Electronic Health Record (EHR) integration is a crucial step for health tech innovators looking to boost their product functionality, scale up their businesses and reach out to more clients. This article provides insights from Olga Ryzhikova – Director of Professional Services at Kepler Team, our indispensable health tech expert with deep knowledge of interoperability and health innovation.

From understanding the various EHR systems to leveraging APIs and complying with security requirements, this article offers a comprehensive guide for health tech startups looking to integrate their solutions with EHR systems.

Integrating your product with EHR: How do you know when it's time

Integrating with an EHR should be considered when it aligns with your health tech startup's goals, target market, and business strategy. This includes situations when you need to:

✅ Acquire new clients or retain existing ones by providing seamless access to patient data

✅ Offer time savings and improved workflows for healthcare providers, patients, or other stakeholders

✅ Reduce the need to log in to multiple systems or manually enter data

✅ Get published on an EHR marketplace can improve visibility and attract new clients or partnerships

When Your Product Does NOT Need an EHR Integration

On the other hand, there are times when EHR integration might not be the best move for your health tech startup:

❌ EHR systems don't align with your target market or customer base

❌ Your clients are not requesting EHR integration or are using a different EHR vendor

❌ Costs and legal requirements outweigh the potential benefits

❌ The product will not benefit from access to sensitive patient data, making integration unnecessary

If you’ve hit more green points than red ones, here’s a walkthrough for further steps.

5 Smart Steps to Initiating EHR Integration 

1. Conducting a cost-benefit analysis

Before embarking on EHR integration, startups should conduct a cost-benefit analysis to understand the potential benefits of integration. This may include acquiring new clients, increasing visibility on the marketplace, or saving time for providers by eliminating the need to log into multiple systems. At this stage, it is also necessary to consider the long-term costs, such as ongoing maintenance and updates.

2. Identifying the right EHR for integration

The next step is to understand the type of EHR system you want to integrate with and why. Different EHRs cater to different markets, such as acute hospitals, post-acute clinics, long-term care facilities, dental practices, and various specialized medical providers. Your product and target customer base will determine the ideal EHR system for integration. You may also want to research market trends and competitor integrations to make an informed decision. For example, here’s a use case from one of our clients who chose to work with Charm EHR to improve their mental health app.

3. Leveraging different types of the APIs

It is possible to get access to PHI by integrating with an EHR directly, through an interoperability platform or a middleware provider. The decision obviously is made depending on the use case. Typically, more sophisticated use cases call to participation in a paid developer program.

Prior to EHR integration, it's crucial to establish an integration strategy:

• Do you aim to integrate with a single EHR or multiple ones over time?

• Will you connect with EHRs directly or through an interoperability platform?

• Does the EHR vendor offer more than one developer program, and if so, which one to use?

Different programs may have specific advantages and disadvantages, such as cost, the range of accessible APIs, and protocol standards (FHIR, HL7). In some instances, the most basic option may suffice, while in others, additional discussions or custom agreements with the EHR vendor might be required to accomplish the desired outcome. 

4. Reaching out to EHR providers and integration partners

It makes sense to reach out to both EHR providers and integration partners at once. Establishing a relationship with these entities can help you access resources, support, and developer programs to ensure a smooth integration process. 

Once the contact with the EHR provider is established, you should request information about their developer programs, security guidelines, and access to documentation. Mind that smaller EHRs are more likely to offer a flexible approach to third-party products, while big providers like Epic or Cerner will expect you to fully cater to their standards. 

When reaching out to EHR providers and integration partners, it's crucial to keep in mind that a successful integration also depends on finding the right software development partner. This is where our eBook, "The Ultimate Guide to Hiring Development Contractors in 2023: 7 Steps To Find the Best Fit," can be a valuable resource. It offers practical advice on finding the right contractor to ensure a smooth EHR integration, as well as tips for establishing a relationship with EHR providers and accessing developer programs. Don't underestimate the importance of finding the right software development partner, and download our free eBook today to help set your healthcare startup up for success.

5. Ensuring compliance with technical requirements

EHR integration usually involves technical compliance with the Fast Healthcare Interoperability Resources (FHIR) standard, as well as legal compliance with Health Insurance Portability and Accountability Act (HIPAA). EHR providers may also require startups to answer security questions and undergo validation to ensure proper use of their APIs. Typical surveys from EHR providers may include questions on two-step authentication, data backup, system access, and so on. The good news is, you are not necessarily expected to hit the 100% mark on each requirement: what is important is the combined overall score. If you do not pass the validation from the first run, you will generally receive a reason with a specific list of issues to address prior to the next try.

One of the major factors impacting the success of your project is securing access to a fully functional development environment for testing the integration. Not every EHR will be able to offer you one with all types of access you need, which is likely to make the integration process more challenging. However, once you have been through one EHR integration, the rest are likely to be easier for you and take up significantly less time.

Should You Handle EHR Integration By Yourself?

One approach to EHR integration is managing the project in-house. This requires assigning a project manager to lead the effort and designating team members to work on the integration. After establishing a relationship with EHR vendors, the actual integration process could take up to six months. 

In one of our previous articles, we have covered five key challenges that health innovators typically encounter on their way to their first EHR Integration. There is no universal developer-friendly method for EHR integration: while standards like HL7v2, C-CDA, and FHIR provide resources and frameworks, there are a lot of aspects that may be unique to your specific integration process, and you will have to figure out how to handle them. Integrating your product with the existing EHR and extracting the necessary data will present distinctive challenges, so it's best to have dedicated staff for this task rather than diverting your product development team's attention.

Instead of tackling the complex process of EHR integration on your own, consider engaging a specialized EHR integration service provider with experience in multiple EHR systems, established relationships with vendors, and proven workflows for resolving issues in this intricate process.

Conclusion

Undertaking EHR integration in-house can be resource-intensive, but it builds expertise for future integrations with the same EHR. If you have limited time and team availability, outsourcing the project to an external provider can save time, and money, and prevent costly mistakes. An experienced team can quickly navigate the integration process, allowing your team to focus on your core business and product innovation.

At Kepler Team, we offer integration services with leading EHR systems in the US. Our clients trust us to help them create universally compatible innovations that seamlessly integrate into various clinical workflows.

Discover more about our Integration services here, or contact us for a free consultation and quote!