Custom EHRVSEpic

Custom EHR vs Epic

Compare custom EHR development vs Epic Systems. Analyze features, pricing, HIPAA compliance, and total cost of ownership for your healthcare organization.

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Feature Comparison

Compare capabilities between custom EHR development and Epic Systems.

Feature	Custom EHR	Epic
Clinical Documentation Patient records and notes
HIPAA Compliance Full regulatory compliance
HL7/FHIR Integration Healthcare data standards
Custom Clinical Workflows Specialty-specific workflows		Limited customization
Interoperability Connect with external systems		Care Everywhere (add-on)
Patient Portal Patient self-service access		MyChart
Revenue Cycle Management Billing and claims
Clinical Decision Support AI-assisted diagnostics
Specialty Modules Specialty-specific features	Built for your specialty	Module-based
Data Ownership Full control of patient data		Hosted by Epic

Specialty practice struggling with generic EHR workflows?

Custom EHRs are built specifically for your clinical processes.

Discuss Your Specialty

Cost Analysis

Pricing & TCO Analysis

Compare realistic costs based on current Epic pricing and custom EHR development.

Custom EHR

Initial Implementation$150,000 - $500,000

Annual Licensing$0

Per-Provider Licensing$0

Annual Maintenance$50,000 - $150,000

Training Costs$25,000 - $75,000

5-Year TCO (50 providers)$400,000 - $1,250,000

5-Year TCO$400,000 - $1,250,000

Epic

Initial Implementation$500,000 - $5,000,000+

Annual Licensing$200,000 - $2,000,000/yr

Per-Provider Licensing$15,000 - $50,000/provider

Annual MaintenanceIncluded (18-20% of license)

Training Costs$100,000 - $500,000

5-Year TCO (50 providers)$2,500,000 - $15,000,000

5-Year TCO$2,500,000 - $15,000,000

Potential Savings with Custom EHR

$2,100,000 - $13,750,000

over 5 years compared to Epic

Advantages & Disadvantages

Understand the benefits and trade-offs of each approach.

Custom EHR

Advantages

No per-provider licensing fees
Build workflows for your specific specialty
Full data ownership and control
Integrate with any system via HL7/FHIR
Lower long-term total cost of ownership
Scale without exponential cost increases

Disadvantages

Significant upfront development investment
6-12 month development timeline
Requires healthcare IT expertise
Must achieve certification independently

Epic

Advantages

Industry-leading comprehensive platform
Proven at large health systems
Extensive module ecosystem
Regular regulatory updates included
Large trained workforce available

Disadvantages

Extremely high implementation costs
Per-provider licensing adds up quickly
Limited customization flexibility
Vendor lock-in with data migration challenges
Significant training investment required

Which is Right for You?

Consider these scenarios to determine the best fit for your organization.

Choose Custom EHR if you...

Specialty Practice

Dermatology, orthopedics, or niche specialties

Startup Health System

New practices without legacy EHR

Unique Workflow Needs

Clinical processes that don't fit standard EHR

Cost-Conscious Organization

Need EHR without enterprise costs

Choose Epic if you...

Large Health System

500+ bed hospitals with complex needs

Academic Medical Center

Research integration requirements

Multi-Hospital Network

Need proven enterprise scalability

Full Suite Required

Need comprehensive EHR immediately

Need help evaluating EHR options for your practice?

Schedule Consultation

Migration Path

Development Timeline

What to expect when building a custom EHR system.

4-6 weeks

Requirements & Compliance

Document clinical workflows and regulatory requirements

4-6 weeks

Architecture Design

Design HIPAA-compliant system architecture

16-24 weeks

Core Development

Build clinical documentation and workflows

6-8 weeks

Integration & Interop

HL7/FHIR connections to labs, pharmacies, HIEs

6-8 weeks

Testing & Certification

Security testing and ONC certification if needed

4-6 weeks

Training & Go-Live

Staff training and phased deployment

Total Migration Timeline

40-58 weeks

Migration Benefits

Complete patient data migration with full history
Zero downtime deployment strategy
Staff training tailored to your workflows
HIPAA compliance verification included
Post-launch support and optimization

Our Solutions

Explore Our Healthcare Solutions

Custom software for healthcare organizations.

Healthcare Software Development

Custom HIPAA-compliant software for healthcare organizations.

HIPAA compliance
HL7/FHIR integration
Patient portals

Learn more

Healthcare CRM

Patient relationship management built for healthcare.

Patient communication
Appointment scheduling
Care coordination

Learn more

Patient Acquisition Platform

Manage patient referrals and marketing leads.

Referral tracking
Lead scoring
Conversion analytics

Learn more

View All Solutions

Comparison

Epic implementation costs vary significantly by organization size. Small practices (10-50 providers) typically pay $500,000-$2,000,000 for implementation plus $15,000-$50,000 per provider annually in licensing. Large health systems can spend $50-$500+ million. A custom EHR for a 50-provider organization costs $150,000-$500,000 to build with $50,000-$150,000 annual maintenance—a fraction of Epic's ongoing licensing.

Absolutely. Custom EHRs can achieve full HIPAA compliance through proper security architecture: encryption at rest and in transit, access controls, audit logging, backup procedures, and BAA agreements with cloud providers. We build HIPAA compliance into the architecture from day one.

ONC Health IT Certification is required for EHRs participating in certain federal programs (Medicare/Medicaid incentives). Custom EHRs can achieve certification, though the process takes 3-6 months and costs $50,000-$150,000. Many specialty practices operate effectively without certification.

Custom EHRs implement HL7 FHIR and v2 standards for data exchange with labs, pharmacies, imaging centers, and health information exchanges (HIEs). Modern cloud architecture often makes custom systems more flexible for integration than legacy platforms.

Often, yes. Epic is designed for large health systems with complex needs. Specialty practices (dermatology, orthopedics, ophthalmology) frequently find Epic's generic workflows don't match their clinical processes. Custom EHRs can be built specifically for your specialty at a fraction of the cost.

Specialties with unique workflows benefit most: dermatology (image-heavy documentation), orthopedics (surgical planning), ophthalmology (detailed exams), behavioral health (different privacy rules), and pain management (prescription monitoring). These specialties often struggle with generic EHR templates.

Knowledge Base