In uncertain times of COVID-19, technology has become an enabler for many businesses and industries across the world. Healthcare is no exception. EHR & telehealth software, though a bane of many healthcare organizations, has provided the needed connectivity and flexibility required to deliver care in these difficult times. By enabling providers to offer telehealth services and improve processes at the point of care in emergency departments, EHR companies have stepped up in these times of crisis.

While many physician practices see the utility of either switching from paper or outdated EMR systems to a solution offered by top EHR companies, cost considerations can be a hindrance.

In this article, we will explore whether the investment is worth the cost involved in implementing EHR software in 2024.

Justifying The Cost Of Implementing A Top EMR

A significant obstacle faced by healthcare organizations during EHR selection is whether the investment is justifiable, especially if it's a new practice with low patient volume or one that has already spent a significant amount of time and money with the wrong EHR company.

While listing the pros of investing in a top EHR company, organizations must look beyond meeting regulatory requirements towards the tangible benefits an EMR provides.

Here are some key benefits:

  • Easier access to patient information
  • Fewer documentation errors through charting and recording
  • Improved quality of provided health care
  • Secure and protected storage of patient records
  • Maintained patient privacy
  • Streamlined daily operations

How Much Will EMR By Top EHR Companies Cost?

While there are clear benefits for implementing an EMR, an approximation for the return on investment can only be determined if we know the cost involved. For the purchase to make sense, the price should not succeed the profits in the long term.

The cost of implementing an EMR system can range from anywhere between a hundred to thousands of dollars.  Here are a few scenarios:

  • If you choose, you have the option of using a low cost or even free EMR. Most low-cost EMRs cost between $80 to $100 per provider per month. These EMR software companies, however, do not provide any customization or training to their users
  • If you decide to pay and opt for a traditional on-premise EMR solution, you should expect to spend between $1,500 and $5,000 on software licensing. If you consider hardware installation and employee training costs, it will end up costing a small practice around $10,000
  • The price for cloud/web-based EMRs will be lower than on-premise EMR solutions
  • Enterprise-level systems usually implemented in hospitals, such as Cerner EMR and Epic EMR, can incur significant costs

The following chart provides an estimated average upfront cost, yearly cost, and five-year total cost of ownership (TCO) for on-site and SaaS EHR deployment based on the experiences of Regional Extension Centers (RECs).

In addition to deployment types and organization size, several other aspects determine the overall cost of EMR software you will incur.

These include:

  • The pricing model
  • Training and hardware cost
  • Update and customization costs

What Main Factors Affect EMR Cost?

Pricing Models

As you may already know, different vendors use different pricing models to price their EMR software. You must choose EMR software companies whose pricing model fits your practice financial situation. Here is what to expect from different vendors. 

Subscription Pricing

Most vendors offer a fixed monthly per provider pricing, commonly referred to as the" pay-as-you-go" model.

Medical practices have to pay a one-time upfront cost that usually ranges between $1500 to $5000 for a small practice, followed by a monthly fee that can be anywhere between $200- $700 per month per provider. Though these vendors do not charge separately for users such as the front desk or your billing staff, they will consider staff that bills under their NPI as a provider, thus liable to pay the monthly fee.

The cost of part-time providers is also different and usually lower than that of a full-time provider. In some cases, this pricing model is paired with a "percentage of collection" pricing with a Free EMR if you use the company's medical billing services.

Examples of Top EHR companies with this model:

Pay Per Visit Based Pricing

It is a relatively less popular pricing model offered by either small players in the EMR market or by bigger EMR players specifically to practices with low patient volume.

You only have to pay based on the number of patient encounters or, in short, the usage of the system rather than a fixed monthly cost. The cost per visit can range from anywhere between $.50 to $1.5 per visit. It will cover the maintenance, support, and usage cost.

Examples of EHR companies with this model:

EMR Deployment Types


Purchasing EHR software with an on-premise deployment method allows you to host it on your servers. You'll need a perpetual software license, which is usually accompanied by a high upfront fee ranging from between $1,200 and $500,000 or more. The provision also needs to be made for initial purchasing of hardware such as servers and ongoing premium support, for example, expanded telephone support hours.

Hidden costs to note with an on-premise purchase include software customization, integration with your current online systems, and payment of IT staff for additional maintenance work.

Opting for an on-premise server model means the management of operating the EHR software and related technology rests on you. Your practice will need heavy-duty servers, a reliable data backup storage system, and perhaps even additional technologies to do so effectively.


It is usually the cheaper option. Buying EHR software via a cloud-based deployment means your data will be stored remotely on your vendor's servers, allowing you access through the internet. It requires an annual or monthly subscription license. A monthly subscription fee is generally charged per provider or user. It can be from as little as $200 to as much as $35,000. The latter is what more major healthcare organizations can expect to pay, in addition to premium support such as extended phone support hours.

The initial start-up fee of a cloud-based EHR system isn't as high compared to the price of an on-premise software. The benefit is there aren't as many upfront costs as an on-premise system. You also won't need to include the purchasing of additional servers, data security, storage, and backups in your budget. Much like the on-premise option, you'll need to budget for the hidden costs of software customization and integration with your current online systems, as well as additional storage for patient data.

A drawback to using a cloud-based EHR system is how it limits your staff's access to the software. If you have a small practice, this works exceptionally well. Should more users be required to access this software, your monthly fee will increase.

EMR Implementation Cost Breakdown

Installation Cost

Remember, whether you opt for on-premise or cloud-based deployment, you'll still need to invest in your local network hardware. Consider desktop computers, iPads or tablets, printers, scanners, and other devices you might require.

You'll be using the expertise of qualified technicians to install such systems, and this does directly influence the software's cost. On average, you'll spend between $1,000 and $3,000 on installing and configuring software.  The financial provision also needs to be made for the required technical support.

Staff Training Cost

Most medical practices can spend at least $20,000 on EMR software staff training costs. Your staff needs to know how the systems work, regardless of whether you're using entirely new software or merely migrating from one system to another.

Sometimes this training is provided by the vendor, or it could be facilitated by in-house staff. It depends on how complex the new system is. Some medical practices try to save on costs by accessing training materials online at no charge via attending webinars or tutorial videos. On the other hand, some medical practices have spent even more on training their staff.

Training offered by an expert has guaranteed that their employees understand the new EMR software well enough to use it successfully and has significantly reduced time spent on training, so productivity isn't primarily affected.

Maintenance Cost

Within your first year of implementing EHR software, you could anticipate spending on maintenance costs to total at least $85,000. Remember that as smart as technology is, it can also malfunction. Even a top EMR system can be affected, so ongoing system maintenance and technical support are required to ensure it's working as smoothly as possible.

Sometimes the continuous maintenance and upgrade costs are included in an organization's EHR software monthly subscription.

Customization Cost

As mentioned above, customization of software involves, for example, creating patient note templates with customized fields as well as being able to report or analyze patient data.

Even purchasing a standard EMR system involves a few amendments and adjustments to meet your practice's needs better. If you opt for a top EMR software system, you can expect to pay for it. You might be able to save on some of these costs should you opt for a system with a high level of user configuration.

Customization cost depends on your selected software features and how many users will be accessing it. It's important again to remember how on-premise or cloud-based hosting influences your costs.

Data Migration Cost

If you have existing software that you'd like to extract, export, and import onto the new system, you may have to incur an additional cost. Some vendors offer essential data migration free of cost, while others require additional payment based on the volume and size of the extractions.

Budgeting For EMR Implementation: A Checklist

Transitioning to an EMR system is a significant undertaking that requires thorough planning and budgeting. From evaluating options and selecting a vendor to configuring the software and training staff on the new workflows, successful EMR implementation depends on addressing each step of the process.

The following checklist outlines the key items your practice needs to account for when allocating funds for their EMR implementation.

  • Evaluate practice needs and review potential vendors for software selection – allocate budget for vendor demos and the selection process 
  • Allocate funds for EHR licenses and negotiate contracts – account for license fees, subscription costs, and contract terms
  • Allocate finances for system configuration and customization – cover expenses for template development, order sets, and integrations
  • Designate data migration expenses, estimating the time and resources required for transferring paper or existing electronic records
  • Assign resources to cover training development and planning, including material development and scheduling training sessions
  • Set aside funds for testing scenarios and issue resolution to ensure thorough testing before the system's go-live
  • Include hardware maintenance, support, and ongoing upgrade costs

The checklist above provides a framework for clinics to identify all cost points and plan budget during the transition to optimize their EMR investment. Thorough planning using this checklist can help ensure a smoother implementation process.

Ways To Control EMR Implementation Costs

Controlling costs during EMR implementation can make a huge difference in the overall success of a practice's transition to a digital healthcare system. Here are some effective strategies medical practices can consider:

  • Select the right features: Carefully assess your workflows and patient care needs before selecting features. Opt only for functionality that directly enhances operations rather than "nice-to-haves." This focused approach prevents spending on unused modules. It's also a good idea to get input from clinicians, administrators and other staff on what tools they use most in their day-to-day roles
  • Pick a subscription-based model: Opting for a subscription-based pricing model can provide predictable monthly expenses, making budgeting more manageable. Look for EMR vendors that offer flexible pricing plans tailored to your practice size and requirements
  • Explore bundled services: Some EMR vendors offer bundled services that include not only the EMR software but also additional features such as practice management tools, billing services, or telemedicine solutions. By bundling services, your practice may benefit from cost savings compared to purchasing these services separately
  • Follow EMR implementation best practices: Adhering to best practices during the implementation process can help minimize costs associated with delays, rework, and inefficiencies. Ensure thorough planning, effective communication, and comprehensive training for staff to optimize the use of the EMR system

By implementing these cost-control measures, medical practices can maximize the value of their EMR investment while keeping expenses in check.

Is It Worth It?

The various advantages of using EHR software are evident. There aren't only financial benefits from such a system, but also practical paybacks.

According to a study conducted by Health Affairs, an average practice of multiple physicians can expect to spend approximately $162,000 on EHR implementation. Furthermore, medical practices should cover their initial installation costs within roughly two and a half years. After that, they can expect to receive an estimated average of $23,000 in net benefits for each full-time staff member annually.

Taking into consideration these findings, medical practices in various settings, sizes, and financial conditions can find some justification in utilizing these software solutions. It's more than merely complying with regulations; it's enjoying the benefits.

Medical practices have reported increased efficiency as their main motivation for utilizing EMR systems, in addition to improved service delivery, overall reduced costs, and increased profits.

Ensure that investing in EHR aligns with your current short-term budget and includes a cost-benefit analysis and ROI forecast before going ahead with your final selection.

Opting for EHR software does involve initial and ongoing investment. With the numerous long-term benefits, your medical practices' budget should also include implementing an EHR system.

For a detailed breakdown of EHR pricing trends and vendor costs in 2024, check out the comprehensive guide below.