A recent study published by the American Journal of Managed Care analyzed the usage of the patient portal among more than 250,000 adults aged 50 and older with at least one chronic condition. While 61% of the patients activated their patient portals, only 54% logged in at least once between 2011 and 2024.

That gap highlights a bigger issue in healthcare technology investments—building digital tools doesn’t guarantee value. If systems aren’t designed around real workflows and outcomes, adoption drops and ROI never materializes.

The same challenge applies to AI in EHR systems.

That’s why organizations in 2026 are no longer asking “Should we adopt AI?”—they’re asking “What is the return, and where does it actually create value?”

This is where an AI EHR development investment guide 2026 becomes essential.

Investing in AI-powered EHR isn’t just about adding automation—it’s about improving clinical efficiency, reducing administrative burden, and enabling better decision-making. But without a clear strategy, even advanced AI features can fail to deliver measurable AI EHR ROI.

To build a strong AI EHR business case, healthcare organizations need to understand where AI creates real impact—from documentation and workflow automation to predictive insights and patient engagement.

In this guide, we’ll break down how to approach investing in AI-powered EHR, what drives ROI, and how to ensure your investment delivers long-term value.

Where AI Creates Value in EHR Systems (Investment Perspective)

One of the things that decides whether the patient portal will be used is features, but adding multiple features is also not the right strategy. What healthcare organizations need to do when they build a patient portal is to choose features that make the portal reliable and easily accessible.

Here are the features that every effective patient portal software must have to make it work seamlessly:

• Secure Access to Health Records: Patients expect easy access to their medical records, lab results, and prescriptions. This data must be accurate and up to date, which is only possible when the portal is from the source system rather than relying on delayed or partial updates.

• Appointment Scheduling & Digital Intake: Online scheduling and digital intake forms allow patients to manage appointments and submit information before visits. When this data flows seamlessly into the EHR, clinics reduce administrative burden, avoid duplicate data entry, and start visits with complete patient information.

• Secure Patient-Provider Communication: Secure messaging enables patients to ask questions, follow up on care plans, and stay engaged between visits. The message should be routed to the appropriate care team and automatically documented within the EHR to ensure continuity and clinical accountability.

• AI-Assisted Triage & Pre-Visit Support: AI-driven intake tools can help patients before starting the visits, collecting data like symptoms and demographics. It also guides them to the next steps and prepares clinicians with structured data. If used correctly, AI enhances efficiency without replacing clinical judgement.

These are the core features that a modern healthcare patient portal must have, as they build the foundation to a portal that patients actually use and trust.

How AI-Powered EHR Integration Impacts ROI?

The main purpose of the patient portal is to make data more accessible for patients, and it is only possible when the EHR seamlessly shares data. But when the data is not shown quickly, no matter how good you make the interface, adoption drops if patients are seeing outdated lab results or inconsistent data.

• Why Deep Integration Is Essential for Real-Time Accuracy: In modern healthcare, patients expect that the data must be updated in real-time. But if the portal is only reflecting the data after days or a week, it erodes the trust in the software, and they don’t use it often. This is where deep integration ensures that patient-facing data is refreshed in real time, reducing inconsistencies and preventing low engagement.

• Bi-Directional Sync Between Patient Actions & Clinical Records: Patients’ actions must be reflected in the EHR without any lag. Meaning, when a patient books an appointment, submits a form, or updates a symptom, it should seamlessly flow back to the EHR automatically. This bi-directional synchronization makes keeping care continuous easier and reduces manual data entry for staff.

• Avoiding Data Silos Across Patient & Provider Systems: The biggest drawback of standalone patient portals is data silos. If the patient updates their data in the portal, it remains in that system, breaking the flow of information. But a tight integration eliminates these silos, creating a single source of information for both patients and clinicians. This leads to faster access, fewer errors, and a more reliable care experience.

In short, when the patient portal and EHR are connected, there are no delays or usability gaps; it turns a patient portal into a true extension of the EHR.

To be effective for patient engagement, patient portals can’t act as a standalone system. They must be connected seamlessly with EHR software. We explore how you can do that in our blog, Building EHR Systems With Seamless Integrations.

Technical Considerations When Investing in AI-Powered EHR

Once the importance of EHR integration becomes clear, the next question becomes: how should a patient portal be built to stay reliably connected to EHR? The right technical foundation determines whether integration remains scalable, secure, and adaptable as care models evolve. Whereas, wrong architectural choices often lead to brittle portals that struggle with performance, compliance, and future enhancements.

• Native EHR Modules vs Custom Patient Portals: Some EHRs offer built-in portal modules with pre-built workflows and features. Although this speeds up the development, it limits the flexibility and customization of portals. On the other hand, custom patient portals allow organizations to design portals around their design and as per their needs. But the trade-off is complexity, as they demand stronger integration, ongoing maintenance, and more time.

• API-First Design Using FHIR & Interoperability Standards: An API-first approach is essential when building a modern patient portal. Standards like FHIR enable consistent access to clinical data while reducing tight coupling with a single EHR vendor. This approach supports cleaner integrations, easier upgrades, and long-term interoperability across systems.

• Authentication, Constant, & Role-Based Access: Providing easy access is important, but it should not violate the security of patient data. The architecture should support secure authentication, granular consent management, and role-based access to ensure patients only see what they are authorized to view, without creating security risks.

• Real-Time vs Batch Data Synchronization: While real-time data updates are crucial, not all data needs to be updated instantly. The architecture should prioritize the data; for instance, lab results, messages, and medication changes must be updated in real-time. But the historical data can be updated in batches. This helps in improving performance and reducing delays in data transfer.

So, robust architecture is an important factor in building a patient portal that is reliable, secure, and trusted by the patients to access care quickly and easily.

Adoption and Usability: Key Drivers of AI EHR ROI

Even the most technically sound patient portal will fail if patients find it hard to navigate through and have to click too many times. So, to ensure this does not happen, the design of the patient portal software needs to be intuitive and consider how digitally literate the user is. This is how you can design the systems to make it highly adoptable and easy to use:

• Simplifying Access & Navigation for All Demographics: Patients should be able to log in, find key information, and complete common tasks without instructions or training. Clear navigation, intuitive labels, and a minimal number of steps are essential. When patients struggle to locate lab results or send a message, engagement drops quickly, regardless of how powerful the portal is behind the scenes.

• Accessibility for Elderly and Non-Technical Users: Older adults and patients with limited technical experience often face the greatest barriers. Designing with larger text, clear contrast, simple language, and mobile-friendly layouts improves usability across all age groups. Accessibility features aren’t edge cases; they directly impact adoption among patients who rely most on ongoing care.

• Using AI to Simplify Complex Health Information: Clinical data can be overwhelming. AI can help translate medical terminology into patient-friendly explanations, summarize visit notes, and highlight next steps. When used responsibly, AI reduces cognitive load and helps patients better understand their health—without replacing clinical guidance.

Designing for adoption turns a patient portal from a digital tool into a trusted part of the care journey.

Common Risks When Investing in AI EHR Systems

While developing a responsive and reliable patient portal software, many organizations face multiple challenges. And most of these issues come from design decisions, integration gaps, and competing priorities rather than technical failures. But understanding and identifying these challenges early helps development teams avoid costly rework and complete the development without any major setbacks:

Frequently Asked Questions