zapEHR Blog | Navigating the Build vs. Buy Decision in the Era of Headless EHRs (2024)

TL;DR: Choosing to build or buy an EHR system involves careful evaluation of organizational needs, resources, and long-term goals. Each option has its advantages and disadvantages. However, the rise of headless EHR software like ZapEHR offers a promising alternative.

In the ever-evolving landscape of technology in the healthcare industry, the decision to buy or build your own Electronic Health Records (EHR) system is a critical choice that requires a thorough evaluation of organizational needs, resources, and long-term goals. Both options present unique advantages and challenges, but a rising alternative, headless EHR software like ZapEHR, promises to revolutionize the way healthcare organizations approach their technology stack.

Understanding Headless EHRs:

Headless EHRs represent a paradigm shift, separating the front-end from the back-end to provide greater flexibility, scalability, and seamless integration with various systems. Beyond these benefits, headless EHRs play a pivotal role in optimizing care coordination among healthcare professionals. The dynamic and interoperable environment they foster contributes to enhanced patient outcomes through improved collaboration and information sharing across the healthcare ecosystem.

The Build Option:

The most enticing aspect of the build option lies in the absolute flexibility it affords. Startups can sculpt a bespoke front-end experience that not only aligns precisely with their unique workflows but also reflects their distinct brand identity. This level of customization serves as a catalyst for fostering an environment where innovation flourishes, setting the stage for a truly differentiated user experience and a foundation for providing value-based care.

Beyond customization, custom development of an EHR system empowers startups to architect workflows that are not just efficient but also fully tailored to their clinical care processes. For instance, a startup might seamlessly integrate cutting-edge technologies, such as telemedicine, right into the fabric of their EHR, ensuring a forward-looking approach to patient care that distinguishes them in the competitive landscape.

Interoperability becomes a strategic advantage with the build option, allowing startups to seamlessly integrate with other systems and emerging healthcare solutions. This interconnectedness paves the way for a holistic healthcare ecosystem, where data flows seamlessly, contributing to a more comprehensive and informed approach to patient care.

The build option shines when it comes to compliance measures. For a startup, having control over the development process ensures that their EHR system is not merely a passive tool but an active partner in ensuring adherence to the latest healthcare regulations, data security protocols, and interoperability standards. This proactive stance not only mitigates future compliance risks but also establishes a foundation of trust with patients and regulatory bodies.

However, challenges include a significant investment of time, money, and resources. Development teams must possess a deep understanding of healthcare regulations, patient data security, and knowledge of interoperability standards, and ongoing maintenance costs may divert resources from critical tasks.

While the initial investment of time, money, and labor may seem daunting, a digital-first startup with the right resources and vision can turn these challenges into opportunities. Consider, for instance, the long-term cost-effectiveness of building a system that grows organically with the organization, where updates and enhancements are seamlessly integrated, and the investment in skilled developers pays dividends in creating a competitive edge.

zapEHR Blog | Navigating the Build vs. Buy Decision in the Era of Headless EHRs (1)

The Buy Option:

For a large clinical organization, opting for a pre-built enterprise solution emerges as a strategic and expedient avenue, leveraging several compelling advantages. Vendors in this space have already invested significantly in developing products that align seamlessly with industry standards, positioning them as turnkey solutions for rapid deployment. This accelerated implementation process ensures that large clinical organizations swiftly derive benefits from the EHR, streamlining their operations and enhancing patient care without protracted development timelines or building software themselves.

Established vendors often offer a valuable lifeline in the form of third party support and updates, alleviating the burden on internal IT teams. This external support mechanism ensures that the EHR system remains current with the latest industry developments, security protocols, and regulatory standards. This not only frees up internal resources but also provides peace of mind, knowing that the organization is not solely responsible for navigating the ever-evolving landscape of healthcare technology.

However, it's imperative for large clinical organizations to approach the buy option with a discerning eye. While off-the-shelf solutions bring a wealth of standardized features and benefits, they may not seamlessly align with the unique needs and workflows of every organization.

Large EHR vendors find themselves grappling with the shifting tides of technology trends, notably in the realms of cloud computing and APIs. The increasingly prevalent adoption of cloud-based infrastructure is reshaping how healthcare data is managed and exchanged.

However, traditional monolithic EHR systems, by their nature, face challenges in keeping pace with these trends.The inherent limitation in customization options could necessitate certain workflow adjustments, potentially impacting the organization's ability to tailor the EHR system precisely to their requirements.

In light of these considerations, large clinical organizations should carefully weigh the trade-offs between the rapid benefits of a pre-built EHR solution and the potential need for workflow adjustments. The decision should align with the organization's strategic goals, operational requirements, and the need for a balance between standardization and customization.

Making the Decision:

Organizations navigating the build vs. buy decision must carefully assess their specific needs, resources, and long-term goals. Considerations include customization requirements, in-house expertise, budget and resources, vendor reputation, interoperability, and scalability. Balancing these factors is crucial for making an informed decision that aligns with the organization's strategic objectives to improve both the provider experience, but also the patient experience.

The Alternative: Headless EHRs:

Enter headless EHRs as a compelling alternative, combining the benefits of both build and buy solutions. ZapEHR, a leading platform in this space, adopts a modular design that empowers healthcare providers to craft personalized solutions. The platform's features, such as serverless APIs, managed authentication, and compliance, guarantee efficiency. With transparent pricing, starter code, and access to Ottehr, an open-source EHR ready for production, ZapEHR simplifies development for practices of all sizes and may be a better option for your growing organization.

Customized Solution: ZapEHR's modular design facilitates a customized solution, allowing healthcare providers to add or remove components as needed, ensuring that the system aligns seamlessly with their unique workflows and requirements. For example, implementation of artificial intelligence for clinical decision support. As ZapEHR's product roadmap shows, services like clinical decision support, or reporting will allow for an easy plug and play for your EHR to support these important capabilities to improve clinical outcomes without having to build from scratch or house the data.

Certified EHR: ZapEHR helps cut your effort toward ONC certification standards, ensuring that the platform meets the necessary requirements for security, interoperability, and data exchange, providing healthcare organizations as they work toward a certified EHR solution.

Constantly Evolving: ZapEHR continuously introduces new products and functionality to its platform, staying ahead of the curve in meeting the evolving needs of healthcare professionals. This commitment to innovation ensures that users benefit from the latest advancements in healthcare technology.

No More Manual Workarounds: With ZapEHR, organizations can significantly reduce reliance on manual workarounds, additional licensing fees, or integration fees, streamlining operational processes and minimizing the risk of errors associated with manual data entry.

Operational Costs: The efficiency of ZapEHR's headless EHR platform translates into reduced operational costs for healthcare organizations. The modular design minimizes the need for extensive customization, leading to cost-effective implementation and maintenance. At ZapEHR, our scalable pricing structure aligns with values of our customers. We follow a usage-based model, which means no upfront expenses, no lengthy annual commitments, no per-provider or fixed monthly fees, no revenue percentage deductions, and absolutely no concealed costs for integrations or API access. Our pricing is straightforward and crystal clear, and we even offer a free tier for you to get started.


The decision to build or buy an EHR system is a complex one, requiring careful consideration of organizational needs, resources, and long-term goals. While both options have their merits and challenges, the emergence of headless EHRs, exemplified by ZapEHR, offers a compelling alternative. By providing a customized solution, supporting clinical decision support, adhering to certification standards, and prioritizing patient engagement, ZapEHR stands as a beacon of innovation in the healthcare technology landscape. Its business model, commitment to introducing new functionality, and applicability in diverse healthcare settings make it a valuable asset for organizations seeking a digital-first approach to healthcare operations. In embracing ZapEHR's headless EHR platform, healthcare organizations can not only create a better user experience but also provide top-of-the-line patient care, optimizing outcomes and reducing operational costs.


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1. How does ZapEHR's headless EHR platform simplify development for healthcare organizations?

ZapEHR's headless EHR platform simplifies development by adopting a modular design, allowing healthcare providers to craft personalized solutions. This means organizations can add or remove components as needed, ensuring the system aligns seamlessly with their unique workflows and requirements. The platform also provides starter code and access to Ottehr, an open-source EHR ready for production, streamlining the development process for practices of all sizes.

2. What advantages does ZapEHR offer over traditional EHR systems in terms of cost transparency and operational efficiency?

ZapEHR stands out by offering a transparent pricing structure based on usage. There are no upfront expenses, no fixed monthly fees, and no concealed costs for integrations or API access. The modular design minimizes the need for extensive customization, reducing operational costs for healthcare organizations. This approach ensures cost-effective implementation and maintenance.

3. How does ZapEHR contribute to meeting certification standards?

ZapEHR helps healthcare organizations cut effort toward ONC certification standards, ensuring that the platform meets necessary requirements for security, interoperability, and data exchange. By providing a certified EHR solution, ZapEHR supports organizations in adhering to the latest healthcare regulations and data security protocols.

zapEHR Blog | Navigating the Build vs. Buy Decision in the Era of Headless EHRs (2024)


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