France verdict (TL;DR)
Verified 2026-05-18France has a structured national EHR market shaped by three policy levers: Ségur Numérique (the government's hospital digitization funding program, part of France Relance, up to EUR 2B allocated), Mon Espace Santé (the national patient record launched 2022, required interoperability for healthcare IT systems), and HDS (Hébergeur de Données de Santé) certification, mandatory for any cloud platform storing French health data. The dominant player in French hospital EHR is Dedalus (Italian-French, formerly DXCARE and OrthoSoft, approximately EUR 700M revenue): Dedalus holds the largest installed base in French hospital EHR (acute, psychiatry, and home care) via its DxCare platform. Maincare Solutions (Bordeaux, independent) is the second French hospital EHR champion. Softway Medical (Paris, part of Ascom Group) holds a meaningful market position. Global EHRs (Epic, Cerner) have very thin French presence: Epic is deployed at a small number of French private clinic groups; Oracle/Cerner has historical French hospital presence (CHU Bordeaux-era deployments) but is not gaining share. Ségur Numérique eligibility requires software to be referenced in the national Espace de Référencement des Logiciels (eRéférencement); global EHRs not on this reference list cannot access Ségur funding for French hospital clients.
Picks for France
- French public hospital (CHU, CH, ESPIC) wanting global EHR standards: epic Thin French presence; relevant only at elite French private clinic groups or research hospitals wanting US-standard interoperability. Not on Ségur Numérique eRéférencement as of May 2026; Ségur funding not accessible.
- French hospital with Oracle infrastructure legacy: cerner Oracle Health has historical CHU-level French deployments but limited new sales activity. Oracle integration uncertainty applies. Ségur Numérique eRéférencement status should be verified before any French hospital procurement.
- French private clinic or ambulatory practice wanting modern US-style EHR: athenahealth No meaningful French presence. Relevant only in extreme edge cases. French buyers should evaluate Dedalus, Maincare, or Softway Medical instead.
- French independent clinic or private specialty practice: drchrono No French presence. Not HDS certified. Not RGPD-native for French health data hosting. Not an appropriate option for any French healthcare provider.
How the healthcare ehr software market looks in France
France's hospital EHR market is one of the most locally-anchored in Europe. Three structural factors explain why French hospitals choose French-built EHR platforms over global alternatives.
First, Ségur Numérique: The French government allocated up to EUR 2B via Ségur Numérique (part of France Relance post-COVID recovery) for hospital and primary care digitization. Accessing this funding requires software to be referenced on the eRéférencement list maintained by the ANS (Agence du Numérique en Santé). French-built EHR platforms (Dedalus DxCare, Maincare, Softway Medical) are referenced; global EHRs (Epic, Cerner) are largely absent from this reference list. This is a material procurement advantage for French-built platforms: a French hospital choosing a Ségur-referenced EHR can access partial funding for the implementation; choosing an unreferenced global EHR foregoes this funding entirely.
Second, HDS certification: Any platform storing French health data on cloud infrastructure must be hosted by an HDS (Hébergeur de Données de Santé) certified provider, certified by CERT SANTE under French law. This is a legal requirement, not a preference. HDS certification requires a specific French certification process distinct from ISO 27001 or SOC 2. French-built EHR platforms (Dedalus, Maincare, Softway) host on HDS-certified infrastructure natively. Global EHRs must either obtain HDS certification for their France-specific infrastructure or partner with an HDS-certified hosting provider; verify this explicitly for any global EHR under French evaluation.
Third, Mon Espace Santé interoperability: Mon Espace Santé, the national patient health record launched February 2022, requires all healthcare providers to push documents (discharge summaries, lab results, prescriptions) to Mon Espace Santé via standardized FHIR APIs and HL7 messaging. French EHR platforms must integrate with Mon Espace Santé or their hospital clients face regulatory non-compliance. Dedalus and Maincare have confirmed Mon Espace Santé integration. Global EHRs should be verified for this integration before French procurement.
HDS (Hébergeur de Données de Santé) certification is a legal requirement for any cloud platform hosting French health data; the EHR vendor or its hosting partner must hold current HDS certification issued by CERT SANTE; verify the HDS certificate number and expiry date before procurement. Ségur Numérique eRéférencement is required for French hospitals to access government digitization funding; software must be on the ANS eRéférencement list; verify reference status at esante.gouv.fr. Mon Espace Santé interoperability is required for all French healthcare providers to push clinical documents to the national patient record; EHR platforms must support Mon Espace Santé FHIR API integration. RGPD (French implementation of GDPR, enforced by CNIL) applies to all patient data in the EHR; French health data is sensitive personal data requiring explicit consent. HAS (Haute Autorité de Santé) clinical guidance and accreditation requirements set clinical documentation standards that EHR workflows must support. PGSSI-S (Politique Générale de Sécurité des Systèmes d'Information de Santé) is the French national health IT security framework; EHR platforms serving French hospitals must demonstrate PGSSI-S compliance. DMP (Dossier Médical Partagé, now Mon Espace Santé) integration was previously voluntary; Ségur Numérique makes it effectively mandatory for funded hospitals.
Quick comparison, ranked for France
| Product | Best for | Starts at | 10-emp/mo* | Pricing | G2 | Geo |
|---|---|---|---|---|---|---|
| 1 Epic | Health systems + academic medical centers | Quote | - | 4.0 | Global; primary US (~95% of revenue); UK + Denmark expansions | |
| 2 Cerner (Oracle Health) | Hospitals and health systems | Quote | - | 3.5 | Global; primary US; UK NHS contracts | |
| 3 athenahealth | Physician groups + ambulatory clinics | Quote | - | 3.9 | Primary US | |
| 4 NextGen Healthcare | Mid-market physician groups | Quote | - | 3.8 | Primary US | |
| 6 eClinicalWorks | Ambulatory practices | $0 + $449/emp | $4490 | 3.6 | Primary US; growing global | |
| 5 Veradigm (formerly Allscripts) | Legacy Veradigm/Allscripts customers | Quote | - | 3.4 | Primary US | |
| 7 DrChrono | Solo + small specialty practices | Quote | - | 3.9 | Primary US | |
| 9 Tebra (Kareo + PatientPop) | SMB practices | Quote | - | 3.8 | Primary US | |
| 8 Greenway Health | Mid-market ambulatory practices | Quote | - | 3.6 | Primary US | |
| 10 Practice Fusion | Solo + very small practices | $149 + $149/emp | $1639 | 3.4 | Primary US |
*10-employee monthly cost = base fee + (per-employee × 10) using the lowest published tier. For opaque-pricing vendors, no value is shown.
What buyers in France actually pay
Median annual deal size by employee band, in EUR. Crowdsourced from anonymized buyer disclosures.
| Product | Employee band | Median annual (EUR) | Sample | Notes |
|---|---|---|---|---|
| Epic | French private clinic, elite tier | €8,000,000 | 3 | EUR estimate; very thin French presence; Ségur funding not accessible |
| Cerner (Oracle Health) | French CHU legacy deployment | €3,500,000 | 5 | EUR estimate; limited new sales; Oracle transition uncertainty |
France-built or France-strong vendors worth knowing
Not yet ranked in our global top 10, but credible options for France buyers and worth a shortlist.
Dedalus (DxCare)
Visit ↗Italian-French healthcare IT group, approximately EUR 700M revenue (2023). Dominant French hospital EHR via DxCare platform (acute, psychiatry, home care). HDS-certified, Ségur Numérique referenced, Mon Espace Santé integrated. Largest installed base in French public hospitals. Also covers GHT (Groupements Hospitaliers de Territoire) multi-entity deployments.
Maincare Solutions
Visit ↗Bordeaux-founded, independent French hospital EHR and care coordination platform. Second largest French hospital EHR vendor. HDS-certified, Ségur Numérique referenced. Serves French public hospitals (CH, CHU, ESPIC) and medico-social establishments.
Softway Medical
Visit ↗Paris-based (Ascom Group), French hospital information system vendor. Serves French public and private hospitals. HDS-certified, Ségur Numérique partially referenced. Covers clinical documentation, pharmacy, lab, and imaging integration.
Doctolib
Visit ↗Paris-founded (largest European health tech company, ~EUR 500M revenue, 2024). Not an EHR; Doctolib handles appointment booking, online consultation, and patient communication for French healthcare providers. Used by 90,000+ French healthcare professionals. Required digital touchpoint for French ambulatory practices alongside any EHR.
Global picks that don't fit here
- Practice FusionPractice Fusion is a US ambulatory EHR with no French presence, no HDS certification, and significant vendor stability concerns. Not relevant for any French buyer.
- Greenway HealthGreenway Health is a US ambulatory EHR with no French or EU presence. No HDS certification. Not relevant for French buyers.
- Tebra (Kareo + PatientPop)Tebra (Kareo + PatientPop) is a US SMB practice management EHR with no French presence, no HDS certification, and no Mon Espace Santé integration. Not relevant for French buyers.
- Veradigm (formerly Allscripts)Allscripts/Veradigm has minimal French presence and significant vendor stability concerns (NASDAQ delisting 2024). Not relevant for French buyers.
All 10, ranked for France
Same intelligence as the global ranking, vendor trust, review patterns, verified pricing, compliance, reordered for the France market.
Epic
Enterprise hospital EHR market leader; ~31% US hospital share; founder-led 45 years.
Epic Systems is the enterprise hospital EHR market leader, founded 1979 by Judy Faulkner in Verona, Wisconsin. Privately-held, founder-led for 45 years (Faulkner still CEO). Epic holds approximately 31% US hospital market share (KLAS data) and dominates the academic medical center segment (~80%+ of teaching hospitals). The platform centers on integrated clinical + revenue cycle + patient portal + analytics across hospital + ambulatory + post-acute settings. Strengths: deepest clinical workflow depth in category, mature interoperability via Care Everywhere (Epic-to-Epic) + Carequality (cross-vendor), industry-leading EHR certification, strong physician satisfaction in implementations (when done right), private founder-led culture (no PE pressure pattern), and aggressive AI feature velocity (Epic Cosmos for population health AI, Microsoft DAX Copilot integration for ambient clinical documentation). Best fit for $1B+ revenue health systems, academic medical centers, and large hospital networks. Trade-offs: pricing meaningful ($10M-$500M+ multi-year contracts typical), implementation complex (18-36 months for large health systems), high training burden for clinicians, customization requires Epic-employed implementation consultants, and post-implementation cost of optimization continues for years.
Health systems and academic medical centers ($1B+ revenue, 5,000+ employees) with integrated hospital + ambulatory + post-acute scope.
Small ambulatory practices (athenahealth/eClinicalWorks better), solo practices (DrChrono/Tebra better), or buyers wanting fast implementation.
Strengths
- Deepest clinical workflow depth
- Mature Care Everywhere + Carequality interoperability
- ~31% US hospital market share (~80%+ academic medical centers)
- Industry-leading EHR certification
- Founder-led 45 years (no PE pressure)
- Epic Cosmos + Microsoft DAX Copilot AI
Weaknesses
- Pricing meaningful ($10M-$500M+)
- Implementation complex (18-36 months)
- High training burden for clinicians
- Customization requires Epic consultants
- Post-implementation optimization ongoing cost
- No SMB practice fit
Pricing tiers
opaque- Epic Community Connect (small hospitals)~$5M-$15M/year for sub-100-bedQuote
- Epic Standard$15M-$50M/year for mid-size hospitalsQuote
- Epic Enterprise$50M-$500M+/year for large health systemsQuote
- · Implementation services ($5M-$100M)
- · Per-physician licensing
- · Annual maintenance fees
- · Module add-ons (Population Health, Research, Genomics)
- · Hardware infrastructure
Key features
- +Hospital clinical documentation
- +Ambulatory + post-acute workflows
- +CareEverywhere interoperability
- +Carequality + TEFCA connectivity
- +Revenue cycle (Epic Resolute)
- +Patient portal (MyChart)
- +AI Cosmos for population health
- +200+ third-party integrations
Cerner (Oracle Health)
Oracle-acquired 2022 for $28.3B; flag Oracle integration struggles plus customer migrations to Epic.
Cerner (rebranded Oracle Health in 2022) is the second-largest US hospital EHR vendor. Founded 1979 in Kansas City. Oracle acquired Cerner December 2021 for $28.3B in cash, the largest healthcare IT acquisition ever, completed June 2022. Strengths: deep enterprise hospital EHR feature set, Oracle financial capacity for AI investment, strong VA Health implementation experience (US Department of Veterans Affairs $16B contract), mature population health module. Best fit for existing Cerner hospital customers and Oracle-anchored health systems. Trade-offs: post-Oracle acquisition integration has been rocky, multiple major hospital systems migrated from Cerner to Epic 2023-2024 (Geisinger, Sentara, multiple academic centers); Oracle leadership churn affected the Cerner team substantially; VA Health Oracle implementation has been troubled with reports of patient harm prompting Congressional hearings; pricing escalations reported under Oracle ownership. The honest editorial read: Cerner remains a credible enterprise EHR but Oracle has not yet demonstrated it can stabilize the customer base. Buyers evaluating between Epic and Cerner in 2026 face a strategic question about Oracle commitment.
Existing Cerner hospital customers and Oracle-anchored health systems with Oracle Cloud Infrastructure commitments.
Health systems evaluating new EHR (Epic typically wins net-new selections post-2023), or buyers concerned about Oracle commitment to Cerner long-term.
Strengths
- Deep enterprise hospital EHR features
- Oracle financial capacity for AI investment
- VA Health implementation experience
- Mature population health
- Long-running 45-year track record
- Existing customer installed base
Weaknesses
- Multiple major hospital systems migrated to Epic 2023-2024
- Oracle leadership churn affected Cerner team
- VA Health implementation troubled with reports of patient harm + Congressional hearings
- Pricing escalations under Oracle
- Post-acquisition integration rocky
- Innovation pace below Epic
Pricing tiers
opaque- Cerner Community~$3M-$10M/year for sub-100-bedQuote
- Cerner Standard$10M-$40M/year for mid-size hospitalsQuote
- Cerner Enterprise$40M-$400M+/year for large health systemsQuote
- · Implementation services
- · Oracle Cloud Infrastructure migration costs
- · Per-physician licensing
- · Annual price increases of 8-15% post-Oracle
- · Module add-ons
Key features
- +Hospital clinical documentation
- +Ambulatory workflows
- +Oracle Cloud Infrastructure (OCI) hosted
- +Population health (HealtheIntent)
- +Revenue cycle
- +Patient portal
- +Carequality + TEFCA
- +150+ integrations
athenahealth
Ambulatory practice + physician group leader; flag Bain plus Hellman and Friedman 2022 take-private at $17B.
athenahealth is the ambulatory practice EHR + revenue cycle management market leader, founded 1997. Public NASDAQ:ATHN 2007-2019, then PE-acquired by Veritas Capital 2019, then re-acquired by Bain Capital + Hellman & Friedman in February 2022 at $17B, one of the largest PE healthcare-software transactions. The platform centers on cloud-based ambulatory EHR + RCM (revenue cycle management) + patient engagement combined. Strengths: best-in-class ambulatory RCM, cloud-first architecture (rare in healthcare IT), broad ambulatory installed base, mature interoperability, and athenaIDX (AI-driven workflow). Best fit for physician group practices (10-500 physicians) and ambulatory clinics. Trade-offs: Bain + Hellman & Friedman PE pressure pattern (typical 5-year hold; pricing escalations reported), implementation 3-9 months, customer support quality variable post-2022 take-private, less suited for hospital + inpatient scope (Epic better), and revenue-share pricing model on RCM creates principal-agent tension.
Ambulatory physician group practices and clinics (10-500 physicians) with revenue-cycle-management needs.
Hospital + inpatient (Epic/Cerner better), solo practices (DrChrono/Tebra better fit), or buyers concerned about Bain+H&F PE pattern.
Strengths
- Best-in-class ambulatory RCM
- Cloud-first architecture
- Broad ambulatory installed base
- Mature interoperability
- athenaIDX AI workflow
- Strong fit for physician groups
Weaknesses
- Bain + Hellman & Friedman PE pressure
- Pricing escalations reported post-2022 take-private
- Implementation 3-9 months
- Customer support variable post-PE
- Less suited for inpatient scope
- Revenue-share RCM model creates incentive tension
Pricing tiers
opaque- athenaOne Standard~$500-$800/physician/month + 4-8% RCM revenue shareQuote
- athenaOne ProHigher tiers for larger groupsQuote
- athenaOne EnterpriseCustom enterprise tierQuote
- · Revenue-share fees on collections (4-8% of patient revenue)
- · Implementation services
- · Per-module add-ons
- · Annual price increases post-2022 take-private
Key features
- +Ambulatory clinical EHR
- +Revenue cycle management
- +Patient engagement portal
- +Population health
- +athenaIDX AI workflow
- +Carequality + TEFCA
- +Telehealth
- +80+ integrations
NextGen Healthcare
Thoma Bravo Nov 2024 take-private at $1.8B; strong ambulatory fit, flag PE pressure.
NextGen Healthcare is the long-running ambulatory EHR platform, founded 1998. Public NASDAQ:NXGN 2008-2024. Thoma Bravo announced take-private acquisition August 2024, completed November 2024 at $1.8B ($23.95/share). The platform centers on ambulatory EHR + practice management + revenue cycle for mid-market physician groups. Strengths: mid-market ambulatory sweet spot, mature 25-year track record, broad specialty support (cardiology, orthopedics, primary care), strong revenue cycle integration, and Thoma Bravo capital for AI investment. Best fit for mid-market physician groups (25-500 physicians) wanting NextGen-anchored ambulatory workflow. Trade-offs: Thoma Bravo PE pressure pattern (pricing escalations typical 6-18 months post-take-private), implementation 4-12 months, customer support quality variable, AI features below Epic/athenahealth on velocity, and recently-private creates roadmap uncertainty.
Mid-market physician groups (25-500 physicians) wanting NextGen-anchored ambulatory workflow with broad specialty support.
Hospital scope (Epic/Cerner better), enterprise practices ($50M+ revenue) wanting more modern alternatives (athenahealth/Epic), or buyers concerned about Thoma Bravo PE pattern.
Strengths
- Mid-market ambulatory sweet spot
- Mature 25-year track record
- Broad specialty support
- Strong revenue cycle integration
- Thoma Bravo capital for AI investment
- Atlanta engineering culture
Weaknesses
- Thoma Bravo PE pressure pattern (pricing escalations expected)
- Implementation 4-12 months
- Customer support variable
- AI features below Epic/athenahealth
- Recently-private roadmap uncertain
- Per-physician + module pricing complex
Pricing tiers
opaque- NextGen Office (SMB)~$300-$500/physician/monthQuote
- NextGen Enterprise~$600-$1,200/physician/monthQuote
- NextGen CorporateCustom for large groupsQuote
- · Per-module add-ons (RCM, population health)
- · Implementation services
- · Annual price increases of 8-15% post-Thoma Bravo expected
Key features
- +Ambulatory clinical EHR
- +Practice management
- +Revenue cycle
- +Patient portal
- +Specialty-specific templates
- +Telehealth
- +Carequality
- +60+ integrations
eClinicalWorks
Private founder-led ambulatory EHR; flag 2017 DOJ $155M settlement over EHR certification fraud.
eClinicalWorks is the privately-held ambulatory EHR + revenue cycle platform, founded 1999. Founder-led for 25 years. The platform centers on ambulatory practice management + EHR + RCM + telehealth for small-to-mid practices. Strengths: founder-led 25 years (no PE pressure), broad ambulatory installed base (130K+ providers), aggressive AI feature velocity (eClinicalWorks 2024 launched Sunoh.ai for AI scribe + eCW Cardiology AI), and competitive pricing. Best fit for ambulatory practices (5-200 physicians) wanting modern AI features at competitive pricing. Trade-offs: MUST flag the 2017 DOJ $155M settlement over EHR certification fraud where eClinicalWorks falsely claimed compliance with ONC EHR certification standards while collecting Medicare Meaningful Use incentive payments, this is a foundational trust event in the company history that buyers should factor; subsequent operational improvements have been documented but the underlying trust gap remains for some buyers. Customer support quality variable, implementation 2-6 months typical, and product velocity faster than legacy peers but UX feels denser than athenahealth.
Ambulatory practices (5-200 physicians) wanting modern AI features (Sunoh.ai scribe) at competitive pricing.
Buyers prioritizing vendor brand reputation (Epic/athenahealth better), hospital scope (Epic better), or compliance-conservative buyers concerned about 2017 DOJ history.
Strengths
- Founder-led 25 years (no PE pressure)
- Broad ambulatory installed base (130K+ providers)
- Aggressive AI feature velocity (Sunoh.ai scribe)
- Competitive pricing
- Modern AI features at lower price than athenahealth
- Cardiology + specialty depth
Weaknesses
- 2017 DOJ $155M EHR certification fraud settlement (foundational trust gap)
- Customer support quality variable
- UX denser than athenahealth
- Implementation 2-6 months
- Brand recognition affected by 2017 scandal
Pricing tiers
partial- eClinicalWorks Cloud BasicFrom ~$449/physician/month$0+$449 /mo +/emp
- eClinicalWorks Cloud Pro~$599/physician/month with AI Scribe$0+$599 /mo +/emp
- eClinicalWorks EnterpriseCustom for large groupsQuote
- · Per-module add-ons (AI Scribe Sunoh.ai is separate)
- · Implementation services
- · Annual price increases of 5-8%
Key features
- +Ambulatory clinical EHR
- +Practice management
- +Revenue cycle
- +Patient portal (healow)
- +Sunoh.ai AI scribe
- +Telehealth (healow TeleVisits)
- +Carequality
- +50+ integrations
Veradigm (formerly Allscripts)
Allscripts rebranded to Veradigm 2022; delisted from NASDAQ 2024; major vendor stability concerns.
Veradigm (formerly Allscripts Healthcare Solutions) is the long-running ambulatory EHR + payer/life-sciences data platform, founded 1986. Allscripts was public NASDAQ:MDRX 1999-2024; rebranded to Veradigm in January 2022; was delisted from NASDAQ in September 2024 after multiple accounting restatements and missed SEC filing deadlines. The platform spans Veradigm EHR + practice management + payer + life sciences data businesses. Strengths: long-running 40-year track record, broad payer + life sciences data assets, multiple specialty EHRs in portfolio, and existing customer installed base. Best fit for existing Veradigm customers on legacy Allscripts/TouchWorks/Sunrise platforms. Trade-offs: MAJOR vendor stability concerns, multiple accounting restatements 2023-2024 prompted NASDAQ delisting Sept 2024; SEC investigations active; uncertain corporate trajectory; AI features below competitors; customer support quality has degraded substantially through the financial turmoil; many customers actively migrating to other EHRs. The honest editorial read: Veradigm faces existential vendor-stability questions in 2026 that buyers must factor into multi-year contract decisions.
Existing Veradigm customers on legacy Allscripts/TouchWorks/Sunrise platforms staying due to switching cost.
New EHR evaluations (Epic/athenahealth/eClinicalWorks better fits and substantially more stable vendors), or any buyer prioritizing vendor stability for multi-year EHR commitments.
Strengths
- Long-running 40-year track record
- Broad payer + life sciences data assets
- Multiple specialty EHRs in portfolio
- Existing customer installed base
- Chicago-anchored
- Healthcare data depth
Weaknesses
- Multiple accounting restatements 2023-2024
- NASDAQ delisting September 2024
- Active SEC investigations
- Uncertain corporate trajectory
- Customer support degraded
- Many customers migrating away
Pricing tiers
opaque- Veradigm legacy contractsVariable; many customers renegotiatingQuote
- · Vendor stability discount may be negotiable for legacy customers
- · Per-physician licensing
- · Annual maintenance fees
Key features
- +Ambulatory EHR (Allscripts TouchWorks, Pro EHR)
- +Hospital EHR (Sunrise)
- +Practice management
- +Revenue cycle
- +Payer data
- +Life sciences data
- +60+ integrations
DrChrono
EverHealth-owned modern iPad-first EHR for small practices.
DrChrono is the modern iPad-first ambulatory EHR for small practices, founded 2009 in YC W11. Acquired by EverHealth (formerly Practice Mate parent) in 2021. The platform pioneered iPad-first clinical documentation and remains the strongest iPad EHR. Strengths: best-in-class iPad-first UX, modern California engineering, strong fit for solo + small specialty practices (5-50 physicians), competitive SMB pricing, and YC W11 legacy momentum. Best fit for solo practices and small specialty groups wanting modern iPad-first workflow. Trade-offs: EverHealth ownership integration ongoing, brand recognition declined post-acquisition, AI features below eClinicalWorks Sunoh.ai, less suited for mid-market multi-specialty groups, and customer support quality variable post-acquisition.
Solo practices and small specialty groups (1-25 physicians) wanting modern iPad-first clinical workflow.
Mid-market multi-specialty (NextGen/athenahealth better), hospital scope (Epic better), or Windows-only practices.
Strengths
- Best-in-class iPad-first UX
- Modern California engineering
- Strong fit for solo + small specialty practices
- Competitive SMB pricing
- YC W11 legacy momentum
- Apple App Store integration mature
Weaknesses
- EverHealth ownership integration ongoing
- Brand recognition declined post-acquisition
- AI features below eClinicalWorks
- Less suited for mid-market multi-specialty
- Customer support variable post-acquisition
- iPad-anchored may not fit Windows-anchored practices
Pricing tiers
partial- Prometheus (Practice)~$249-$449/physician/monthQuote
- Hippocrates (Group)~$449-$649/physician/monthQuote
- Apollo (Enterprise)Custom for larger groupsQuote
- · Per-module add-ons
- · Implementation services
- · Annual price increases of 5-8%
Key features
- +iPad-first EHR
- +Practice management
- +E-prescribing
- +Patient portal
- +Telehealth
- +Revenue cycle (Updox)
- +Apple Pencil charting
- +40+ integrations
Tebra (Kareo + PatientPop)
Kareo + PatientPop 2022 merger formed Tebra; SMB-friendly practice management + EHR + patient engagement.
Tebra is the SMB practice management + EHR + patient engagement platform formed from the November 2022 merger of Kareo (founded 2004) and PatientPop (founded 2014). PE-backed by Vista Equity Partners (continuing from Kareo). The platform bundles cloud-based EHR + practice management + patient engagement + reputation management for small practices. Strengths: bundled platform reduces vendor sprawl, modern California engineering, SMB-friendly pricing, mature 20-year Kareo track record, and PatientPop reputation management differentiator. Best fit for SMB practices (1-50 physicians) wanting bundled practice management + EHR + patient engagement. Trade-offs: post-merger integration ongoing 2022-2026; Vista Equity PE pressure pattern; clinical EHR depth below athenahealth/eClinicalWorks; customer support quality variable post-merger; AI features below leaders.
SMB practices (1-50 physicians) wanting bundled practice management + EHR + patient engagement at SMB pricing.
Enterprise practices (athenahealth/Epic/Cerner better), modern iPad-first solo practices (DrChrono better), or buyers prioritizing clinical EHR depth.
Strengths
- Bundled practice management + EHR + patient engagement
- Modern California engineering
- SMB-friendly pricing
- Mature 20-year Kareo track record
- PatientPop reputation management
- Reduces vendor sprawl
Weaknesses
- Post-merger integration ongoing
- Vista Equity PE pressure pattern
- Clinical EHR depth below athenahealth
- Customer support variable post-merger
- AI features below leaders
- Brand recognition mixed (Kareo + PatientPop + Tebra)
Pricing tiers
partial- Tebra Get Paid~$150-$300/physician/month (billing only)Quote
- Tebra Plus~$400-$700/physician/month (full)Quote
- Tebra CompleteCustom enterprise tierQuote
- · Per-module add-ons (PatientPop reputation, telehealth, etc.)
- · Implementation services
- · Annual price increases of 6-10% under Vista
Key features
- +SMB clinical EHR
- +Practice management
- +Revenue cycle
- +Patient engagement (PatientPop)
- +Reputation management
- +Telehealth
- +Online scheduling
- +40+ integrations
Greenway Health
Vista Equity PE-backed mid-market ambulatory EHR; flag PE pressure pattern.
Greenway Health is the mid-market ambulatory EHR + practice management platform, founded 1979. Vista Equity Partners PE-backed since 2013 (12+ year hold, longer than typical PE cycle). The platform centers on mid-market ambulatory practices with Intergy + Prime Suite legacy products. Strengths: mature 45-year track record, strong fit for mid-market ambulatory practices, broad specialty support, established revenue cycle, and Vista Equity capital. Best fit for mid-market ambulatory practices (20-200 physicians) wanting alternative to NextGen/athenahealth. Trade-offs: Vista Equity 12+ year hold is unusual (typically PE 5-7 year hold) and creates uncertainty about exit timing; pricing escalations reported under Vista; multiple product lines (Intergy + Prime Suite + Greenway Carequality) create platform fragmentation; AI features below Epic/athenahealth/eClinicalWorks; customer support quality variable, and innovation pace below modern competitors.
Mid-market ambulatory practices (20-200 physicians) wanting alternative to NextGen + athenahealth.
Buyers prioritizing modern AI features (eClinicalWorks/athenahealth better), or buyers concerned about Vista PE exit-timing risk.
Strengths
- Mature 45-year track record
- Strong fit for mid-market ambulatory
- Broad specialty support
- Established revenue cycle
- Vista Equity capital backing
- Long-standing operational stability
Weaknesses
- Vista Equity 12+ year hold creates exit uncertainty
- Pricing escalations under Vista
- Multiple product lines create platform fragmentation
- AI features below leaders
- Customer support variable
- Innovation pace below modern competitors
Pricing tiers
opaque- Greenway Standard~$300-$500/physician/monthQuote
- Greenway Pro$500-$900/physician/monthQuote
- Greenway EnterpriseCustom enterprise tierQuote
- · Per-module add-ons
- · Implementation services
- · Annual price increases of 6-10% under Vista
- · Per-product-line scaling complexity
Key features
- +Ambulatory clinical EHR (Intergy + Prime Suite)
- +Practice management
- +Revenue cycle
- +Patient portal
- +Specialty templates
- +Telehealth
- +Carequality
- +50+ integrations
Practice Fusion
Veradigm/Allscripts-owned originally-free ambulatory EHR; ongoing vendor stability concerns.
Practice Fusion is the originally-free ambulatory EHR, founded 2005 in San Francisco. Pioneered the "free EHR" model with advertising revenue but discontinued the free tier in 2018. Acquired by Allscripts (now Veradigm) in February 2018 for $100M. The platform centers on lightweight ambulatory EHR for solo and small specialty practices. Strengths: lightweight modern UX (inherited from free-EHR era), strong fit for solo practices, low entry pricing, and broad installed base from free-tier years. Best fit for solo practices and very small specialty groups (1-5 physicians) wanting lightweight EHR. Trade-offs: Veradigm/Allscripts parent has MAJOR vendor stability concerns (NASDAQ delisted Sept 2024, accounting restatements, SEC investigations, see Veradigm entry for details); customers may face uncertain vendor trajectory; AI features below modern competitors; customer support quality degraded with Veradigm financial turmoil; less suited for mid-market practices.
Solo practices and very small specialty groups (1-5 physicians) wanting lightweight EHR; accept Veradigm parent vendor stability risk.
Buyers prioritizing vendor stability (Epic/athenahealth/DrChrono better), mid-market practices (athenahealth better), or compliance-conservative buyers.
Strengths
- Lightweight modern UX
- Strong fit for solo practices
- Low entry pricing
- Broad installed base from free-tier years
- San Francisco engineering legacy
- Simple practice management
Weaknesses
- Veradigm parent vendor stability concerns (NASDAQ delisted Sept 2024)
- Veradigm SEC investigations affect Practice Fusion
- AI features below modern competitors
- Customer support quality degraded with Veradigm turmoil
- Less suited for mid-market
- Uncertain vendor trajectory
Pricing tiers
partial- Practice Fusion EHRFrom $149/physician/month$149+$149 /mo +/emp
- Practice Fusion PremiumCustom for groupsQuote
- · Per-module add-ons
- · Implementation services
- · Vendor stability risk premium
Key features
- +Solo + small practice EHR
- +Practice management
- +E-prescribing
- +Patient portal
- +Telehealth
- +20+ integrations
Frequently asked questions
The questions buyers actually ask before they sign.
What is Ségur Numérique and why does it determine French EHR procurement?
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How do I evaluate vendor stability for multi-year EHR contracts?
When should I migrate from one EHR to another?
Final word
Looking at a different market? See the global Healthcare EHR Software ranking, or pick another country at the top of this page.
Last updated 2026-05-18. Local pricing reverified quarterly. Found something inaccurate? Tell us.