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How to Build EMR Software for your Business?

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Alexander Safonov
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Electronic Medical Record (EMR) management software allows you to record, store, use and maintain information that is usually collected in traditional paper medical records: first and last name, demographics, visits, diagnoses, test results, allergies, treatment contraindications, notes, etc. Further we will tell you how to develop such EMR software for your business.

Step 1: understand which EMR you need

How to Build EMR Software for your Business?

More and more users are concerned not with unauthorized access to confidential medical information, but with data errors that can negatively affect the quality of treatment. At the same time, every fifth patient found such an error in his EMR. Source

Before you start creating an EMR system for your business, you need to understand what kind of software you need: what tasks, functions, design, navigation, architecture, technologies you need to implement. To understand all this, you need to perform the following steps (research):
  • Define your strategic goals. These should be specific and understandable goals that can be measured. For example, if your goal is to reduce the time it takes to visit a patient, then you need to explore the possibility of integrating the online appointment function, and then measure whether it has reduced the time it takes to see a patient.
  • Talk to your users about their needs. Patients, clinical staff, insurance companies, and other future users of the EMR you create can provide valuable insights into what software needs to be built (design, function, etc.) and how to make it more orient towards patients and hospital.
  • Analyze the solutions of your competitors. So you will understand which solutions of your competitors were liked by users, and which turned out to be controversial or useless. Thanks to this, there will be no need to reinvent the wheel and repeat the mistakes of other companies.
  • Document your requirements. Once you have identified your strategic goals, user needs, and competitive advantages, you can begin to transform this information into business requirements, which will then be used to write a functional specification for developing EMR software for your business.

Step 2: study the relevant laws

How to Build EMR Software for your Business?

7 Key Elements of HIPAA Compliance for EMR and EHR Services. Source

So, to understand how to create EMR software, you need to study the laws related to medical application development and sensitive data. These are the key laws and certification systems in the US and EU:
  • GDPR. Regulates the rules for the collection, management and protection of personal data in the EU. Imposes a duty on a healthcare provider to ensure that data such as names, addresses, demographics, medical diagnoses and more are highly protected, which, among other things, includes creating a system to instantly delete or correct information.
  • EuroRec. It is a certification system for software development that must be passed by all providers of EMR and EHR solutions operating within the EU or using data from EU citizens.
  • HIPAA and HITECH. Regulate the rules for the use and storage of personal data, as well as the rules (standards) for the development of medical software in the United States. There is a detailed guide on GitHub on how to create HIPAA compliant EMR software.
  • Medicare and Medicaid. In 2011, CMS established the Targeted Use Program, to promote the adoption of digital health records in medical practice. This is part of the HITECH law and is meant to certify software according to CEHRT.
  • ONC-ATCB. This is the initial certification of electronic health record technology in the United States. The certification body helps healthcare organizations implement and update their information technology.

Step 3: decide on the functionality of the system

How to Build EMR Software for your Business?

Top 10 functional and design issues EMR / EHR users face. Source

Patient page. EMR systems usually contain personal data of patients: full name, address, age, gender, diagnoses, test results, allergies, prescribed medications, contraindications to treatment, DNA test results and other information that gives an overview of the patient's health.

Patient registration. When a patient first comes to the hospital or makes an appointment, the front office needs to get their information - name, age, address, insurance company - and enter this data into the system. Some EMR software allows you to scan your driver's license and insurance cards by automatically filling in many of the required fields.

Planning, calendar. After registering a patient in the system, you can add him to the schedule of appointments and assign him a specific doctor. Typically, scheduling tools resemble a calendar, where you can select the type of meeting, date and time, contact information, lead source, etc.

Patient record. Detailed tracking of the history of diseases and their treatment, prescribed medications and contraindications. This feature increases the doctor's chances of making a correct diagnosis in a short time and making the right decision about treatment. Also, based on the many medical histories, it is possible to understand how effective the treatment is (whether medications and medical practices work).

Filling out medical records. This is the least favorite activity among doctors in the whole world. Therefore, one of your main tasks when developing software for an EMR system is to make this process as simple and understandable as possible, as well as automate it where possible. This can be achieved with custom templates, machine learning and blockchain technologies.

Integration with laboratories. It is needed to simplify, improve and speed up the interaction between hospitals and laboratories. For example, you can implement in your EMR the function of tracking the delivery of samples to the laboratory and outputting the results directly to the system, which will give more complete control over the treatment process and eliminate errors associated with manual transfer of data from laboratory to medical records.

Reminders, notifications. Automatic appointment reminders sent to patients by email or SMS will save a lot of time and reduce the number of missed appointments. For doctors, this option is also useful, as it allows you to concentrate on treating patients and not waste time memorizing the schedule of all events and appointments.

Electronic recipes. These are tools that track patient prescriptions, including information about what types of treatment they are receiving now and in the past. Advanced EMR software can automatically warn that a new prescribed drug should not be taken along with the one the patient is currently taking.

Making reports. EMR management software typically includes a suite of analysis and reporting tools that provide an overview of information about patients, doctors, and the clinic as a whole.

Patients portal. The electronic health record management system should also include a user interface for patients that provides them with access to the following data:

  • History of visits.
  • Patient record and treatment.
  • Laboratory tests with results.
  • Detailed hospital discharge reports.
  • Prescriptions of prescribed medications (drugs).
  • Online requests for renewal of prescribed medications.
  • Information about whether the patient is a donor.
  • Reservation of appointments with doctors, their schedule.
  • Immunization, allergies, contraindications.
  • Treatment costs, payments, insurance.
  • Possibility of downloading your medical card.

Step 4: select the API technology stack

From a technical point of view, a user site or application consists of a client (front-end) and a server (back-end), which are connected to each other and to other services through an API (Application Programming Interface). When creating your EMR system, you need to choose which development tools and APIs you will use in your project. Here are some recommendations.

Front-end. Includes all software elements with which end users interact: doctors and patients. This is the user interface and the interface of the EMR system. The table below lists the most commonly used development tools for the three main platforms.

How to Build EMR Software for your Business?

Back-end. The server part of the EMR system, which works with information and corresponds to the place where the main service functions are performed and transmitted with the necessary results to the front-end component of the system. This is what the technology stack for internal EMR software development looks like:

  • Programming language: Ruby (recommended), Elixir, Python, PHP, Java.
  • Database servers: PostgreSQL (preferable), MySQL.
  • Web frameworks: Ruby On Rails (recommended), Phoenix.
  • Web servers: nginx (preferable) or Apache.
  • Hosting: Amazon Web Services (AWS, EC2, S3 etc.).
API (Application Programming Interface). A set of software solutions for connecting external and internal interfaces, as well as integrating the necessary third-party services that extend the functionality of your platform. Different systems will require different types of APIs, depending on the focus and required functionality. The table below shows the possible services that you can use when developing your own EMR platform:

How to Build EMR Software for your Business?

How to Build EMR Software for your Business?

How to Build EMR Software for your Business?

Step 5: get started developing EMR

EMR systems are complex software with very high safety and reliability requirements that can only be achieved through custom development, since WordPress and website builders simply cannot provide even minimal protection of personal data. Where to find someone who can be entrusted with such development is described in detail and with examples in the article «How to choose a developer company».

When you select a developer, the EMR creation process will be like this:

  1. Signing a contract. At the first stage, you, as a customer and a development company, as a performer, draw up a detailed technical description of the project, indicate the timing, cost and performance indicators. When all these things are agreed, you enter them into the contract and sign it.
  2. Prototyping the application. Next, interface designers, based on the technical description and analysis of the target audience, develop the wireframe of your EMR system. A wireframe is a simplified schematic illustration of a user interface showing only the architecture and navigation of a site and / or application, and all other design elements (text, images, buttons, icons, videos, and animation) are replaced with empty blocks.
  3. Creation of interface design. When the wireframe is ready, UI designers use it to create a mockup and possibly a prototype for the user interface. A layout is a static representation of a design as it will be presented to users. Prototype is an animated layout where all icons, animations and transitions work, but functions do not work.
  4. Direct encoding. After mockups and prototypes are created, front-end, back-end, and mobile developers take over and write the code for your EMR management software.
  5. Product testing. When the program code is written, it is thoroughly tested for errors and bugs, the ability to work normally under all possible loads. All this is checked by QA engineers.
  6. Deployment. At the second-to-last stage, EMR is filled with data and released to the market, added to various listings and offered to clinics for testing. If this is a mobile application, then it is also added to the listings of Google Play and App Store marketplaces.
  7. Support. In parallel with the deployment of the product, the developers launch and configure the work of the support service, which will help users to solve problems. Also, support usually collects feedback for the subsequent improvement of the software.

The cost of creating EMR software

How to Build EMR Software for your Business?

How to Build EMR Software for your Business? key takeaways:
  1. Step 1: understand which EMR you need
  2. Step 2: study the relevant laws
  3. Step 3: decide on the functionality of the system
  4. Step 4: select the API technology stack
  5. Step 5: get started developing EMR
  6. The cost of creating EMR software
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