The Basics

Several studies estimate the cost of purchasing and installing an electronic health record (EHR) ranges from $15,000 to $70,000 per provider.1-5 Costs vary depending on whether you select on-site EHR deployment or web-based EHR deployment. Web-based EHR deployment, known as Software as a Service (SaaS), typically requires providers to pay a fixed monthly subscription cost. On-site deployment typically requires providers to pay for ongoing costs to support and manage on-site data servers.

The following chart from the Michigan Center for Effective IT Adoption provides estimated average upfront cost, yearly cost, and five year total cost of ownership (TCO) for on-site and SaaS EHR deployment. These cost estimates are based on the experiences of Regional Extension Centers (RECs) in the field.

Upfront CostYearly Cost5 Year TCOUpfront CostYearly Cost5 Year TCO
Estimated Average Cost $33,000 $4,000 $48,000 $26,000 $8,000 $58,000

Doing the Math - The Five Main Components of EHR Implementation

To estimate how much EHR ownership will cost your organization, you should consider the five main components of EHR implementation. These cost components relate to ambulatory primary care settings, as opposed to hospitals which may have different cost structures.

  • Hardware: Potential hardware costs may include database servers, desktop computers, tablets/laptops, printers, and scanners.
  • EHR Software: Potential software costs include an EHR application, interface modules (e.g. lab interface module), and upgrades to your EHR application. Remember, software costs vary depending on whether you select an on-site EHR deployment or a SaaS EHR deployment.
  • Implementation Assistance: Potential implementation assistance costs include IT contractor, attorney, electrician, and/or consultant support; chart conversion; hardware/network installation; and workflow redesign support. Your local Regional Extension Center (REC) can help. Contact your local REC to find out if you are eligible for free or reduced-price support.
  • Training: Your organization will need to train your physicians, nurses, and office staff before and during EHR implementation. Physicians, nurses, and office staff need to understand how to use the EHR and associated hardware and how the EHR will create new workflows for your practice.
  • Ongoing Network Fees and Maintenance: Potential ongoing costs include hardware and software license maintenance agreements, ongoing staff education, telecom fees, and IT support fees. In addition, your organization may need to hire new staff, such as IT operations staff, clinical data analysts, or application analysts.

Your Local Regional Extension Center Can Help

Your local Regional Extension Center (REC) can help you calculate how much EHR implementation will cost your practice. RECs are located in every region of the country to help health care providers select, implement, and become adept and meaningful users of EHRs. Contact your local REC to find out if you are eligible for free or reduced-price support.


  1. Blumenthal D, Glaser JP. “Information Technology Comes to Medicine.” N Engl J Med. 2007.
  2. Smith PD. “Implementing an EMR System: One Clinic’s Experience.” Fam Pract Manag. 2003.
  3. Fleming NS, Culler SD, McCorkle R, Becker ER, Ballard DJ. “The Financial And Nonfinancial Costs Of Implementing Electronic Health Records In Primary Care Practices.” Health Aff. 2011.
  4. Miller RH, Sim I, Newman J. "Electronic Medical Records: Lessons from Small Physician Practices" [PDF - 477.3 KB]. iHealth Reports. 2003.
  5. Bodenheimer T, Grumbach K. “Electric technology: a spark to revitalize primary care?” JAMA. 2003.