What is the Price Tag for an EHR?

a close-up view of stethoscope on dollar bills

Healthcare organizations are certainly not oblivious to electronic health records (EHRs). When considering the implementation of EHRs, their primary concern often revolves around the cost. While the process of implementing EHRs is not overly complex, the associated expenses can sometimes pose challenges. The cost of EHRs tends to fluctuate based on specific requirements and the choice of vendors. The 2022 EHR Project Report highlights that it takes about 12 weeks for a healthcare organization to decide on an EHR, influenced by the size of their practice. This report also notes that the average budget per user for EHR software is approximately $1200. Interestingly, solo practices generally allocate a higher budget for EHR development compared to larger practices, possibly because larger groups might enjoy lower costs per user due to economies of scale. It’s important to recognize that in the context of EHR purchases, a ‘user’ encompasses not just physicians but also support and administrative staff who need access to the system for tasks like scheduling. 

A study, although conducted over a decade ago, revealed that average EHR maintenance costs were about $1,500 per physician each month. This study was based on the then-dominant on-premises systems. Today’s reliance on cloud technology means that the maintenance cost breakdown is largely controlled by the EHR vendor. However, factors like support and training, additional server costs, and expenses for IT staff to manage and secure data are crucial considerations in determining the overall EHR pricing.  In exploring the theme of the “Cost of EHR,” it’s essential to delve into specific EHR systems like Epic to gain a deeper understanding of the financial considerations associated with their implementation and maintenance.

For those interested in delving deeper into the various elements influencing EHR costs, this article offers insights into both the integration and implementation expenses of EHRs.

Electronic Health Record (EHR) Implementation Costs

As previously emphasized, the cost associated with implementing Electronic Health Records (EHR) serves as a substantial hurdle for many healthcare providers. However, it’s important to recognize that EHR systems can ultimately lead to increased revenue over time. According to a report published in Health Affairs, solo practitioners and small medical offices can typically recoup the average EHR investment within 2.5 years.  In this discussion, let’s delve into the breakdown of EHR implementation costs.

  • Direct Costs: A survey conducted by Health Affairs revealed that the average multi-physician practice invests approximately $162,000 in EHR implementation, with a significant portion, roughly $85,000, allocated to first-year maintenance expenses. While this estimate harks back to the early days of EHR adoption, it still provides a foundational understanding of potential EHR software expenditures. Medical practices embarking on EHR adoption can anticipate regaining their initial investment within approximately 2.5 years, subsequently reaping an average of $23,000 in net benefits per year for each full-time employee;
  • Indirect Costs: It is imperative to take into account indirect EHR expenses, including initial and standard installation fees. These concealed costs constitute a substantial portion of the overall adoption expenditure. EHR training is often regarded as a crucial component of the implementation budget. Investing in comprehensive training for both physicians and staff may initially seem costly. However, neglecting this aspect can lead to more significant costs in the long term as healthcare professionals and support staff struggle to fulfill their responsibilities. Prioritize extensive training for those in need, as it is an investment that will ultimately save you money;
  • Staffing-Related Expenses: Another crucial consideration involves assessing the extent to which your IT team may need to be reconfigured following the online deployment of the EHR software. Even if your practice’s IT demands are relatively modest, it’s essential to evaluate whether additional IT support will be necessary during the implementation phase. Virtually every medical practice relies on certain IT tools, such as revenue cycle management software, that need to operate around the clock. Maintaining these systems can be time-consuming. While most cloud-based providers offer technical assistance, on-premises systems typically require skilled IT personnel;
  • Unexpected Expenditures: It is vital to be mindful of the possibility of unforeseen EHR costs arising during the implementation process. Recognizing potential challenges and assessing your situation accordingly is critical. While it may be impossible to predict the exact implementation cost, keeping these considerations in mind can help mitigate unexpected expenses post-purchase.

A Closer Look at Customization Costs

In the realm of healthcare, the diverse array of medical specialties necessitates unique and customized systems to cater to each practice’s specific needs. For instance, practices may require tailored solutions for remote patient monitoring, telehealth services to facilitate virtual care delivery, and streamlined medical billing processes to ensure efficient reimbursements. While general practitioners and hospitals can often make use of off-the-shelf EHR systems, the landscape changes for medical professionals such as pediatricians, surgeons, mental health facilities, hospices, and other organizations with specialized service focuses.

The cost associated with EHR deployment can vary significantly from one provider to another, primarily contingent upon the scope of features and integrations required. This cost spectrum spans from approximately $50,000 to $500,000 for different clients seeking tailored EHR solutions. Although the upfront investment in custom EHR systems may appear substantial, it represents a strategic approach that can yield substantial long-term savings for the healthcare practice. 

EHR Implementation Budgets

Budgeting for the implementation of Electronic Health Records (EHR) is a multifaceted endeavor influenced by specific features and individual practice requirements. The precise cost estimation for EHR implementation can be intricate, as it hinges on various factors and the choice of system type (web-based or on-site). Cloud-based solutions typically involve subscription fees, while on-site systems require ongoing management and support. To effectively plan for EHR implementation, it is essential to consider five fundamental components that necessitate budget allocation:

  • Hardware and Networking: Ensuring the optimal functionality of an EHR system is paramount for healthcare organizations to realize its full potential. Adequate and up-to-date hardware and infrastructure play a pivotal role in this regard. EHR vendors often provide guidance on necessary adjustments before implementation, which may entail acquiring new devices such as computers, laptops, and printers, as well as enhancing the network, operating system, or applications. Taking a proactive approach to hardware and networking not only contributes to optimal system performance but also proves to be cost-effective in the long run;
  • Implementation: Tailoring the adoption of an EHR system to the specific objectives and requirements of healthcare organizations can lead to cost-effective strategies. Some opt for budget-friendly solutions such as off-the-shelf EHR software, primarily focusing on software expenses. Alternatively, tech-savvy teams may explore open-source EHR software, which can be economical or even free. However, many institutions seek expert assistance due to their intricate needs. Customization, integration with third-party tools, and workflow adjustments are often essential to ensure a seamless EHR implementation that aligns with their organizational goals.
  • Training: The implementation of a new system or a substantial overhaul of existing processes inevitably requires the updating of personnel knowledge and skills. The costs associated with training can vary significantly based on factors such as the extent of new features introduced, changes in workflows, the scale of the organization, and the intricacies of the adopted system. Taking these training expenses into account is crucial when evaluating the overall costs of implementing an EHR system;
  • Ongoing Costs: Continual expenses encompass maintenance, support, internet connectivity, and contractual agreements. Practices seeking to minimize ongoing costs might explore options like open-source EHR software or collaborate with vendors offering flexible pricing structures. Furthermore, assessing the cost-to-benefit ratio before EHR implementation ensures that the anticipated benefits outweigh the expenditures. With prudent planning and careful consideration of these factors, healthcare organizations can successfully adopt an EHR system and reap enduring advantages.

Analyzing Electronic Health Record (EHR) Costs

a doctor in medical white suit putting a coin  with croos into blue piggy bank

Delving into the realm of Electronic Health Records (EHR) costs often leads to a familiar response: “It depends.” Determining the exact expense of an EHR system is a nuanced endeavor, contingent upon various factors, and as such, it necessitates a thorough examination of influencing variables. This EHR cost compilation entails a comprehensive evaluation of key determinants, including:

Deployment Methods: Cloud vs. On-Premises

The choice of software deployment method can significantly impact the long-term expenses associated with an Electronic Health Record (EHR) system. As previously highlighted, the total cost of ownership (TCO) over a five-year period can diverge significantly between on-premises and cloud-based systems. Cloud-based options may entail different upfront and ongoing costs when compared to office-based alternatives.

However, a comprehensive evaluation of EHR system costs goes beyond TCO and encompasses various factors, such as system reliability, hardware investments, maintenance expenditures, and security considerations. These elements play a substantial role in the overall cost estimation, extending beyond the parameters addressed in the mentioned study.

The Cost of High-Quality EHR Systems

Determining the cost of EHR implementation can be a complex task, given the variability in specific contexts and plans. Case-specific examples shed light on the diversity of implementation expenses. For instance, a study in Health Affairs highlighted the typical expenditures of multi-physician practices for EHR implementation and maintenance. Similarly, a study in Medical Economics delved into the expenses incurred by primary care practices for hardware, software, peripherals, and support services. When it comes to hospital EHR implementation costs, which tend to be on a larger scale, there are wide variations among community hospitals.

Uncovering Hidden Costs

When analyzing the costs associated with EHR implementation, it is crucial to consider both direct and indirect expenses. Direct expenses encompass items such as software licensing, maintenance projections, consulting and training fees, labor costs (including potential overtime), and, in the case of on-premises setups, hardware expenditures. Equally significant are the indirect costs, which may include reduced revenue, productivity losses, and a decrease in patient visits. Quantifying these factors can have a substantial influence on the overall budgetary impact of EHR implementation. Understanding the full scope of costs is essential for making informed decisions about EHR adoption and ensuring financial preparedness.

Pricing Analysis of Well-Known EHR Systems

Understanding the expenses associated with widely used EHR systems hinges on factors such as the chosen application, deployment method, and the inclusion of supplementary add-ons. The diversity in pricing stems from considerations such as purchasing versus leasing options and user/data volume licensing structures. This intricate pricing landscape can pose challenges when it comes to projecting EHR costs.

Given that detailed pricing information is often not readily available online, gaining insights into EHR expenses typically necessitates initiating a request for information or proposal process. Nevertheless, healthcare practices can accumulate dependable cost estimates for prospective EHR systems as part of their selection process. By navigating this pricing complexity, they can make well-informed decisions about their EHR investments.

  • Epic: Epic Systems primarily caters to larger healthcare organizations, including hospitals and health systems. The cost of Epic’s Electronic Health Record (EHR) solutions is highly dependent on the specific needs and scale of healthcare organizations. For self-hosted solutions, pricing typically starts at $1,200. However, for larger clinics and hospitals, costs can begin at $500,000. Epic does not offer a free trial but does provide interested parties with the opportunity to explore their offerings through a free demo facilitated by their sales representatives;
  • Cerner: Cerner, a prominent EHR vendor serving both inpatient and ambulatory healthcare providers, offers flexible deployment options, including cloud-based and on-premise solutions. Their cloud-based service is priced at approximately $25 per month, while on-premise deployment costs can vary widely depending on the organization’s specific requirements. Cerner offers a range of specialty-focused products but does not provide a free trial option for potential users;
  • Allscripts: Allscripts specializes in serving medium to small healthcare practices and offers a variety of products, including EHR, revenue cycle management, and population health solutions. Pricing details for Allscripts’ products are not disclosed online, and interested users are encouraged to contact the company directly for personalized pricing information. Additionally, Allscripts does not offer a free trial, and costs can vary based on the specific features and products chosen by healthcare organizations;
  • eClinical: eClinical is known for its comprehensive suite of healthcare solutions, including EHR, practice management, and patient engagement tools. Their EHR is priced at $449 per month, and for EHR with practice management functionality, the cost is $599 per month. In addition, eClinical offers revenue cycle management services priced at 2.9% of collections. Detailed pricing information is available on their website, and while eClinical does not provide a free trial, their transparent pricing structure allows potential users to assess their options easily.

Effective Strategies for Managing EHR Costs

While Electronic Health Record (EHR) systems offer a multitude of benefits and compelling evidence suggests that their implementation costs are often recovered within two to three years, healthcare providers continually grapple with the issue of insufficient budgets for digitalization. Notably, these budgetary constraints are consistently recognized as a significant hurdle in the journey towards EHR adoption. In response to this challenge, experts in the field have put forth a set of valuable recommendations designed to help mitigate the expenses associated with EHR implementation.

Implementing Open-Source EHR Solutions

While open-source EHR systems may not always offer the sleek user interfaces of their proprietary counterparts, they hold the potential to provide essential functionalities to medical practices without incurring significant expenses. In cases where an organization lacks in-house IT expertise for open-source implementation or requires additional features and integrations, considering the engagement of a developer can often be a more cost-effective choice compared to opting for a proprietary EHR solution.

Streamlining Feature Selection for Cost Efficiency

Before embarking on the search for an Electronic Health Record (EHR) system, it is prudent to conduct a comprehensive business and market analysis. This analysis aims to identify the core functionalities that are indispensable for the healthcare organization. When budget limitations come into play, it becomes essential to discern between essential features and non-essential “nice-to-have” elements, as well as to determine the necessity of specific integrations within daily workflows. Additionally, it is crucial to distinguish between EHR and EMR systems and select the one that aligns most closely with the organization’s specific needs. This strategic approach not only optimizes costs but also ensures the selection of a suitable EHR solution that meets the organization’s requirements.

woman sitting on the coins with laptop on her laps, the stethoscope and sheet with cross on it

Uncompromising Commitment to Data Security

When healthcare organizations explore cost-saving strategies for Electronic Health Record (EHR) implementation, safeguarding the security of medical data must remain the top priority. The healthcare sector frequently witnesses data breaches, which not only pose significant financial implications but also jeopardize patient confidentiality. Opting for a less expensive EHR system with inadequate security measures may lead to expenses far surpassing the initial investment required for a more reliable, albeit higher-priced, solution.

Embrace a Subscription-Based Model

For healthcare organizations seeking to manage initial upfront costs, the availability of EHR platforms offering annual subscription payments can be advantageous. While this subscription model may entail a slightly higher total cost of ownership over time, it offers flexibility. This flexibility allows organizations to adapt their service plans or make changes as needed, ensuring that the budget can accommodate unforeseen circumstances and allowing room for necessary adjustments.

Forge Collaborative Partnerships with Experienced Vendors

Healthcare organizations stand to gain significant advantages by collaborating with software companies that have a proven track record of successful EHR implementations. Such experienced vendors bring valuable insights to the table, often addressing overlooked cost optimization areas. Their seasoned teams expedite the implementation process, resulting in reduced project costs and quicker access to the benefits of the EHR system. This collaborative approach proves instrumental in achieving cost-effectiveness and maximizing the advantages derived from the EHR system.

Conclusion 

Implementing an Electronic Health Record (EHR) system is a complex undertaking, but when executed correctly, it offers numerous advantages for healthcare practices. By gaining a clear understanding of EHR costs, meticulous preparation, and the guidance of a proficient EHR implementation expert, you can navigate the process successfully and without errors. Once your EHR system is up and running, you’ll likely find yourself wondering why you didn’t adopt it sooner.

This article has shed light on the intricacies of EHR implementation costs in hospitals and clinics, with the hope that it will facilitate your planning and budgeting efforts. Additionally, the cost of the EHR system should no longer be a matter of curiosity, as you are now equipped with insights to make informed decisions in this regard.