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9 Major Types of Electronic Health Record Systems

9 Major Types of Electronic Health Record Systems

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What are EHRs? It's a term you'll see often when managing patient information. Electronic health record (EHR) systems store medical information or patient records so that healthcare providers across multiple offices or medical centers can access valuable patient data in a single location. When asking what the top EHR systems are available, organizations need to consider the most effective way to properly collect, store, manage, and use data from within these systems to achieve prospective goals, including diagnosing and treating medical conditions.

EHRs help: 

  • Healthcare organizations effectively manage health information

  • Clinicians make better patient decisions

  • Ensure that diagnoses and medical histories are always up to date

Ultimately, the best method to control and manage electronic medical records can minimize critical medical errors. What are EHRs and what are the top EHR systems used today? Here is what you need to know.

Determining the Best EHR System

What are the top EHR systems?  As of 2021, about 88 percent of office-based practices and 96 percent of acute care hospitals had adopted an EHR system. What is an EHR system? At its most basic, an EHR is an electronic version of a patient's chart. However, EHRs can do far more than store medical records. If you are looking to implement an EHR system or switch vendors, there are many options available. Here are nine types of electronic health record systems.

Healthcare organizations need the most advanced and robust solutions to meet their needs. When it comes to health information technology, investing in the right healthcare system is critical to make sure that the investment produces a beneficial return on investment. To understand the options, consider the best solutions that offer an easy-to-use user interface, robust features, solutions for all care settings, and an EHR platform that's flexible and versatile to grow with the location over time.

Factors to Consider in Choosing the Best Electronic Medical Records Solution

When considering what are the top EHR systems, it is all about the details. It's important to choose an EHR system based on a system's real-world application. For example, if you offer telemedicine, your EHR system should support telehealth appointments.  Consider your needs as you review potential EHR systems, but also consider these important attributes.

An EHR system should:

  • Integrate with your healthcare organization's current software solutions

  • Meet your organization's practical and ethical standards, as well as data compliance laws and regulatory requirements, such as HIPAA

  • Provide access to patient information in real-time from anywhere

  • Streamline patient data management without additional steps

  • Support clinicians' roles and bolster patient care

  • Provide remote employee access

Other factors to consider include:

  • The system's market share: How relevant will this solution be over time? Is it updated regularly and commonly used?

  • Cost: What pricing tiers are available? EHR system investment can be significant for a smaller hospital, ambulatory group, or rural practice.

  • Efficiency: Does the system allow patient engagement through a user-friendly patient portal?

  • User-friendliness: Is there a substantial learning curve?

  • Mobile app support: Some EHR systems offer Android and/or iOS apps that give employees and patients access to key components, like support and in-app messaging.

Recommended Reading:

Electronic Health Record Systems: Types 

Organizations consider factors like healthcare settings, clinical data maintenance (e.g.: test results, vital signs, progress notes, etc.), and patient demographic engagement when choosing an EHR system.  What are the top EHR systems available today? Consider types first.

What are the top 3 EHR system types?

There are three main types of EHR software: on-premise, SaaS, and custom. The best system type depends on the care provided, clinical documentation used,  e-prescribing or lab result communication needs, and messaging requirements.

1. On-Premise EHR Software

With on-premise EHR software, you purchase the product from an EHR vendor and install it on servers in your office. Although on-premise EHR software requires an upfront investment in software, servers, and local network connectivity, there is generally no monthly subscription fee, which often saves you money in the long run compared to Software as a Service (SaaS) approaches.

You can use most enterprise on-premise EHR software out of the box. However, your organization might need to customize certain items, such as clinical content, templates, reports, or other functions.

2. SaaS EHRs

Unlike on-premise EHR software, software as a service (SaaS) or cloud-based solutions do not require your office to have servers or other infrastructure on-site. Instead, your organization accesses a SaaS EHR system via the web or hosted services. SaaS approaches often have a lower upfront investment but require a monthly or annual subscription fee. SaaS EHRs are also often less customizable than on-premise EHR solutions.

3. Custom EHR Builds

If your organization or its partner offices are highly specialized, you could benefit from a custom-built EHR, but custom EHR systems require a large upfront investment. With so many Enterprise EHRs on the market, a custom system is typically unnecessary. Instead, your office can take a hybrid approach and build custom interfaces, templates, and reports into a flexible enterprise on-premise EHR.

Electronic Health Record System: Data Storage Methods

There are also three major types of EHR data storage methods.

4. On-Site EHR Data Storage

With on-site data storage, your enterprise or custom EHR system stores all data on in-house servers. The benefit of this approach is that it lets your organization closely monitor privacy and security and ensures you have control over your data. Some drawbacks of on-site EHR storage, however, include:

  • Cost: Maintaining on-site storage can be prohibitive for small organizations. 

  • Maintenance: Requires regular onsite and offsite backups of your systems in case of server failure. 

  • Connectivity: Requires internet speeds and always-up functionality to access your EHR at all times.

5. EHR Data Remotely Hosted on Dedicated Servers

Many EHR vendors offer the option to store data on dedicated, offsite servers. Your organization rents space on offsite servers which eliminates the need for an in-house server room. Your organization can maintain control of your data without purchasing, housing, and maintaining onsite servers.

6. Cloud-Based EHR Data Storage

SaaS EHRs generally use cloud-based data storage by default. Storing your EHR data in the cloud can be cheaper than local or dedicated remote servers, and your EHR vendor helps maintain privacy and security. Cloud-based storage also allows your providers and patients to access data from anywhere using an internet connection.

While cloud-based storage typically has lower upfront costs, there are monthly or annual subscription charges. Additionally, it's crucial to check a couple other items: 

  • Review the data ownership provisions in the contract to ensure you retain ownership of your organization's data. 

  • Verify the provider's reputation for past data breaches and data handling and management protocols.

Electronic Health Record Systems: Integration and Interoperability

What are EHRs in terms of how well they can work for your organization's needs? EHR systems vary in their ability to integrate with other systems and share data.

7. Certified EHRs

The Office of the National Coordinator for Health IT (ONC) certifies EHR systems meet the functionality, technical, and security requirements set by the U.S. Department of Health and Human Services (HHS). Purchasing a certified EHR system helps your organization meet Merit-based Incentive Payment System (MIPS) standards with minimal effort. Certified EHR systems also include interoperability functions that ensure you can share data as needed with other providers. These functions help you meet regulatory requirements like the Information Blocking Rule.

8. Stand-Alone EHRs

If your organization is small, your EHR may mainly serve as an electronic patient chart. A stand-alone EHR system can offer clinical functionality, including data sharing, with minimal start-up costs. However, stand-alone systems can be difficult to integrate with practice management and accounting systems, so your organization could spend more time extracting, cleaning, and transforming data than with an integrated solution.

9. Integrated EHR and EPM Systems

Integrated EHR and EPM systems, like NextGen EHR and EPM, include both EHR and practice management software in one solution. These systems book appointments, chart office visits, and bill payers all in one place.

What Are the Top 3 EHR Systems in the EHR Market Today?

What are the top EHR systems for your specific needs? With the design options and styles outlined, it is now possible to consider some of the most sought-after and respected solutions that can take your organization from using a paper chart to managing your primary care office using the most robust e-health solutions. We highly recommend the use of our team's services at TempDev to determine which solution is best for managing your quality improvement and patients' medical history data. However, the following are three of the largest and most trusted ambulatory solutions available today.

NextGen Healthcare

NextGen Healthcare provides an exceptional tool applicable to most organizations, with options for smaller physician practices and larger organizations. It is one of the most comprehensive solutions available because it is easy to configure and meet an organization’s specific needs, including those that are growing. It includes an integrated Practice Management system with unparalleled interoperability between the two systems.


One of the most notable EHR platform options is the use of Athenahealth, a cloud-based platform ideal for most hospitals and clinics. It offers a patient portal for patient engagement and an integrated suite of solutions. Used for both inpatient and outpatient care, this tool is robust enough for most applications. It can be used by pharmacies, public health, government organizations, and other stakeholders looking for robust EHR features.


A third option for practice management and EHR in one tool is eClinicalWorks. It works more readily with independent clinics and large hospitals. It can offer a number of benefits, including device integrations, documentation support, scheduling tools, and health insurance and health plan support. It offers practice-care support, including lab results, ambulatory care needs, immunizations, and wellness goal-setting and management.

TempDev Can Help You Select an Electronic Health Record System

The EHR experts at TempDev can help you customize your NextGen EHR and EPM system to meet your organization's needs. TempDev's developers, consultants, and trainers can help implement, switch, or upgrade your EHR system.

Call us at 888.TEMP.DEV (888.836.7338) or contact us online for help selecting, implementing, or upgrading your NextGen EHR system.


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