Costs to consider for EMR implementation

Despite what most EMR vendors may want you to believe, there is more to budget for than monthly costs along with the initial training and implementation fees. While costs have decreased significantly over the last few years, most EMRs still require a small fortune. Many providers still rank cost as the highest in hurdles to adoption and while the government may incentivize EMR adoption through meaningful use, the initial investment is still to be paid by the provider alone.

Research and Analysis (Sunk Cost)

What most providers do not account for is the opportunity cost of researching and analyzing the EMR product. While for some it may just translate into free time and hectic schedules, for others it may require sacrificing available time slots for patients, resulting in business loss. One should also include the cost for visiting onsite references, hiring staff overtime for analysis or consultation fees.

Hardware Costs

Most EMR vendors are able to provide hardware specifications for optimum results. While Software as a Service (SaaS) model for EMRs may reduce the upfront spending, those shifting from paper will still need to set up exam rooms and nurse stations. Recognized EMR vendors often work with hardware vendors to provide their clients with discounted deals and bulk buys.

Software Costs

EMR users are required to pay licensing cost, either upfront for a client server model or on a monthly basis for SaaS based product. Physician’s assistant and Nurses may also require separate user licenses apart from the provider’s own. The upfront licensing cost for a client based server can range between $5000-25000 depending on the solution and user base while some hospital based vendors may even charge in excess. SaaS based EMR vendors usually charge around an average of $500 per license.

Training and Implementation Costs

The training and implementation costs can vary significantly from vendor to vendor.  Most EMR vendors prefer to train providers through remote desktop access, because not only is it more cost effective but flexible too. Sessions can be configured to suit the user requirements, while personal sessions can be set up at the discretion of the user, independent of location. However, most practices still prefer onsite training which may cost more but help smoothen the implementation process itself. Training hours can be billed somewhere from $100-300 dependent on the method and vendor.

Support and Maintenance 

Hospitals and large care corporations are able to hire dedicated staff to provide ongoing assistance when and wherever required. However, EMR vendors especially for SaaS based products are able to provide offsite support through telecommunication and online portals. This method is more cost effective in most cases and one of the major reasons driving the adoption of SaaS based EMRs. These costs however do not include hardware maintenance in most cases which then would have to be arranged independently by the provider if required.

Other ongoing costs

It is important for the provider to consider other miscellaneous expenditure that may or may not be required during or after the EMR implementation. These can include hardware and software upgrades, new employee training, additional feature requests and customizations.


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