Why build custom instead of using Epic or Cerner?

Custom EHR fits your specialty workflow exactly, enables AI on your data model, becomes a platform asset, and costs less per clinician over 5 years than per-seat EHR licensing for specialty platforms.

How long does EHR development take?

Starter specialty MVP: 12–16 weeks. Growth multi-specialty with billing and ONC: 16–20 weeks. Enterprise hospital-grade: 20–28 weeks.

How much does EHR development cost?

From $100K for Starter MVP, $150K–$200K for Growth, $200K–$250K+ for Enterprise-all fixed-price.

Can you build a SMART on FHIR app inside Epic?

Yes. SMART on FHIR apps launch within Epic's clinical UI using Epic's FHIR R4 APIs-adding specialty functionality without changes to the base EHR installation.

How do you handle clinical UAT?

Structured UAT with real clinicians using realistic patient scenarios. We iterate on clinical UX based on findings before production launch.

How does the fixed-price engagement work?

Scoped in a free 30-min call with clinical workflow interviews. Proposal in 48 hours. Locked before any code is written. 70% extend to 6+ month roadmaps.

How do I get started?

Book a free 30-min strategy call with your specialty workflow requirements, EHR pain points, integration targets, and ONC compliance needs. Proposal within 48 hours.

AI Accelerator Top 20 Startups

Top 20 Indian Startups

EHR / EMR Software Development Company in USA

Q: What is EHR / EMR software development?

Building clinical information systems with specialty workflows, FHIR R4 interoperability, ONC certification pathway alignment, HIPAA PHI handling, e-prescribing, lab integration, and billing connectivity.

Q: Will the EHR meet ONC certification requirements?

We build to ONC §170.315 criteria and produce alignment documentation for the certification pathway. Full ONC certification requires ATL engagement, which we can coordinate.

Q: Can you add AI clinical documentation?

Yes. Ambient AI scribe using Whisper + GPT-4o for structured SOAP notes, ICD-10 coding suggestions, and care plan drafts-included in Growth and Enterprise tiers.

Build a custom EHR or EMR system tailored to your specialty's clinical workflows, HL7/FHIR R4, ONC certification pathway, AI clinical documentation, and payer integrations from $100K. Shipped for specialty practices, digital health platforms, and hospital systems across Boston, New York, Nashville, and beyond. Off-the-shelf EHR systems are built for everyone, which means they work perfectly for no one. We design around your specific specialty, your documentation patterns, and your patient population, so your clinicians spend less time clicking and more time delivering care.

Book a Free 30-min Strategy Call See Our EHR Work

EHR / EMR Software Development Company in USA

97% Client Retention Rate

100+ products launched

04 Unicorns Shipped

USA · UK · KSA delivery

ISO & NDA Compliant

Trusted by category-defining, companies across India, USA, UK & the Middle East.

WHO IT'S FOR

How to Work With EngineerBabu on AI Agent Development

Your product stage defines your engagement model. We offer three ways to access our AI agent development services, from a single sprint to full end-to-end ownership.

Founder / CEO (Specialty HealthTech Startup)

You're building a clinical platform for a specific specialty-behavioral health, oncology, dermatology, or physical therapy-and the generic EHRs (Epic, Cerner, athenahealth) don't fit your workflow. A custom EHR gives you the clinical UX that drives clinician adoption, the specialty-specific data model that enables your AI features, and a platform asset that becomes a competitive moat.

Get a free consultation

CTO / Head of Engineering (Digital Health Platform)

You're building a care management or virtual care platform that needs its own clinical data store, not just an Epic integration that breaks every upgrade cycle. You need a FHIR-native clinical data layer, specialty-specific clinical modules, and the right architecture to scale confidently to multi-state multi-provider deployments without ever having to rebuild from scratch.

Get a free consultation

Chief Medical Informatics Officer (Hospital / IDN)

Your current EHR doesn't support a specific clinical program, whether that's complex behavioral health workflows or research data capture at scale. You need a precisely scoped module-level custom build that integrates bidirectionally and reliably with your existing Epic environment while delivering the exact clinical workflow that no off-the-shelf system can match or configure.

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Key Features

Built for Teams Shipping AI in Production

Specialty Clinical Workflows

Custom SOAP note templates, structured data entry, clinical decision support rules, and specialty-specific documentation workflows-built for your clinicians, not a generic average.

FHIR R4 Native Data Model

FHIR R4-compliant clinical data store using HAPI FHIR server-storing patients, encounters, observations, conditions, medications, procedures, and care plans as FHIR resources for interoperability.

ONC Certification Pathway Architecture

System architecture aligned to ONC Health IT certification criteria (§170.315)-including clinical quality measures (CQM), patient access API, and e-prescribing requirements for ONC-certified EHR designation.

AI Clinical Documentation

Ambient AI scribe using Whisper (speech-to-text) + GPT-4o generating structured SOAP notes, ICD-10 coding suggestions, and care plan drafts-reducing documentation burden by 60–70%.

Lab, Imaging & Results Management

Integration with LabCorp, Quest Diagnostics, and hospital lab systems via HL7 v2 ORU messages-with structured results display, critical value alerting, and result-to-problem-list linkage.

E-Prescribing & Management

Surescripts-integrated e-prescribing with drug-drug interaction checking, formulary lookup, medication history, and EPCS (electronic prescribing for controlled substances).

Billing & RCM Integration

ICD-10 / CPT code capture, superbill generation, claims submission to clearinghouses, ERA/EOB processing, and patient responsibility calculation integrated with your RCM system.

Patient Portal & Care Coordination

FHIR-native patient portal meeting ONC patient access requirements-lab results, visit summaries, medication lists, care messaging, and appointment scheduling for patient engagement.

Want one of these live in 8 weeks?

Book a strategy call

AI AGENT SOLUTIONS

Types of EHR / EMR Systems You Can Build With Us

Specialty-Specific EHR

A purpose-built EHR for a specific clinical specialty-behavioral health, oncology, dermatology, physical therapy, or addiction medicine-with specialty-appropriate documentation templates, scoring tools, and clinical workflows that generic EHRs don't support. Best for: Specialty practice groups, behavioral health networks, oncology centers, PT/OT clinics.

Behavioral Health EHR

Built specifically for the complexity of behavioral health documentation-DSM-5 diagnosis tools, treatment plan workflows, progress note templates, group therapy notes, outcome measurement (PHQ-9, GAD-7, PCL-5), and Medicaid/Medicare billing support. Best for: Outpatient behavioral health practices, CMHCs, substance use disorder programs, IDD providers.

Care Management with EHR

A care management system for complex care populations, chronic disease, high-utilizer programs, SDOH screening, with its own dedicated clinical data store, care team coordination workflows, and reliable bidirectional Epic/Cerner integration that stays in sync. Best for: ACOs, payer care management programs, federally qualified health centers.

Clinical Trial Data Capture

A research-grade clinical data capture system, structured CRFs, protocol-driven visit workflows, REDCap integration, and CDISC-compliant data export, with full HIPAA-compliant data handling, IRB documentation support, and audit trails built to withstand regulatory scrutiny. Best for: Academic medical centers, CROs, pharma-sponsored investigator sites.

EHR Integration Layer

A custom integration module connecting your existing clinical workflows to Epic, Cerner, or Athenahealth-adding specialty-specific documentation, AI features, or custom reporting that the base EHR doesn't support via SMART on FHIR app architecture. Best for: Hospital innovation teams, specialty practices using existing EHRs, digital health add-on products.

Not sure which agent fits your workflow?

Get a free use-case audit

Trusted by Industry Leaders

LLMs & Foundation Models We've Worked With

We're proud to have partnered with top VC-backed companies, helping them achieve their growth milestones.

GPT-4o

Anthropic Claude 3.5 Sonnet

Mistral Large

Google Gemini 1.5

Cohere Command R+

Meta Llama 3

Agent Frameworks We've Worked With

We're proud to have partnered with top VC-backed companies, helping them achieve their growth milestones.

LangChain

LangGraph

CrewAI

LlamaIndex

AutoGen

Semantic Kernel

Agent Frameworks We've Worked With

We're proud to have partnered with top VC-backed companies, helping them achieve their growth milestones.

Pinecone

Weaviate

pgvector

Qdrant

Elasticsearch

Mongo Atlas Vector

Agent Frameworks We've Worked With

We're proud to have partnered with top VC-backed companies, helping them achieve their growth milestones.

AWS · Bedrock

Google Cloud

Azure OpenAI

Kubernetes + Terraform

Vercel · Modal

LangSmith + Datadog

Pricing

Built for Teams Shipping AI in Production

$100K-$150K /month

(12-16 weeks)

Starter

Best for: Specialty EHR MVP, single-specialty practice, Series A fundraise

Specialty clinical workflow design + FHIR R4 data model
Core clinical modules (chart, SOAP notes, problem list, medications, labs)
HIPAA-compliant infrastructure (AWS HIPAA-eligible)
E-prescribing via Surescripts
1 EHR integration (if needed-SMART on FHIR)
Basic patient portal (ONC patient access API)
AI ambient documentation (Whisper + GPT-4o)
30-day post-launch support + IP ownership+

A Process Designed for Outcomes

We follow a transparent, collaborative process, from discovery to deployment. Designed to help founders move fast, stay lean, and build reliable, scalable products.

Clinical Workflow Discovery & Architecture

Conduct clinical workflow interviews with physicians, nurses, and billers-map specialty-specific documentation needs, data model, and integration requirements. Deliverable: Clinical workflow diagrams, FHIR data model spec, ONC alignment checklist, integration architecture.

FHIR Data Layer & Infrastructure

Build HAPI FHIR server, define custom FHIR profiles for specialty data, configure HIPAA-compliant infrastructure, and set up clinical terminology (SNOMED, ICD-10, LOINC) bindings. Deliverable: FHIR R4 server live, infrastructure compliant, terminology services configured.

Core Clinical Module Build

Build specialty clinical workflows-patient chart, SOAP notes, problem list, medication management, lab ordering, and results display-with AI scribe integration. Deliverable: Core clinical module with AI documentation, tested by clinical SMEs on realistic patient scenarios.

Billing, Lab & Pharmacy Integration

Integrate e-prescribing (Surescripts), lab ordering/results (HL7 v2), claims submission, and ERA processing. Deliverable: Full billing cycle tested end-to-end; lab results flowing; e-prescriptions sent to pharmacy network.

Patient Portal & ONC Compliance

Build FHIR-native patient portal, implement ONC patient access API requirements, and complete ONC §170.315 criteria checklist. Deliverable: Patient portal live, ONC patient access API operational, compliance documentation package.

UAT, Security Testing & Launch

Clinical user acceptance testing with real clinicians, penetration testing, HIPAA safeguard review, and phased production launch. Deliverable: UAT sign-off, pentest report, HIPAA compliance documentation, live production EHR.

Aanchal Chaurasia Director, EngineerBabu

Schedule a Free Consultation

CASE STUDIES

What We’ve Built With Leaders and CXOs

Bank Open Neobank Platform

Bengaluru

Google x EngineerBabu AI Based Hackthon Assessment

India

Airbox E-commerce Marketplace

Singapore

Chhattisgarh PoliceSummons & Warrant Management

India

Shule Direct Ed Tech Platform

East Africa

Invulb Wealth Management App

India

Framebazaar E-commerce Platform

India

LumiereB2B Healthcare Marketplace

Singapore

ShoppiGrocery Delivery App

Africa

AskMeEdTech App

India

BURQ Custom Logistics Platform

USA

Supersourcing AI-Powered Hiring Platform

India

Digital Training Platform Baxolile Mabinya

Deviare Digital Training Platform

South Africa

Delivery Management Platform Deepak Verma

Delivr Delivery Management Platform

UAE

Rx Agile Trainer-First Learning Platform

Bengaluru

Nigerian Air Force Process Automation Platform

Africa

Butterfly Social Discovery App

Switzerland

Why Us

Why EngineerBabu?

We sign strict NDAs, ensure full IP ownership, and follow ISO-certified processes. With dedicated development teams, flexible engagement models, and 24/7 support, we are a trusted CMMI level 5 hybrid app development company committed to quality and on-time delivery.

1250+ Projects Delivered

1000+ Happy Clients

170+ Expert Talent

Transparent Pricing

Proven Expertise

Top-notch IT Solutions

Get a Free Consultation

Backed by Industry Leaders and Certifications

Featured in Google for Startups AI Accelerator and recognized by LinkedIn as a Top Startup.

AI ACCELERATOR TOP 20 STARTUPS 2024

Top 20 Indian Startups 2023 & 2024

Highly rated on Clutch with an impressive 4.9★!

Proudly showcased in the Google for Startups AI Accelerator and celebrated by LinkedIn as a Top Startup!

Regulatory Compliance, Built Into Every Layer

Our Mortgage App Development Services are designed with regulatory compliance at the core. From PCI DSS and PSD2 to GDPR, AML/KYC, CCPA, and Open Banking standards, we embed audit-ready controls directly into your platform architecture.

Honest feedbacks

Stories From Founders Who’ve Worked With Us

Harshit Thareja Co-Founder

Singapore

Anish AchuthanCEO & Co-Founder

Bengaluru

Bhavna GuptaIPS Officer

Chhattisgarh

Danny SchwartzFounder & CEO

United States

Adam Faanes CTO & Co-Founder

New York

Andile NgcabaChairman & Founder

South Africa

Lakshmikant SinghFounder & CEO

India

Baxolile Mabinya Co-Founder

South Africa

Analyzing the Competition

Agencies Deliver Projects, We Deliver Growth.

Offshore Body-Shop

Freelancer / Local Studio

Entry price

NDA + IP transfer pre-discovery

Design-led product thinking

Senior AI engineers on every project

Code, prompts & weights ownership

Post-launch SLA

Founder / CTO access

Weekly demos

US-timezone overlap

From $100K (custom-built, IP yours)

Specialty-specific workflows, your design

Certification pathway architecture + docs

FHIR R4-native, SMART on FHIR, HL7 v2

Ambient AI scribe (Whisper + GPT-4o) included

100% yours, contractually

Every sprint, without asking

Full PT-ET coverage daily

Structured clinical UAT with real clinicians

$40K-$80K (no clinical expertise)

Generic templates

Claimed, rarely documented

Basic REST only

Not available

Often retained

Monthly at best

2-4 hrs overlap

Rarely included

$50K-$200K/yr licensing

Workarounds required

Certified (rigid)

Partial

Add-on, expensive

Vendor owns platform

N/A

US-based

Not included

US DELIVERY COVERAGE

Trusted by EHR Development Teams Across the USA

EngineerBabu has built custom EHR and EMR systems for behavioral health networks, oncology platforms, FQHCs, care management organizations, and specialty practice groups across every major US health market. Whether you're building a behavioral health EHR in Boston, an oncology module in New York, a care management platform in Nashville, or a specialty EHR for a multi-site practice in Chicago-we've shipped in your specialty and against your regulatory requirements.

We serve clients across Boston · New York · Nashville · Chicago · San Francisco · Los Angeles · Seattle · Atlanta · Houston · Denver-with full PT–ET timezone alignment and same-day response across all US health markets.

From the academic medical ecosystems of Boston and New York to the community health centers of Nashville and Atlanta, and the specialty practice markets of Chicago and Los Angeles-custom EHR development in the USA requires deep clinical workflow knowledge, FHIR R4 expertise, ONC compliance architecture, and a development team that has put production clinical software in front of real clinicians under real time pressure.

Get a Free Consultation

Mayank Pratap Singh Founder, EngineerBabu

Supporting AI Teams Across the United States

FAQs

Frequently Asked Questions

Building clinical information systems that capture, store, and exchange patient health data-with specialty clinical workflows, FHIR R4 interoperability, ONC certification pathway alignment, HIPAA-compliant PHI handling, e-prescribing, lab integration, and billing system connectivity. Custom development delivers the clinical UX your specialty needs-without workarounds.

Epic and Cerner are designed for broad coverage across all specialties-meaning every specialty uses workarounds. A custom EHR fits your specific specialty workflow exactly, enables AI features on your own data model, becomes a proprietary platform asset, and costs less per clinician over a 5-year horizon than per-seat EHR licensing-especially for specialty platforms with 50–500 providers.

Starter specialty EHR MVPs take 12–16 weeks. Growth multi-specialty platforms with billing, lab integration, and ONC alignment take 16–20 weeks. Enterprise hospital-grade EHRs with multi-site deployment and HITRUST certification take 20–28 weeks.

From $100K for a Starter specialty EHR MVP, $150K–$200K for a Growth multi-specialty platform with full billing cycle and ONC alignment, and $200K–$250K+ for an Enterprise platform with multi-site deployment and HITRUST documentation-all fixed-price.

Yes. SMART on FHIR allows custom applications to launch within the Epic clinical UI-using Epic's FHIR R4 APIs for patient context and clinical data. We build SMART on FHIR apps that add specialty functionality to Epic without requiring changes to the base EHR installation.

We build to ONC §170.315 certification criteria-clinical quality measures, patient access API, e-prescribing, and interoperability requirements-and produce alignment documentation for the certification pathway. Full ONC certification submission requires an ONC-Authorized Testing Laboratory (ATL) engagement, which we can coordinate.

Yes. Ambient AI documentation using Whisper for HIPAA-compliant audio capture and GPT-4o for structured SOAP note generation-with ICD-10 coding suggestions, care plan drafts, and review-and-sign workflows-is included in all Growth and Enterprise tiers.

We conduct structured clinical user acceptance testing with real clinicians-using realistic patient scenarios mapped to the specialty's actual case mix. We iterate on clinical UX based on UAT findings before production launch. Clinician sign-off is a milestone in our project plan.

Scoped in a free 30-min strategy call including clinical workflow interviews. Written proposal in 48 hours. Scope, price, and timeline locked before any code is written. 70% of clients extend into 6+ month feature roadmaps.

Book a free 30-min strategy call. Bring your specialty workflow requirements, current EHR pain points, integration targets (Epic, Cerner, labs, payers), and any ONC compliance requirements. Scoped proposal within 48 hours.