implement a custom EHR system?
   If you need to build a custom EHR system, the timeline varies dramatically based on the artificial complexity added to your new billing system; depending on the specifics, your system can take several months or more than a year to implement.
7. What are the common challenges in implementing EHR systems?
   Typical hurdles include data migration problems, staff resistance to change, integration with existing systems, regulatory compliance, and complexity.