EHR Implementation In 2023 – The Definitive Guide

EHR Implementation Steps - Inspired Image

Over the last few decades, electronic health records (EHRs) have transformed administrative and clinical workflow procedures across hospitals, clinics, medical practices and healthcare organizations around the globe. Still, in mid-2023, we often hear potential subscribers and existing buyers questioning what a successful EHR implementation – or other medical software setups – actually looks like/entails in a clinical setting.

Please note that the adoption of an EHR system is a multi-step process. A medical practice must prepare strategically to plan a successful system transition

On average, it takes approximately 8 to 12 months to successfully implement a new EHR software, but the transition time depends entirely on the initial planning level. A good, practical roadmap can certainly save hours of work and effort for every member of your team.

In this guide, we’ll go over in detail what you can expect when it comes to deploying the right EMR in your practice – from selecting your vendor of choice to finalizing go-live steps – as well as the implementation mistakes to avoid.

We’ll cover such context-setting and ‘quick action’ concerns centered on the implementation process as:

  • Understanding the Changing Landscape of Healthcare Technology/EHR Systems
  • The EHR Implementation Plan: Roadmap and Prepping Your Facility
  • Building Your EHR Implementation Team
  • Defining the Budget, Anticipating Implementation Costs, Potential Hardware and Network Upgrades
  • Analyzing the New EHR System for Compliance
  • Transferring Patient and Practice Data
  • Developing an Ongoing Training Program for Medical Professionals
  • Other Critical Success Factors
  • EHR Implementation Process: The Three Ts?

We’re confident that if you follow this step-by-step approach, you’ll be well on your way to a successful, long-term setup!

Let’s get started‍️️.

The Current Healthcare Tech./Software Landscape

Before we dive straight into EHR implementation step-by-step, it’s important to gain a clear picture of where the domain is presently located (its de facto operating context).

The healthcare technology and software landscape in 2023 has seen a significant transformation, driven by the advent of advanced tech and the increasing demand for high-quality patient treatment tools and services.

Overall, the industry is witnessing a noticeable shift towards at-home care, ambulatory care, and telehealth, with a growing emphasis on the use of automated tools (often incorporating AI and machine learning modules) to improve patient outcomes and streamline healthcare operations.

Key Trends

Rise Of Telehealth

One of the most prominent trends in 2023 is the rise of telehealth or telemedicine (which many modern-day EMRs cater to). With the help of digital platforms, healthcare providers are now able to deliver medical services remotely, enhancing accessibility and convenience for patients. This trend has been further accelerated by the COVID-19 pandemic, which necessitated social distancing measures and led to an increase in demand for ad-hoc healthcare services.

Increased AI And Robotics Use

Artificial Intelligence (AI) and robotics are also playing a crucial role in shaping the healthcare terrain. AI is being used to analyze patient data, predict health outcomes, and assist in decision-making processes. Meanwhile, robotics is revolutionizing surgical procedures, improving precision and reducing the risk of complications.

Largescale Shift Toward Cloud Computing

Cloud computing is another key trend in 2023, particularly in the context of outsourced billing. By leveraging cloud-based solutions, healthcare organizations can efficiently manage their billing processes, reduce administrative burdens, and enhance data security.

User Preference for Interoperable EHR Systems

In terms of EHR suites, there has been a notable shift towards digitalization and interoperability. EMR systems (often considered interchangeably with the former) are becoming increasingly sophisticated, offering features such as real-time updates, secure data sharing, and predictive analytics. Moreover, the integration of EHRs with AI and IoT is enabling more personalized and efficient patient care.

Demand For Improved Security, Analytics, And Automation (At Scale)

Healthcare IT leaders are also focusing on improving security, data analytics, and workflow automation. With the growing volume of sensitive patient data being handled, healthcare organizations are prioritizing data privacy and cybersecurity measures to protect against potential breaches.

The EHR Implementation Plan: Getting Started

The first step in implementing an EHR system is to outline the major tasks and procedures that need effective execution by your team members, including the IT staff, physicians, practice managers, nurses, and medical assistants.

The key considerations here will be to:

  • Enlist your EHR implementation team from stakeholder groups
  • Outline your costs and define the total budget for the implementation process
  • Check your software for HIPAA and other regulatory compliance
  • Transfer patient and practice data from existing record systems (paper/manual or software)
  • Develop a user-training program for involved healthcare organization personnel
  • Communicate expected system downtime (how long the implementation may take) to all clinical staff and patient affectees
  • Decide on what to do when your EHR system is unplugged (the in-between phase)
  • Define and state your go-live tasks
  • Point out critical success aspects and evaluation strategies

At this stage, it’s vital to document all of these concerns and obtaining complete, formal stakeholder buy-in for the plan. Clearing this step will ensure a smooth EHR system implementation in the proceeding steps.

Build Your EHR System Implementation Team

Building a Team for EHR software implementation

After defining your implementation tasks, you need to recruit people to perform each process step according to your schedule and budget.

A strategic team will help drive your EHR implementation process smoothly. It should typically include members of the healthcare organization’s administrative staff, physicians, medical assistants, and nurses. Each team member will add to the implementation process by passing on their EHR skills and identifying any installation challenges along the way.

The following specialized roles can be sourced to work with native clinical staff to run the implementation process effectively – especially recommended for fresh/’unprecedented’ EHR system setups:

  • Project Manager – responsible for managing the team/overseeing the EHR implementation plan
  • Application Developer – responsible for system configuration and customization/adapting software production environment and features to unique healthcare requirements
  • QA Test Engineer – responsible for new EHR system performance and testing
  • Application Analyst – responsible for patient/staff/process data migration
  • Nurse Advocate – representative of nurses
  • Physician Advocate – representative of physicians, advises on training
  • Billing Advocate – representative of the billing department, advises on data and testing
  • Meaningful-Use Manager – needed if MU attestation is required
  • Super-Users – the initial adopters for training programs

A top-rated EHR implementation crucially relies on team cooperation at every turn. Problems of stagnating administrative and executive bureaucracies (the people who ‘run the show’) can, in fact, derail the entire process: a major limiting factor that needs to be guarded against.

Define Your Budget And Predict EHR Implementation Costs

Analyzing the cost of EHR implementation

The following are mandatory considerations when defining a budget/anticipating expense for EHR implementation:

  • Practice staff and temporary staff/project management costs
  • Expected productivity losses (often estimated as high as 50% – on aggregate clinical workflow)
  • Hardware and network upgrades
  • Customization service from the EHR vendor
  • EHR consultant/other consultancy costs (including initial project evaluation)
  • Vendor training expenses
  • Data backups and storage along with cloud EHR costs
  • Potential legacy system data transfer cost
  • System testing/data errors resolution

Typical EHR Subscription Costs In The US – 2023

The average cost of electronic health record software implementation/subscription per user in the US varies widely depending on the size of the healthcare setting, the specific software, and whether it’s cloud-based or on-premise.

For a small solo practice, the cost can be about $250 per month. However, some healthcare software can start as low as $74 and go as high as $729 for a single user per month.

On a yearly basis, these systems average around $8,000 in expenses.

That being said, it’s important to note that the costs can escalate for larger practices and hospitals. For instance, prices for self-hosted EHR systems can go over $500,000 per year.

It’s also worth noting that there are one-time upfront costs associated with implementing these systems, which can range from $2,000 to $33,000. A typical multi-physician practice might spend about $162,000 on EHR implementation.

At this point, if you’re even remotely worried by these expected cost ranges, don’t be!

Just get in touch with our friendly helpline executives at (661) 384-7070 to get quick, custom quotes and implementation advice on the best EHR for your practice and budget.

We strive not to disappoint.

Analyze Your Chosen Electronic Health Record System

Prior to finalizing a leading EHR software pick, you need to ensure it meets several criteria for compliance.

The implementation of electronic health record systems in the U.S. is governed by a number of federal regulations to ensure patient safety, privacy, and data interoperability:


The Centers for Medicare and Medicaid Services (CMS) has mandated that EHRs must meet specific certification criteria to advance interoperability and facilitate patients’ access to their own electronic health information. EHR products can enter the U.S. market without earning market authorization, but the government still runs a voluntary certification scheme to process them.

HIPAA Compliance

The Health Insurance Portability and Accountability Act (HIPAA) Security Rule stipulates that healthcare providers must put safeguards in place to protect patients’ electronic health information. This includes ensuring privacy and security compliance during critical EHR implementation steps.

Meaningful Use

An EHR system must meet certain standards for data capture, use, and sharing set by the Stage 1 meaningful use regulations that became effective in 2012.

Patient Safety

Federal rules require hospitals to regularly assess the safety of their EHRs and whether their design or implementation in healthcare settings could impact patient safety.

Clinical Decision Support Tools

Federal EHR systems should include computer-based programs that provide health professionals with patient-specific assessments or recommendations to aid clinical decision-making.

Risk-Based Regulatory Framework

Implementing a risk-based regulatory framework for EHR is important. This involves assessing potential risks associated with the use of EHRs and implementing measures to mitigate them.

Transfer Data

Now comes the step of transferring patient and practice data. For this, you need to sort out the ways to migrate your data from your existing record to the new electronic health records system.

You can perform this task in a variety of ways, such as assigning this function to the existing staff or hiring additional staff to upload information into the new EHR vendor arrangement.

Key aspects of EHR data migration include:

  • Converting paper records into electronic records
  • EHR database setup
  • Data management and verification
  • Mapping legacy data to new databases
  • Migrating information to the new system
  • Testing new data inputs
  • Testing and verification of legacy data

Develop A Sustainable User Training Program

Doctors EHR Training

Now that you’re done with transferring data, designing an interactive training program for users can have a significant impact on the final ROI of your system.

Good training programs inculcate:

  • Program advocates
  • Coherent communication channels
  • Vendor support teams
  • Role-based basic and extensive training for proper relevancy
  • Stable feedback options to keep users connected with project management

Prep For System Outage/Downtime (Intentional And Erroneous)

We cannot dismiss the probability of inaccuracies when technology is involved, so medical practices must be prepared to tackle occasional glitches. A solid backup plan can help you solve potential problems on this front. You also want to prepare for the natural pause – transition time – between relinquishing the old system and adopting the new one. Some of the instances of erroneous outages include power shutdowns and system-wide malfunction. To deal with such occurrences, you will require strategic procedures that assist physicians and staff in managing their regular tasks when the EHR is unavailable. Consider and prepare for the following pointers/proactive response cues for emergencies:
  • How to notify staff and physicians in the case of downtime?
  • How to keep the patient-care flow from being disrupted?
  • How to ensure patient check-in despite the downtime?
  • How to assist physicians and staff in documenting the visit?
In addition to electronic procedures, the availability of paper recourses can help to tackle EHR downtime situations.

Define Your ‘Go-Live’ Tasks

Doctors Excited

The next step in your EHR implementation process is pointing out the necessary activities around your go-live day. These include:

  • The pre- and post-system testing processes
  • Comprehensive communication guidelines for patients/organizational noticeboards
  • System reporting procedure and project evaluation
  • Alteration of appointments and schedules
  • Network speed and reliability analysis

If you satisfy all your pre-set successful EHR implementation benchmarks, it’s safe to say you’re likely in for a good forward run.

Other Critical Success Factors – Rounding Up!

Doctors Measuring Success

Once you’ve surpassed the go-live stage, it’s time to gauge the success of your EHR implementation to determine if it’s all been worth it).

But how do you do that?

Now, you can evaluate your EHR implementation in numerous ways, but the most suitable approach for your practice relies on your practice goals:

  • Calculate your organization’s ROI to determine profitability
  • Assess patient satisfaction rate through a survey to check the (new) quality of care
  • Keep a record of patient throughput to determine check-ins/resolutions efficiency
  • Find out the physician satisfaction rate to evaluate user training
  • Determine data error rates to assess quality

Parting Trivia: The 3 Ts of Good EHR Implementation

If you’re ever in a hurry to condense and explain the contents of this guide to a group of healthcare stakeholders, tell them this:

The successful implementation of EHR software can be boiled down to three main elements (‘actionables’), often referred to as the ‘3 Ts’ – Technology, Training, and Transition – by field vets –


This involves selecting the appropriate EHR system that fits the specific needs of your healthcare organization. It should have the necessary features and functionalities that align with your goals and objectives. The technology should also be user-friendly and easy to navigate for all users.


Proper training is vital for the effective use of the EHR system. All staff members who will be using the system need to be thoroughly trained on how to use it effectively and efficiently. This includes physicians, nurses, administrative staff, and others.


This refers to the process of switching from the old system to the new interface. It involves data migration, system configuration, and other technical aspects. A smooth transition is crucial to minimize disruptions to daily operations and patient care.

By focusing on these main EHR deployment fronts, healthcare organizations can increase the chances of a satisfying, long-term implementation.

So, this concludes our experts’ guide on planning, conducting, and assessing the results of a typical EHR implementation project in 2023.

Please note that the steps detailed here are suitable for electronic health record deployments in all types of medical settings: from small private practices to large, multi-unit government hospitals, ambulatory and in-patient…irrespective of specialty.

If you have any questions concerning picking the right EHR suite for your facility (along with the expected implementation time), you know what to do:

Contact our helpline reps today!

We’ll help you get EHR ready in no time: our Software Finder commitment.

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