What EHR Solution to Choose: Custom or Off-the-Shelf?

EHR software solutions have fairly taken the place of the most popular healthcare tools. By the end of 2026, the electronic medical record market will generate $40.8 billion. For comparison, the market’s revenue was $27.1 billion in 2019. 

Which software should one opt for when choosing between a custom and an off-the-shelf solution? Learn the pros and cons of each one and find out how to choose a healthcare software provider once you decide to develop a custom healthcare solution.

What Is an EHR System, and Who Needs It?

An electronic health record system or EHR is a digital system used by healthcare specialists in hospitals and other healthcare organizations to store and manage items like patient data, lab analysis results, and medical history. 

Those who can directly benefit from EHR are healthcare providers, patients, and researchers.

Advantages of an EHR System for Healthcare

  • Saves time on paperwork. All data is stored in one place, which users can access in real-time. This reduces time spent on the management of paper documents and eliminates data gaps; 
  • Improves patient-and-provider communication. With EHR, doctors can share lab results with patients, send them alerts and notifications, and set follow-up appointments;
  • Enhances digital security of the data. By using a cloud-based EHR solution with implemented top-tier security measures, users can stop worrying about data leaks or hacking;
  • Improves treatment outcomes. With the EHR solution serving as a single source of truth, clinicians and doctors can make well-informed decisions regarding the patient’s treatment; 

Ready-Made EHR Solutions: Pros and Cons

Ready-made or also called off-the-shelf or out-of-the-box solutions are healthcare digital tools with pre-built functionality offered by healthcare software companies. Most often, one must subscribe to the software to use it.

What EHR Solution to Choose: Custom or Off-the-Shelf? 1


  • Easy implementation. Off-the-shelf healthcare software is distributed to thousands and millions of users, hence requires fast installation and reliable functionality;
  • Low costs. Due to the large-scale deployment, the subscription costs are a drop in the ocean compared to the entire development process of custom-made software; 
  • Regular updates. The development company is responsible for updating the software and fixing bugs and glitches.


  • Poor customization. A ready-made solution isn’t flexible and can’t accommodate all specifics of one’s workflow. Sure, it will help providers to automate areas like data management, but it won’t adapt to the provider’s unique needs;
  • Low security. Though a pre-built solution is cloud-based, it is used by a wide audience, hence is an easy target for hackers;
  • Inadequate integration with other tools. A ready-made solution is often built as a closed system and doesn’t interact with other systems well;
  • Ineffective support. Not all healthcare software providers offer 24/7 support. 

Custom EHR Products: Main Benefits

Custom-made or also called bespoke EHR solutions are healthcare digital tools developed according to the unique workflows of a particular medical company or a healthcare provider.

The main benefits of custom-made healthcare software are as follows:

  • Tailored to the company’s needs. A bespoke software considers the company’s specific workflows and can be further customized when the company expands;
  • Power-ups. These are features that enhance the app’s competitiveness with other tools. For instance, AI-supported writing; 
  • Better integration. If a company has got a legacy system, the software can be built in a way that integrates with it;
  • Higher security. The software is used by a limited number of individuals and can be also developed on-premises;
  • Improved support system. Most companies offering the EHR/EMR solutions grant post-development support.

Off-the-Shelf vs. Custom EHR Solutions

No matter, ready-made or custom EHR you choose, they both have some pros and cons. This comparison table will examine the key differences between them.

Off-the-Shelf EHR SolutionsCustom EHR Solution
Cost:Ready-made solutions are already developed and ready to use. Hence, they are relatively cheap compared to custom ones. However, if you need something extra, there may be additional costs for EHR customization or custom EHR development.Custom software is typically more expensive due to the development process. However, it can be more cost-effective in the long run. All because custom EHR is tailored to specific needs, reducing the need for future modifications.
FunctionalityHave a set of predefined features.Can be designed to meet specific needs and workflows. They are more flexible and can be tailored to meet the organization’s needs.
Implementation TimeCan be implemented quickly, as the software is already developed and ready to use.Require a longer implementation time as they need to be developed from scratch. 
Support and MaintenanceOff-the-shelf EHRs typically come with vendor support and maintenanceCustom EHRs require ongoing maintenance and support from the development company.
ComplianceTypically designed to meet industry standards and regulatory requirements.Can also be designed to meet these requirements but require more attention to detail during the development process.

As you can see, ready-made solutions are typically cheaper. Besides, their implementation process goes faster and smoother. They come with pre-built and standardized features.  However, they are less scalable than custom ones. Moreover, the training and support are usually standardized.

On the other hand, custom EHR solutions are highly scalable and tailored to your specific needs. However, they are more expensive and have a lengthy and complex implementation process. The training and support are highly flexible, and maintenance is also highly adjustable to fit your changing needs.

How to Choose the Right Healthcare Software Development Company

To choose the right healthcare software development company, gather reviews online on platforms like G2, TrustRadius, and Capterra. If it’s possible, contact the company’s clients and ask them for feedback. 

After you’ve checked customer reviews and testimonials and decided to focus on a few software developers, go to their site. A company with deep expertise and versatile experience in software development will have a vast portfolio of projects and a detailed description of each of them. 

Further, check if the company has certifications like ISO and CMMI. Learn more about their project management methodology and development tools. 

Before asking for a pilot project, get a thorough consultation on your main project. Most consultations will be free or budget-friendly.

During a consultation, the company’s specialists will:

  • Analyze company’s workflows and gather feedback to define the most problematic areas;
  • Assist at choosing an EHR system that meets your needs and has good usability;
  • Determine the basic functionality and UI/IX of your future app (like patient portals, medical reporting, etc.) and add-on features;
  • Define the resources, timelines, and financial part.

Further, if you’re happy with the pilot project (a small part of the bigger project is often done for free so the client can check whether the company is a good fit for them), you can move on to the bigger project. 

Final Thoughts

Types of electronic health records systems open new opportunities in patient management and come in two packs: ready-made and custom EHR software. 

While a ready-made solution is more cost-effective in the short term, a ready-made solution is cost-effective in the long run. It is also tailored according to the company’s demands, provides higher digital security, and can be customized in the future if the company’s workflows and business needs change. 

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Written by:
Alex Shpachuk Alex Shpachuk CEO
Alex Shpachuk is the owner and strategic partner of Empeek. His effective leadership and a visionary approach to the future of healthcare turned the company into a dynamic environment attracting the brightest minds with the common vision for product impact and service excellence. With over a decade of experience in software engineering and comprehensive knowledge of designing and deploying tailor-made solutions for healthcare providers, Alex channels his passion for software development and consulting into the written word.

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