Custom EHR development company for clinical workflows that don't fit off-the-shelf

It depends on how many roles, workflows and integrations the first version needs, so we price it after a free scoping call, never before. A focused EHR covering one specialty workflow typically ships in 6-8 weeks; a multi-role EHR with clinical notes, scheduling, document management and audit trails takes 8-10 weeks. Every engagement is a fixed scope at a fixed price, with 8 weeks of embedded support included.

6-10 weeks for the build phase. A recent AI-powered dementia care EHR with two connected applications (clinical workflow plus family portal) shipped in 8 weeks on Angular, .NET, and Azure. 8 weeks of embedded support follows every build to ensure clinical adoption.

Off-the-shelf EHRs like Epic and Cerner cost $300K-$1M+ in first-year licensing and require clinical workflows to bend around the software. Custom makes sense when your workflow is specific (specialty clinic, senior care, AI-assisted care), your user count is under 200, or you need integrations the big vendors do not support. The tradeoff: you own the software and control the roadmap; you also own maintenance. We help assess fit before a single line of code.

HIPAA is architected from day one, not bolted on after. Every custom EHR we ship includes encrypted data at rest and in transit (AES-256), role-based access controls with audit logs, BAA-covered cloud hosting, data retention policies matching state requirements, and full audit trails on every PHI access. Three independent HIPAA audits passed on shipped platforms.

No. No EHR is HIPAA compliant by default, custom or off-the-shelf. Compliance is a property of the whole system: the architecture, the hosting agreement, and the procedures your organisation runs around it. What a custom build gives you is control over the architecture, and we ship it HIPAA-first: AES-256 encryption at rest and TLS 1.3 in transit, role-based access mapped to clinical roles, an append-only audit trail on every PHI access, BAA-covered hosting in your own Azure or AWS tenant, and staging environments that use synthetic PHI. Your policies, staff training, and BAAs with other vendors complete the picture. Three independent HIPAA audits passed on platforms we shipped.

Yes. We have migrated patient records, clinical notes, scheduling data, and billing history from legacy EHRs, spreadsheet-based systems, and off-the-shelf platforms. Migration scripts map your data to the new schema, validate every record, and run parallel systems until you verify accuracy. Data never leaves your cloud tenant during migration.

Yes. FHIR R4 endpoints for interoperability with hospitals, labs, and pharmacies. HL7 v2 messaging for legacy integrations. Lab integrations (Quest, LabCorp), e-prescribing (DrFirst, Surescripts), and state immunization registries are standard scope when needed.

Patient records with structured and unstructured data, clinical notes with SOAP/DAP templates, scheduling with calendar integration, document management with OCR, role-based portals for clinicians and patients, e-prescribing, lab order and results tracking, billing exports, and compliance audit trails. AI-assisted features (clinical summarization, note generation, care plan drafting) are increasingly common.

Yes, and it's a common way projects reach us. We audit the code, data model, access controls and hosting first, keep what works, and give you a fixed plan to finish. We don't rebuild what already works. Repository, cloud accounts and IP move into your name as part of the handover.

Medplum is an open-source FHIR platform: a good base when you want a standards-based record and plan to integrate with hospitals and labs. Healthie is a headless EHR with a GraphQL API: fast for virtual and cash-pay practices that can live with its data model. Fully custom fits unusual workflows or products where the record itself is the product. We recommend one on the scoping call, with reasons.

Yes. eClinicalWorks offers an Electronic Health Information export for authorized users at a practice. We map that export to the new EHR, run both systems in parallel, reconcile counts patient by patient, and switch over only when your clinical lead signs off.

Yes. Every engagement includes a signed BAA before we touch any PHI. We operate within your cloud tenant (Azure, AWS, or GCP) where you control data residency and access. Our developers access PHI only through approved staging environments with time-limited credentials and full audit logging.

Yes, but the architecture matters. Direct integration with consumer Claude or ChatGPT is not HIPAA-safe. We build on Azure OpenAI Service (BAA-covered), Claude Enterprise with training disabled, or zero-data-retention API tiers. Every AI interaction with PHI is logged for compliance auditors.