The Virtual Care Blog

How Much Should You Spend on an EMR?

Posted by Teresa Iafolla

Many physicians worry about the costs of converting to electronic medical records (EMRs). But the costs of not converting could soon outweigh your concerns.

The longer EMRs have been around, the more affordable and secure they’ve become. That means less associated costs for you and your practice. In 2014, about half of healthcare providers were using a full-functioning EMR, and more than 40% of those providers were in the market to switch.

When it comes time to decide which EMR system is right for you, watch out for these 10 obvious and not-so-obvious costs your practice might incur.

Data Migration

Whether you use a paper or computer-based system, you will have to migrate your data into the new EMR system. The costs involved in this undertaking can vary widely depending on how you’ve maintained medical records in the past and what you need for your new EMR system.

For example, if handwritten notes are legible enough, a practice can invest in a document scanner and software that interprets and digitizes the handwriting into computerized text-based notes. Potentially, those notes can then be imported into the new EMR system. 

This could cost much less than the alternative – having your staff or a new hire type in all of the records into the new EMR by hand. That means additional labor costs and time not spent on more profitable tasks.

Hardware and Maintenance

Depending on your current computer equipment and the hardware requirements of your chosen EMR system, your practice may need to invest in additional equipment. For example, certain EMRs run only on iOS or only on a Windows-based operating system. These are usually one-time costs you pay upfront when you first purchase your EMR system. However, over time, you may face additional costs for hardware maintenance.

Software and Upgrades

The EMR software and its installation often come with a one-time upfront cost. Vendors often address upgrades with a standard monthly fee that covers all updates, bug fixes, and similar routine system changes. If the updates or upgrades come with a new area of content or new service, however, you may pay a higher monthly fee going forward.

Internet Access

Your new EMR may require a certain bandwidth, or speed of Internet access. This may cost more than what you pay for now if you’re not already at that level.


Sometimes a set amount of hours for training for you and your staff to use the program is built in to the initial upfront software fee. Depending on the software and your experience, you may need more training beyond what’s included. You can likely pay extra for more hours of training, as needed. 

Technical Support

If you pay a monthly fee to use the EMR system, this sometimes comes with some form of tech support. Speak with your vendor to determine if you need to pay an extra fee for more intensive support. Consider if you can or want to have your IT staff manage all the tech support themselves. Hash out these details upfront, because any loss of data access can be costly in terms of downtime for your practice. 


Your EMR should come with its own host of security functions. But depending on your practice’s needs, you may need to invest in additional security software or hardware. This is especially important if you plan on exchanging health data with any other healthcare providers or patient-focused apps.

Flexibility and Customization

All EMRs should have some form of flexibility in terms of enabling physicians to take personalized notes. But different specialties will require personalization in different areas, such as different organ systems, coding for billing, and prescription note-taking and management.

Some EMRs may offer you add-on modules, for billing, patient education, or patient satisfaction. Make sure to analyze your regular documentation needs and determine what functionalities your EMR should have to make your practice run more smoothly. Target the right balance between customization and ease of use.

Ability to Compute Formulas

EMRs are primarily built for documentation, but some EMRs will actually compute formulas, which can be a vital time-saver. For example, many providers would benefit from an EMR that computes a patient’s BMI automatically based on the input of the patient’s weight and height. Physicians that prescribe certain narcotics would benefit from an EMR that can calculate morphine equivalent doses (MEDs) of different medications to ensure patients are taking the appropriate amount.

If having certain formulas done via the EMR would make your practice run faster and more smoothly, that might be a priority you consider spending a little extra on.

Customized Reports

Depending on your specialty and practice’s needs for documentation and regulatory requirements, you may need your EMR to produce customized reports. These could be included in the basic EMR, or they might be part of an additional upgrade, module, or coordinated program.

While there is no one firm cost of setting up or switching EMRs for every practice, those costs have dropped dramatically, especially for cloud-based EMRs. Keep these 10 costs in mind as you make your decision, and you won’t be surprised when you see your total bill.


Teresa Iafolla

About Teresa Iafolla

Teresa Iafolla is an expert writer, researcher, and content wrangler who has previously worked as director of content marketing for a telehealth company and associate editor for a healthcare publishing company.

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