Electronic health record software is bought on a monthly figure that rarely survives contact with a real clinic.
This guide ranks twelve systems by how many hours setup takes, what the bill becomes with portal, billing and interface fees, whether patient data leaves with you, and whether a practice can run it without a partner.
Vendors can pay for visibility on this page. It never changes what an entry
says about a product, including the criticism, and we earn nothing when you click through to a
vendor. How that works.
In short
What EHR software does
EHR software stores patient records, clinical notes, orders and prescriptions, and usually adds scheduling, patient portals and billing so a medical practice or hospital can run care from one system.
In this order: setup effort, what it really costs, how your data comes back out, whether
you can leave, and who each EHR tool is built for. One rule sits on top of those tests:
Places 1 to 3 go to challengers, vendors outside the best-known brands in a category, wherever the category has them; the established names follow from place 4 in their ranked order. Why those five, and why there is no
score out of ten, is on the how we work page.
Health systems wanting one vendor across clinical and patient records
Small practices wanting transparent pricing and quick setup
Country is where the vendor is headquartered or contracts from, which is a
different question from where your data is hosted. Where the two tell different stories, the
entry says so.
Practice management with treatment notes for clinics and allied health
Ranked #1 of 12 in Best EHR Software in 2026.
Published pricingAsia-Pacific
The pricing page shows six bands from one practitioner up to 200, and every plan includes all features, unlimited admin users and support. That makes the real price easy to forecast: you count practitioners and SMS volume.
Data can be imported and exported, and an API exists for add-ons. Accounts created in Australia, the UK and Canada keep data in that country. The limit is scope: it is built for clinics, not for specialty physician practices.
What stands out
Allied health
Published price
Practitioner bands
Where it costs you
Text messages are bought as credits at ten cents each, so reminders add a variable cost
Priced in US dollars, and the band jumps with every extra practitioner group
Right for
Allied health clinics wanting published banded pricing and customisable treatment notes
Wrong for
Physician practices needing orders and prescribing workflows
AustraliaPer month by practitioner band, published; 30-day trial
Scheduling, charting and billing for health and wellness clinics
Ranked #2 of 12 in Best EHR Software in 2026.
Published pricingNorth America
Jane prices its plans per month, with the practitioner count counted by full-time or part-time hours, so a clinic with many part-timers pays less than a headcount suggests. The base plans include unlimited admins, locations and online booking.
Cost grows through add-ons: scribe and group telehealth are charged per opted-in practitioner, insurance billing and payroll monthly. It is a clinic tool; hospitals and specialty physician practices are not the audience.
What stands out
Clinic EMR
Published price
Add-on modules
Where it costs you
The lowest plan caps appointments at twenty a month
Direct insurance billing lists Canadian payers only, and costs extra
Right for
Clinics that want one published plan ladder and optional add-ons
Wrong for
Practices that need direct insurance billing outside Canada
CanadaPer month by plan in Canadian dollars, published; add-ons priced separately
Cloud EHR for dietitians, therapists and coaches, priced by active client
Ranked #3 of 12 in Best EHR Software in 2026.
Published pricingNorth America
Healthie keeps the basics in every plan: charting, scheduling, payments, telehealth and a client portal are in every plan. The ladder is decided by active clients rather than seats, which rewards a small practice and penalises a growing one.
Essentials adds data transfer support, faxing and a claims integration, with the claims tool priced separately. Top-tier features such as group telehealth need Plus.
What stands out
Active-client tiers
Published price
Wellness practices
Where it costs you
The cheapest plan caps active clients at ten
Team members on the group plan are billed per clinician on top of the plan price
Right for
Solo and small wellness practices that want client-count based pricing
Wrong for
Multi-specialty physician groups with complex orders and lab workflows
United StatesPer month by plan, published; 14-day trial of the top plan
OpenEMR gives full control: the source code is open, the data stays on infrastructure you pick, and leaving means moving your own database. A free hosted option exists for US-based providers, and an AWS deployment is offered, but the project does not run your practice for you.
Professional support vendors are listed on the site. Compared with SaaS options, the work shifts from invoices to administration, backups and upgrades, and compliance configuration is yours.
What stands out
Open source
Self-hosted
ONC certified
Where it costs you
Hosting, setup and support are your own cost or a paid third party
The project is asking donors to fund its ONC certification work
Right for
Practices with IT capability that want a licence-free record they control
Wrong for
Clinics wanting a vendor to run everything for one monthly fee
Not stated by the vendorFree to download; open source; professional support listed separately
Primary care EHR with billing and direct primary care membership tools
Ranked #5 of 12 in Best EHR Software in 2026.
Pricing on requestNorth America
Elation's pricing form asks for specialty, payment model and clinician count, which signals how it quotes: per practice. The site describes an EHR, Elation Billing and Patient Passport as separate products, plus telehealth and referral management.
Membership management is aimed at direct primary care practices. The cost of the arrangement is that you only learn the invoice after a sales conversation.
What stands out
Primary care
Quoted price
Membership billing
Where it costs you
No price is shown, so comparison needs a quoted offer
Billing is a separate product, and AI billing is shown as a preview tour
Right for
Independent primary care and direct primary care practices
Wrong for
Hospitals and large multi-site health systems
United StatesQuoted per practice through an online form
EHR and billing for therapists and speech-language pathologists
Ranked #6 of 12 in Best EHR Software in 2026.
Published pricingNorth America
SimplePractice publishes three solo plans, Starter, Essential and Plus, billed monthly, and a Plus group rate with a price for the first practitioner and a lower one for each additional practitioner.
A free credentialing offer is advertised alongside the trial. It is a vertical product: the site lists therapists and speech-language pathologists as its audiences, which is the right fit if you are one and a weak one if you are not.
What stands out
Therapists
Published price
30-day trial
Where it costs you
The three-month half-price offer requires starting a paid account within seven days
Larger practices are sent to custom pricing
Right for
Solo therapists and small mental health or speech therapy practices
Wrong for
Physician practices outside behavioural health and speech therapy
United StatesPer month by plan, published; 30-day trial
Open source healthcare developer platform with a ready-made provider app
Ranked #7 of 12 in Best EHR Software in 2026.
Free tierOpen sourceSelf-hostablePublished pricingNorth America
Medplum publishes its hosted tiers and offers a community self-hosted option under Apache 2.0, so the exit path is to run it yourself. The price ladder reflects that it is sold to builders: a free tier, a production tier, a premium tier and a contact-us enterprise tier.
Its homepage frames it as the developer platform for shipping clinical software, with HIPAA and SOC 2 Type II noted. Time is the cost: the build is yours.
What stands out
Open source
Developer platform
Self-hosted option
Where it costs you
The tier recommended for treating patients is a paid monthly plan
It is a platform to build on, so a clinic without engineers must buy services
Right for
Health-tech teams building their own EHR on open standards
Wrong for
Small clinics wanting a ready EHR on day one
United StatesFree tier for prototyping; paid hosted tiers per month, published; self-host option
Community-built open source medical record system used worldwide
Ranked #8 of 12 in Best EHR Software in 2026.
Free tierOpen sourcePublished pricingElsewhere
OpenMRS describes more than 8,000 facilities and 15 million patient records, and says there are no licence fees or vendor lock-in. The cost is entirely in implementation: the project provides documentation, an academy, community calls and a demo, not a managed subscription.
For a health programme with developers that is a feature. For a three-doctor clinic, it is a project that will need someone to own it for years.
What stands out
Open source
Community-run
Global use
Where it costs you
No company on the project site offers a supported hosted service to sign up for
Local adaptation is expected, which means developer and implementation effort
Right for
Health programmes with technical staff wanting an adaptable open record
Wrong for
Single clinics wanting a ready-to-use cloud EHR
Not stated by the vendorFree open source software with no licence fees
Ambulatory EHR with published per-provider and collections-based prices
Ranked #9 of 12 in Best EHR Software in 2026.
Published pricingNorth America
The pricing page lists two per-provider plans with no start-up costs and cloud hosting, disaster recovery and 24x7 support included, plus billing as a percentage of collections.
It offers to migrate data from an existing EHR for free. The price ladder is honest but incomplete: practice management is the second plan, large practices pay implementation fees, and per-transaction charges exist.
What stands out
Published price
Cloud hosting included
Per-provider
Where it costs you
Practices with more than nine providers pay additional implementation fees, with airfare billed separately
Fees apply per patient statement and per messenger transaction
Right for
Multi-provider ambulatory practices wanting a published per-provider price
Wrong for
Solo clinicians wanting minimal setup and no usage fees
United StatesPer provider per month, published; billing service as a share of collections
Cloud EHR built separately for each of eleven medical specialties
Ranked #10 of 12 in Best EHR Software in 2026.
Pricing on requestNorth America
ModMed calls EMA its specialty-specific EHR, built with workflows for each field, and the home page lists eleven specialties. Founded in 2010, it is headquartered in Boca Raton, with an office in Hyderabad, India.
AI assistants for scribing and claims are part of the current pitch. The trade is depth for narrowness: good if your specialty is on the list, and a cost opaque until a salesperson answers.
What stands out
Specialty EHR
Cloud-based
AI scribe
Where it costs you
The site shows no price, only a demo request
Primary care and behavioural health are not on the specialty list
Right for
Specialty practices in dermatology, ophthalmology, orthopedics or similar
Wrong for
Primary care and therapy practices
United StatesSold through demos; no price list on the pages reviewed
Ambulatory EHR split into Enterprise for ten or more providers and Office
Ranked #11 of 12 in Best EHR Software in 2026.
Pricing on requestElsewhere
NextGen's cost disclosure page is unusually specific about what costs extra. It states that some interfaces and the FHIR API are included in the standard licensing package, while the first-time portal licence carries a one-time setup fee.
The drug interaction database carries an annual per-provider licence fee. For a buyer, that detail helps build a budget. The site gave no headquarters address, so country is not stated here.
What stands out
Ambulatory EHR
Two editions
Add-on fees
Where it costs you
Interfaces for labs and registries need a licence, an implementation fee and annual support
The patient portal has a setup fee and a monthly per-provider subscription
Right for
Ambulatory groups able to negotiate licence, support and interface fees
Wrong for
Practices wanting a single published monthly price
Not stated by the vendorSold through sales; fees listed in a cost disclosure page
Single-vendor health system record used by hospitals and practices
Ranked #12 of 12 in Best EHR Software in 2026.
Pricing on requestNorth America
Epic is based in Verona, Wisconsin, founded in 1979, and lists customers including independent practices, urgent care and mental health alongside hospitals. Its software spans patient experience, health systems, payers and life sciences.
That breadth is the strength and the independence problem: you buy into one vendor's whole platform. Without published pricing, the first ninety days of cost are not visible beforehand.
What stands out
Health systems
Single vendor
No price list
Where it costs you
The site shows no prices or plan tiers
It is a suite from one vendor, so buying one part is not the model
Right for
Health systems wanting one vendor across clinical and patient records
Wrong for
Small practices wanting transparent pricing and quick setup
EHR software stores patient records, clinical notes, orders and prescriptions, and usually adds scheduling, patient portals and billing so a medical practice or hospital can run care from one system. The differences that matter are rarely in the feature list, so this is
the order we would work through them.
01
Decide whether you need a published price
8 of the 12 tools here publish what they cost; the other 4 quote per organisation. The ones you can compare without a sales call: Cliniko, Jane, Healthie, OpenEMR, SimplePractice, Medplum, OpenMRS, eClinicalWorks.
02
Decide how much the jurisdiction matters
These 12 vendors are established in 4 countries across 3 regions (North America 8, Elsewhere 3, Asia-Pacific 1). That decides whose disclosure law applies to what the vendor holds, wherever the servers are.
03
Consider whether you want the source
3 of these are open source: OpenEMR, Medplum, OpenMRS. Hosting one yourself trades a subscription for maintenance.
Practitioner bands, client caps and per-provider rates measure different things
EHR prices look comparable until you ask what the number counts. Cliniko charges by practitioner band, so the sixth practitioner moves a clinic from the two-to-five band to the six-to-eight band. Healthie counts active clients, which means the cheapest plan stops at ten and a growing practice is pushed up quickly. eClinicalWorks counts providers and then adds implementation fees above nine providers, with airfare billed separately.
Jane counts full-time and part-time practitioners differently, which can favour a clinic with many part-timers. Before comparing, rebuild each quote for your own headcount, patient volume and messages sent, and ask which of those the vendor can raise without renegotiating. A cheap entry plan is only useful if you can stay on it.
Count practitioners, active clients and monthly messages before reading any price.
Ask what happens to the price when you add a provider.
Check whether implementation, training and travel are separate lines.
Open source removes the licence and leaves the work
OpenEMR, OpenMRS and Medplum all publish source code, and for each the licence costs nothing. The money moves elsewhere. OpenEMR is free to download, but hosting, setup and support come from you or from third-party vendors, and the project itself is raising donations to keep its ONC certification funded.
OpenMRS has no company selling a hosted service on its site, so a clinic must have people who can implement it. Medplum is a developer platform: its free tier is for prototyping, and the page recommends a paid production tier for treating patients. The honest comparison is licence-free software plus your IT time against a SaaS invoice that includes the work.
List who installs, backs up and upgrades the system and what they cost.
Find out which tier the vendor recommends for real patients.
Ask who signs the support agreement when something breaks.
Specialty fit decides more than feature lists
These products are not interchangeable. ModMed builds a separate EHR for each of eleven specialties, so dermatology and ophthalmology are served in depth while primary care is not on its list. Elation is written for primary care and direct primary care, SimplePractice for therapists and speech-language pathologists, and Cliniko for allied health clinics.
Epic and NextGen cover broad ambulatory and system needs, with Epic naming everything from independent practices to hospitals. A tool built for another specialty usually forces workarounds in templates, billing codes and referrals. Start by testing one real day of work in your specialty, not a generic demo, and see whether notes, orders and claims need extra steps.
Run one real clinic day in the trial, with your own templates.
Confirm your specialty is named on the vendor's own pages.
Ask which specialties the vendor refuses to support.
Quote-only EHRs hide the real price until late
Epic, ModMed, NextGen and Elation do not show a price list. Elation asks for specialty, payment model and clinician count in a form and replies with a personalised price. NextGen publishes a cost disclosure page instead, listing which interfaces and portal features carry licence, setup or per-provider fees. ModMed routes to a demo.
Compare that with eClinicalWorks, whose pricing page lists per-provider plans and a percentage-of-collections billing service. A published price is not always the lowest, but it lets you build a budget before a salesperson is involved. For quoted products, ask for a written list of every fee a practice like yours pays in year one, and for the cost of leaving.
Request an itemised first-year quote including interfaces and portals.
Ask for the exit cost and the export format in writing.
Compare against one published-price option as a reference.
What goes wrong most often when buying EHR software
Choosing the lowest monthly plan without checking that its client, appointment or provider cap fits a normal month.
Treating a free open source download as a finished system and not budgeting for hosting, setup and support.
Buying a specialty EHR such as ModMed or SimplePractice when your specialty is not the one it was built for.
Accepting a quote that omits portal, interface and implementation fees, which NextGen and eClinicalWorks both list separately.
07
Frequently asked questions
8 answers
What is the best EHR software in 2026?
Cliniko leads our ranking of 12. Cliniko covers booking, treatment notes and invoicing for clinics and allied health practitioners, and the monthly price is set by practitioner count in published bands, with every feature in every plan.
It describes itself as a practice management system: its feature list names scheduling, health records, finance and reporting, not orders or prescribing, so a physician group should look at the fuller EHRs below.
Which EHR tools publish their pricing?
8 of the 12, with the pricing model each one publishes:
Cliniko: Per month by practitioner band, published; 30-day trial.
Jane: Per month by plan in Canadian dollars, published; add-ons priced separately.
Healthie: Per month by plan, published; 14-day trial of the top plan.
OpenEMR: Free to download; open source; professional support listed separately.
SimplePractice: Per month by plan, published; 30-day trial.
Medplum: Free tier for prototyping; paid hosted tiers per month, published; self-host option.
OpenMRS: Free open source software with no licence fees.
eClinicalWorks: Per provider per month, published; billing service as a share of collections.
The other 4 quote per organisation.
Is there a free EHR tool?
OpenEMR, Medplum, OpenMRS offer a free tier or a free self-hosted edition.
Where are these EHR software vendors established?
In 4 countries across 3 regions: North America 8, Elsewhere 3, Asia-Pacific 1.
Cliniko: Australia.
Jane: Canada.
Healthie: United States.
OpenEMR: Not stated by the vendor.
Elation Health: United States.
SimplePractice: United States.
Medplum: United States.
OpenMRS: Not stated by the vendor.
eClinicalWorks: United States.
ModMed: United States.
NextGen Healthcare: Not stated by the vendor.
Epic: United States.
Which EHR tools are open source?
OpenEMR, Medplum, OpenMRS.
Which EHR tools can you host yourself?
OpenEMR, Medplum. The other 10 are hosted by the vendor only.
What should you use instead of Cliniko?
Jane and Healthie are the next two on this page. Jane is for Clinics that want one published plan ladder and optional add-ons; Healthie is for Solo and small wellness practices that want client-count based pricing.
Who should not buy Cliniko?
Physician practices needing orders and prescribing workflows. Text messages are bought as credits at ten cents each, so reminders add a variable cost.
If your EHR software product belongs among these 12, tell us what it does and who it is for. Inclusion is an editorial call; what a listing is and is not is set out under software advice.
