How much is this going to cost me?
The Basics
Several studies estimate the cost of purchasing and installing an electronic health record (EHR) ranges from $15,000 to $70,000 per provider.1-5 Costs vary depending on whether you select on-site EHR deployment or web-based EHR deployment. Web-based EHR deployment, known as Software as a Service (SaaS), typically requires providers to pay a fixed monthly subscription cost. On-site deployment typically requires providers to pay for ongoing costs to support and manage on-site data servers.
The following chart from the Michigan Center for Effective IT Adoption 
provides estimated average upfront cost, yearly cost, and five year total cost of ownership (TCO) for on-site and SaaS EHR deployment. These cost estimates are based on the experiences of Regional Extension Centers (RECs) in the field.
| Cost | In-Office | SaaS | ||||
|---|---|---|---|---|---|---|
| Upfront Cost | Yearly Cost | 5 Year TCO | Upfront Cost | Yearly Cost | 5 Year TCO | |
| Estimated Average Cost | $33,000 | $4,000 | $48,000 | $26,000 | $8,000 | $58,000 |
Doing the Math - The Five Main Components of EHR Implementation
To estimate how much EHR ownership will cost your organization, you should consider the five main components of EHR implementation. These cost components relate to ambulatory primary care settings, as opposed to hospitals which may have different cost structures.
- Hardware: Potential hardware costs may include database servers, desktop computers, tablets/laptops, printers, and scanners.
- EHR Software: Potential software costs include an EHR application, interface modules (e.g. lab interface module), and upgrades to your EHR application. Remember, software costs vary depending on whether you select an on-site EHR deployment or a SaaS EHR deployment.
- Implementation Assistance: Potential implementation assistance costs include IT contractor, attorney, electrician, and/or consultant support; chart conversion; hardware/network installation; and workflow redesign support. Your local Regional Extension Center (REC) can help. Contact your local REC to find out if you are eligible for free or reduced-price support.
- Training: Your organization will need to train your physicians, nurses, and office staff before and during EHR implementation. Physicians, nurses, and office staff need to understand how to use the EHR and associated hardware and how the EHR will create new workflows for your practice.
- Ongoing Network Fees and Maintenance: Potential ongoing costs include hardware and software license maintenance agreements, ongoing staff education, telecom fees, and IT support fees. In addition, your organization may need to hire new staff, such as IT operations staff, clinical data analysts, or application analysts.
Your Local Regional Extension Center Can Help
Your local Regional Extension Center (REC) can help you calculate how much EHR implementation will cost your practice. RECs are located in every region of the country to help health care providers select, implement, and become adept and meaningful users of EHRs. Contact your local REC to find out if you are eligible for free or reduced-price support.
References
- Blumenthal D, Glaser JP. “Information Technology Comes to Medicine.” N Engl J Med. 2007.
- Smith PD. “Implementing an EMR System: One Clinic’s Experience.” Fam Pract Manag. 2003.
- Fleming NS, Culler SD, McCorkle R, Becker ER, Ballard DJ. “The Financial And Nonfinancial Costs Of Implementing Electronic Health Records In Primary Care Practices.” Health Aff. 2011.
- Miller RH, Sim I, Newman J. "Electronic Medical Records: Lessons from Small Physician Practices" [PDF - 477.3 KB]. iHealth Reports. 2003.
- Bodenheimer T, Grumbach K. “Electric technology: a spark to revitalize primary care?” JAMA. 2003.
Implementing EHRs – Planning Your Approach
Creation and management of an effective electronic health record (EHR) implementation team is a crucial process. Once you have identified potential members of the implementation team, follow these...
Successfully creating and managing an internal planning team is crucial to planning success. Team members should bring differing perspectives on how the electronic health record (EHR) will be used...
Regional Extension Centers (RECs) are not vendors selling electronic health record (EHR) systems or products. Your REC is a trusted advisor with the same aims as you – to help ensure quality...
The introduction of an electronic health record (EHR) into a practice presents great operational challenges as well as opportunities for the improvement of patient care. Adopting an EHR will change...
Implementation teams interested in maximizing the benefits of electronic health records (EHRs) should pay close attention to these important EHR workflow redesign areas. Workflow analysis should...
Using electronic health records (EHRs) will help health care providers build a sustainable medical practice. The next generation of health care professionals will expect and demand that their own...
For a successful electronic health record (EHR) implementation, you may need to assess the need for additional EHR infrastructure investments. The first step to making a sound hardware decision is...
Your Local Regional Extension Center Can Help
Even if your organization has an existing IT system, your organization should contact your local Regional Extension Center (REC). You may still need...
Redesigning your workflow helps you get the most value from implementing an electronic health record (EHR). To get started, analyze your existing workflow. Create a visual map of how work is...
Tip 1: Identify bottlenecks and inefficiencies in your current workflow. Decide which aspects of your workflow need improvement and prioritize them. Then do the work in stages, creating wins along...
The Basics
Several studies estimate the cost of purchasing and installing an electronic health record (EHR) ranges from $15,000 to $70,000 per provider.1-5 Costs vary depending on whether you select...
There are several resources specific to rural health IT and electronic health record (EHR) implementation. You can use the following resources to learn more about health IT and EHR implementation in...
A Challenge for Rural Providers
Overcoming limited number of staff and resources is challenging in rural communities. No model fits all organizations you must determine the best ways to recruit and...
The Basics
Adopting an electronic health record (EHR) will change your organization's workflows. Workflow redesign is a process your organization should complete before EHR implementation. EHRs may...
Health IT Workforce Initiatives
To address the growing demand for a highly skilled health IT workforce, the Office of the National Coordinator for Health Information Technology (ONC) funds the Health...
Plan Your Approach
You should begin planning as soon as you assess your practice readiness and decide to adopt an electronic health record (EHR). Planning draws on information gathered during the...
Grant Programs and Funding Opportunities
There are several grant programs and funding opportunities intended to help rural providers and rural communities implement health IT.
The Rural Utilities...
Electronic Health Record Implementation Planning
Here are some tactical steps that typically occur during the planning phase. You may collaborate with and use tools provided by your Regional...
Health IT Workforce Resources
Locating qualified health IT professionals can sometimes be a challenge, but health IT professionals can be a valuable resource when you are selecting and implementing...
Creation and management of an effective electronic health record (EHR) implementation team is a crucial process. Once you have identified potential members of the implementation team, follow these...
Successfully creating and managing an internal planning team is crucial to planning success. Team members should bring differing perspectives on how the electronic health record (EHR) will be used...
Regional Extension Centers (RECs) are not vendors selling electronic health record (EHR) systems or products. Your REC is a trusted advisor with the same aims as you – to help ensure quality...
The introduction of an electronic health record (EHR) into a practice presents great operational challenges as well as opportunities for the improvement of patient care. Adopting an EHR will change...
Implementation teams interested in maximizing the benefits of electronic health records (EHRs) should pay close attention to these important EHR workflow redesign areas. Workflow analysis should...
Using electronic health records (EHRs) will help health care providers build a sustainable medical practice. The next generation of health care professionals will expect and demand that their own...
For a successful electronic health record (EHR) implementation, you may need to assess the need for additional EHR infrastructure investments. The first step to making a sound hardware decision is...
Your Local Regional Extension Center Can Help
Even if your organization has an existing IT system, your organization should contact your local Regional Extension Center (REC). You may still need...
Redesigning your workflow helps you get the most value from implementing an electronic health record (EHR). To get started, analyze your existing workflow. Create a visual map of how work is...
Tip 1: Identify bottlenecks and inefficiencies in your current workflow. Decide which aspects of your workflow need improvement and prioritize them. Then do the work in stages, creating wins along...
The Basics
Several studies estimate the cost of purchasing and installing an electronic health record (EHR) ranges from $15,000 to $70,000 per provider.1-5 Costs vary depending on whether you select...
There are several resources specific to rural health IT and electronic health record (EHR) implementation. You can use the following resources to learn more about health IT and EHR implementation in...
A Challenge for Rural Providers
Overcoming limited number of staff and resources is challenging in rural communities. No model fits all organizations you must determine the best ways to recruit and...
The Basics
Adopting an electronic health record (EHR) will change your organization's workflows. Workflow redesign is a process your organization should complete before EHR implementation. EHRs may...
Health IT Workforce Initiatives
To address the growing demand for a highly skilled health IT workforce, the Office of the National Coordinator for Health Information Technology (ONC) funds the Health...
Plan Your Approach
You should begin planning as soon as you assess your practice readiness and decide to adopt an electronic health record (EHR). Planning draws on information gathered during the...
Grant Programs and Funding Opportunities
There are several grant programs and funding opportunities intended to help rural providers and rural communities implement health IT.
The Rural Utilities...
Electronic Health Record Implementation Planning
Here are some tactical steps that typically occur during the planning phase. You may collaborate with and use tools provided by your Regional...
Health IT Workforce Resources
Locating qualified health IT professionals can sometimes be a challenge, but health IT professionals can be a valuable resource when you are selecting and implementing...