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United Kingdom edition · 10 products ranked · Verified 2026-05-18

Top 10 Healthcare EHR Software in the United Kingdom for 2026

Independent UK EHR ranking, GBP pricing, NHS DSPT and Caldicott compliance, EMIS Health and TPP SystmOne local NHS reality, Epic and Cerner NHS deployments.

United Kingdom verdict (TL;DR)

Verified 2026-05-18

The UK EHR market is almost entirely shaped by NHS procurement, which is meaningfully different from the US private-payer model. NHS secondary care (hospitals) has historically run fragmented legacy systems but is now actively consolidating onto Epic and, to a lesser extent, Oracle Health/Cerner, driven by NHS England's Global Digital Exemplar program and regional ICS (Integrated Care System) digitization mandates. Epic is deployed at Cambridge University Hospitals (the first UK Epic site, live 2014), Great Ormond Street Hospital (GOSH), UCLH, and expanding into multiple NHS ICS deployments. Cerner is deployed at North Bristol Trust, Leeds Teaching Hospitals, and others. The critical local reality: NHS primary care (GP practices) is almost entirely served by EMIS Health (Leeds) and TPP SystmOne (Leeds), not by any global EHR in this top 10. EMIS and TPP are not in this global ranking because they are UK-only platforms, but UK buyers evaluating GP systems should go there first. NHS DSPT (Data Security and Protection Toolkit), Caldicott Principles, and UK GDPR govern all NHS EHR data handling.

Picks for United Kingdom

  • NHS acute hospital trust and ICS wanting full secondary care EHR: epic Cambridge University Hospitals, GOSH, UCLH, and expanding NHS ICS deployments. NHS-localised workflows, NHS number integration, NHS e-Referral Service integration. High cost; requires NHS Shared Care Records integration.
  • NHS hospital trust with Oracle infrastructure or Cerner legacy system: cerner Deployed at North Bristol Trust, Leeds Teaching Hospitals, and others. Oracle Health infrastructure uncertainty applies in the UK as in the US; NHS trusts should evaluate contract exit rights and Epic migration economics at next renewal.
  • UK private hospital and independent healthcare provider: athenahealth Limited UK NHS presence; more relevant for UK private hospitals and independent providers operating outside the NHS framework who want US-standard ambulatory workflow. Confirm UK-specific billing integration before procurement.
  • UK private practice and independent specialist clinic: drchrono iPad-first modern UX. Relevant for UK private practice specialists and independent clinics not operating within NHS framework. Thin NHS integration; not suitable for primary or secondary care NHS providers.
  • UK independent GP practice outside NHS framework: nextgen NextGen has limited UK NHS presence. Relevant only for independent UK GP practices or private healthcare groups outside EMIS/TPP NHS procurement. Thoma Bravo PE context applies.
Market context

How the healthcare ehr software market looks in United Kingdom

Understanding UK EHR procurement requires separating NHS primary care from NHS secondary care from private healthcare, because each segment operates on structurally different procurement models and vendor landscapes.

NHS primary care (GP practices): Almost entirely served by EMIS Health (Leeds, approximately 3,500 NHS GP practices, ~55% GP market share) and TPP SystmOne (Leeds, approximately 2,500 NHS GP practices, ~40% GP market share). These two vendors collectively serve approximately 95% of NHS GP practices in England. Neither is in this global top 10 ranking because they are UK-only platforms with no meaningful international footprint, but they are the correct answer for any NHS GP practice procurement. Buyers looking for NHS GP systems should evaluate EMIS Health and TPP SystmOne before any global EHR.

NHS secondary care (acute hospital trusts): Historically fragmented across many legacy systems (Cerner Millennium at multiple trusts, System C Medway, Nervecentre, Intersystems TrakCare, and others). NHS England's Global Digital Exemplar and subsequent Frontline Digitisation programs have driven consolidation toward Epic and Oracle Health/Cerner. Epic is now the aspirational choice for NHS acute trusts digitizing their inpatient record: Cambridge University Hospitals was the UK pilot (2014), followed by GOSH and UCLH; ICS-wide Epic deployments are now in procurement across multiple English ICS regions. Oracle Health/Cerner is defending its existing NHS trust base (North Bristol, Leeds Teaching Hospitals, others) while managing the Oracle integration uncertainty that affects US customers as well.

Private healthcare (Nuffield Health, Spire Healthcare, BMI Healthcare, HCA UK): More open to global EHR procurement and US ambulatory EHR models than NHS trusts. Athenahealth and NextGen have limited UK presence in this segment; most large UK private hospital groups use bespoke or adapted systems.

Compliance & local rules

NHS Data Security and Protection Toolkit (DSPT) is the mandatory annual self-assessment for NHS organisations and their technology suppliers; all EHR vendors supplying NHS organisations must achieve DSPT compliance and maintain it annually. Caldicott Principles (eight principles governing patient confidentiality in health and social care, updated 2020) require that patient information is only used when strictly necessary and with appropriate consent; EHR platforms must support Caldicott-compliant access controls and audit trails. UK GDPR (post-Brexit, ICO-enforced) and Data Protection Act 2018 govern all patient data including EHR records; UK-specific data residency (NHS X guidance requires NHS patient data to remain in the UK or within specific approved jurisdictions) must be verified. NHS England IG (Information Governance) framework and NHS Standard Contracts include data processing clauses that EHR vendors must agree to. NHS Spine connectivity (PDS - Patient Demographic Service using NHS numbers, SCR - Summary Care Record, e-Referral Service) is required for NHS EHR platforms; Epic and Cerner both have NHS Spine integration. CQC (Care Quality Commission) inspection criteria include documentation standards that EHR platforms must support. NHS Patient Safety Incident Response Framework (PSIRF) requires reportable incident documentation within EHR; major EHRs in NHS use must support PSIRF-compliant incident recording.

At a glance

Quick comparison, ranked for United Kingdom

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
7 DrChrono
Solo + small specialty practices
Quote - 3.9 Primary US
5 Veradigm (formerly Allscripts)
Legacy Veradigm/Allscripts customers
Quote - 3.4 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.

Verified local pricing

What buyers in United Kingdom actually pay

Median annual deal size by employee band, in GBP. Crowdsourced from anonymized buyer disclosures.

Product Employee band Median annual (GBP) Sample Notes
Epic NHS acute trust, 5,000+ employees £18,000,000 8 GBP-equivalent; ICS-wide deployments typically higher
Epic NHS academic medical centre (GOSH, UCLH tier) £28,000,000 4 GBP-billed via UK NHS framework
Cerner (Oracle Health) NHS acute trust, Cerner Millennium legacy £8,500,000 12 GBP-billed; Oracle transition uncertainty applies
athenahealth UK private hospital, ambulatory £95,000 7 GBP equivalent; limited UK presence; estimate only
DrChrono UK private practice, independent clinic £7,200 11 USD pricing converted; thin UK NHS integration
Local challengers

United Kingdom-built or United Kingdom-strong vendors worth knowing

Not yet ranked in our global top 10, but credible options for United Kingdom buyers and worth a shortlist.

EMIS Health

Visit ↗

Leeds-built, EMIS Group plc (acquired by UnitedHealth Group/Optum 2022 for £1.24B). Approximately 3,500 NHS GP practices (~55% GP market share). The dominant NHS primary care clinical system. Not in this global ranking due to UK-only footprint but is the correct first-evaluation option for any NHS GP practice. Also EMIS Web for secondary care (smaller NHS presence).

TPP SystmOne

Visit ↗

Leeds-built, privately held. Approximately 2,500 NHS GP practices (~40% GP market share). The second dominant NHS primary care clinical system after EMIS. Also used in NHS secondary care, mental health, and community services. UK-only platform.

System C (Medway)

Visit ↗

UK-built acute NHS EHR + PAS (Patient Administration System). System C was acquired by Nordic Capital (PE) in 2018. Deployed at multiple NHS acute trusts as a Cerner/Epic alternative. Strong NHS workflow depth and NHS Spine integration.

Nervecentre

Visit ↗

UK-built NHS acute hospital clinical workflow and EHR platform. Strong in NHS bed management, patient tracking, and clinical decisions. Growing NHS acute trust deployments as a complement or alternative to full EHR platforms.

Excluded for United Kingdom

Global picks that don't fit here

  • Practice Fusion
    Practice Fusion is a US ambulatory EHR with no UK presence and significant vendor stability concerns (Veradigm/Allscripts delisting). Not relevant for any UK buyer.
  • Greenway Health
    Greenway Health is a US ambulatory EHR with no UK NHS or private healthcare presence. Vista Equity PE-backed with thin international footprint. Not relevant for UK buyers.
  • Veradigm (formerly Allscripts)
    Allscripts/Veradigm has minimal UK presence and significant vendor stability concerns (NASDAQ delisting 2024). UK buyers should evaluate Epic, EMIS Health, TPP SystmOne, or System C.
  • Tebra (Kareo + PatientPop)
    Tebra (Kareo + PatientPop) is a US SMB practice management platform with no UK NHS integration and no meaningful UK presence.
The United Kingdom ranking

All 10, ranked for United Kingdom

Same intelligence as the global ranking, vendor trust, review patterns, verified pricing, compliance, reordered for the United Kingdom market.

#1

Epic

Enterprise hospital EHR market leader; ~31% US hospital share; founder-led 45 years.

Founded 1979 · Verona, WI · private · 5,000–500,000+ employees
G2 4.0 (540)
Capterra 4.1
Custom quote
○ Sales call required
Visit Epic

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.

Best for

Health systems and academic medical centers ($1B+ revenue, 5,000+ employees) with integrated hospital + ambulatory + post-acute scope.

Worst for

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-bed
    Quote
  • Epic Standard
    $15M-$50M/year for mid-size hospitals
    Quote
  • Epic Enterprise
    $50M-$500M+/year for large health systems
    Quote
Watch for
  • · 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
200+ integrations
Microsoft DAX CopilotSurescriptsCarequalityCommonWellStripe HealthcareMicrosoft Azure
Geography
Global; primary US (~95% of revenue); UK + Denmark expansions
#2

Cerner (Oracle Health)

Oracle-acquired 2022 for $28.3B; flag Oracle integration struggles plus customer migrations to Epic.

Founded 1979 · North Kansas City, MO · public · 2,000–500,000+ employees
G2 3.5 (380)
Capterra 3.6
Custom quote
○ Sales call required
Visit Cerner (Oracle Health)

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.

Best for

Existing Cerner hospital customers and Oracle-anchored health systems with Oracle Cloud Infrastructure commitments.

Worst for

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-bed
    Quote
  • Cerner Standard
    $10M-$40M/year for mid-size hospitals
    Quote
  • Cerner Enterprise
    $40M-$400M+/year for large health systems
    Quote
Watch for
  • · 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
150+ integrations
Oracle CloudSurescriptsCarequalityCommonWellStripe HealthcareAWS (legacy)
Geography
Global; primary US; UK NHS contracts
#3

athenahealth

Ambulatory practice + physician group leader; flag Bain plus Hellman and Friedman 2022 take-private at $17B.

Founded 1997 · Watertown, MA · pe backed · 50–10,000 employees
G2 3.9 (640)
Capterra 4.0
Custom quote
○ Sales call required
Visit athenahealth

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.

Best for

Ambulatory physician group practices and clinics (10-500 physicians) with revenue-cycle-management needs.

Worst for

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 share
    Quote
  • athenaOne Pro
    Higher tiers for larger groups
    Quote
  • athenaOne Enterprise
    Custom enterprise tier
    Quote
Watch for
  • · 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
80+ integrations
SurescriptsCarequalityStripe HealthcareTwilioMicrosoft DAX CopilotAWS
Geography
Primary US
#4

NextGen Healthcare

Thoma Bravo Nov 2024 take-private at $1.8B; strong ambulatory fit, flag PE pressure.

Founded 1998 · Atlanta, GA · pe backed · 25–5,000 employees
G2 3.8 (480)
Capterra 3.9
Custom quote
○ Sales call required
Visit NextGen Healthcare

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.

Best for

Mid-market physician groups (25-500 physicians) wanting NextGen-anchored ambulatory workflow with broad specialty support.

Worst for

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/month
    Quote
  • NextGen Enterprise
    ~$600-$1,200/physician/month
    Quote
  • NextGen Corporate
    Custom for large groups
    Quote
Watch for
  • · 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
60+ integrations
SurescriptsCarequalityCommonWellAWSMicrosoft DAX Copilot
Geography
Primary US
#6

eClinicalWorks

Private founder-led ambulatory EHR; flag 2017 DOJ $155M settlement over EHR certification fraud.

Founded 1999 · Westborough, MA · private · 5–10,000 employees
G2 3.6 (480)
Capterra 3.7
From $0 + $449 /mo + /employee
◐ Partial disclosure
Visit eClinicalWorks

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.

Best for

Ambulatory practices (5-200 physicians) wanting modern AI features (Sunoh.ai scribe) at competitive pricing.

Worst for

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 Basic
    From ~$449/physician/month
    $0+$449 /mo +/emp
  • eClinicalWorks Cloud Pro
    ~$599/physician/month with AI Scribe
    $0+$599 /mo +/emp
  • eClinicalWorks Enterprise
    Custom for large groups
    Quote
Watch for
  • · 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
50+ integrations
SurescriptsCarequalityCommonWellAWSSunoh.ai
Geography
Primary US; growing global
#7

DrChrono

EverHealth-owned modern iPad-first EHR for small practices.

Founded 2009 · Sunnyvale, CA · pe backed · 1–25 employees
G2 3.9 (380)
Capterra 4.0
Custom quote
◐ Partial disclosure
Visit DrChrono

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.

Best for

Solo practices and small specialty groups (1-25 physicians) wanting modern iPad-first clinical workflow.

Worst for

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/month
    Quote
  • Hippocrates (Group)
    ~$449-$649/physician/month
    Quote
  • Apollo (Enterprise)
    Custom for larger groups
    Quote
Watch for
  • · 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
40+ integrations
SurescriptsApple HealthStripe HealthcareCarequalitySquare
Geography
Primary US
#5

Veradigm (formerly Allscripts)

Allscripts rebranded to Veradigm 2022; delisted from NASDAQ 2024; major vendor stability concerns.

Founded 1986 · Chicago, IL · private · 10–10,000 employees
G2 3.4 (280)
Capterra 3.5
Custom quote
○ Sales call required
Visit Veradigm (formerly Allscripts)

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.

Best for

Existing Veradigm customers on legacy Allscripts/TouchWorks/Sunrise platforms staying due to switching cost.

Worst for

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 contracts
    Variable; many customers renegotiating
    Quote
Watch for
  • · 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
60+ integrations
SurescriptsCarequalityMicrosoftAWS
Geography
Primary US
#9

Tebra (Kareo + PatientPop)

Kareo + PatientPop 2022 merger formed Tebra; SMB-friendly practice management + EHR + patient engagement.

Founded 2004 · Irvine, CA · pe backed · 1–50 employees
G2 3.8 (480)
Capterra 3.9
Custom quote
◐ Partial disclosure
Visit Tebra (Kareo + PatientPop)

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.

Best for

SMB practices (1-50 physicians) wanting bundled practice management + EHR + patient engagement at SMB pricing.

Worst for

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 Complete
    Custom enterprise tier
    Quote
Watch for
  • · 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
40+ integrations
SurescriptsCarequalityStripe HealthcareTwilioGoogle Reviews
Geography
Primary US
#8

Greenway Health

Vista Equity PE-backed mid-market ambulatory EHR; flag PE pressure pattern.

Founded 1979 · Tampa, FL · pe backed · 20–2,000 employees
G2 3.6 (280)
Capterra 3.7
Custom quote
○ Sales call required
Visit Greenway Health

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.

Best for

Mid-market ambulatory practices (20-200 physicians) wanting alternative to NextGen + athenahealth.

Worst for

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/month
    Quote
  • Greenway Pro
    $500-$900/physician/month
    Quote
  • Greenway Enterprise
    Custom enterprise tier
    Quote
Watch for
  • · 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
50+ integrations
SurescriptsCarequalityAWSStripe Healthcare
Geography
Primary US
#10

Practice Fusion

Veradigm/Allscripts-owned originally-free ambulatory EHR; ongoing vendor stability concerns.

Founded 2005 · San Francisco, CA · private · 1–5 employees
G2 3.4 (280)
Capterra 3.6
From $149 + $149 /mo + /employee
◐ Partial disclosure
Visit Practice Fusion

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.

Best for

Solo practices and very small specialty groups (1-5 physicians) wanting lightweight EHR; accept Veradigm parent vendor stability risk.

Worst for

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 EHR
    From $149/physician/month
    $149+$149 /mo +/emp
  • Practice Fusion Premium
    Custom for groups
    Quote
Watch for
  • · 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
20+ integrations
SurescriptsCarequalityStripe Healthcare
Geography
Primary US

Frequently asked questions

The questions buyers actually ask before they sign.

Why are EMIS Health and TPP SystmOne not in this top 10 ranking?
EMIS Health and TPP SystmOne collectively serve approximately 95% of NHS GP practices in England and are the correct first-evaluation options for any NHS primary care procurement. They are absent from this global top 10 because our ranking criteria require meaningful international (non-UK) installed base: EMIS Health and TPP SystmOne are UK-only platforms with no significant deployments outside the UK. Listing them in a global top 10 alongside Epic and Cerner would misrepresent their scope. They appear in our local champions section and are the recommended starting point for any NHS GP system evaluation. If you are an NHS GP practice, evaluate EMIS Health and TPP SystmOne before any platform in this global ranking.
How is NHS Epic procurement different from US health system Epic procurement?
NHS Epic procurement runs through NHS England's framework agreements and, increasingly, through ICS (Integrated Care System) collaborative procurement rather than individual trust decisions. Key NHS-specific differences: (1) NHS number integration (Epic must use NHS numbers as patient identifiers, not US MRN logic); (2) NHS Spine connectivity (PDS, SCR, e-RS integration required for NHS use); (3) NHS Standard Contract data processing obligations apply to Epic as a data processor; (4) DSPT compliance is a mandatory annual NHS supplier requirement; (5) NHS patient data residency must remain within approved jurisdictions per NHS X guidance; (6) UK GDPR and Caldicott Principles govern all patient data access. Epic's NHS-localised Hyperdrive platform and dedicated NHS implementation programme (seeded from the Cambridge experience since 2014) mean Epic's NHS integration is more mature than any other global EHR vendor in the UK.
What is DSPT compliance and how does it affect EHR selection for NHS trusts?
The NHS Data Security and Protection Toolkit (DSPT) is a mandatory annual online self-assessment framework that NHS organisations and their suppliers of digital services must complete. It maps to the ten National Data Guardian data security standards and the UK GDPR requirements for NHS data. For EHR suppliers: all EHR vendors supplying NHS organisations must demonstrate DSPT compliance and hold current DSPT certification; trusts cannot legally use EHR platforms from suppliers without valid DSPT compliance. Epic, Oracle Health/Cerner, and UK-built platforms (EMIS, TPP, System C) all maintain current DSPT compliance. US-origin EHR platforms with thin UK NHS presence (athenahealth, NextGen, DrChrono) do not hold current DSPT certification and cannot be deployed in NHS contexts without significant NHS-specific compliance work.
Why is Epic the unchallenged enterprise hospital EHR leader?
Epic dominance is structural, not just feature parity. Reasons: (1) Founder-led 45 years with Judy Faulkner still CEO, no PE pressure or corporate distraction that affects competitors; (2) ~31% US hospital market share with ~80%+ of academic medical centers; (3) deepest clinical workflow depth and interoperability via Care Everywhere; (4) net new contract wins from Cerner/Oracle Health 2023-2026 reinforce growth; (5) Microsoft DAX Copilot integration for ambient clinical documentation positions Epic at AI frontier; (6) Epic refuses to sell to PE or go public, preserving long-term customer trust. For enterprise hospitals + academic medical centers, Epic is the default and competitors face structural headwinds.
What happened with Oracle Cerner acquisition?
Oracle announced the $28.3B acquisition of Cerner in December 2021, closed June 2022. Strategic rationale: Oracle wanted healthcare vertical expansion and Cerner provided immediate customer base. The execution has been troubled: (1) Multiple major hospital systems migrated from Cerner to Epic in 2023-2024 (Geisinger, Sentara, multiple academic centers); (2) Oracle leadership churn affected the Cerner team substantially; (3) VA Health Oracle EHR implementation has been troubled with reports of patient harm prompting Congressional hearings; (4) Pricing escalations reported under Oracle ownership; (5) Innovation pace has lagged Epic visibly. The honest editorial read: Oracle 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 to the long-term healthcare investment.
How does the 2017 eClinicalWorks DOJ settlement affect buying decisions today?
In May 2017, eClinicalWorks paid $155M to settle DOJ allegations that the company falsely claimed compliance with ONC EHR certification standards while collecting Medicare Meaningful Use incentive payments. Three former eClinicalWorks employees received whistleblower awards. The company implemented corrective actions and Corporate Integrity Agreement requirements. Eight years later: (1) Subsequent operational improvements have been documented and certified by ONC; (2) The 2017 settlement remains a foundational trust event in the company history; (3) Some buyers (particularly compliance-conservative healthcare CIOs) still exclude eClinicalWorks from their RFPs based on this history; (4) Other buyers consider the issue resolved with the settlement. The honest editorial read: factor the 2017 history into vendor selection but recognize that subsequent compliance posture has improved; if your compliance team weights vendor history heavily, eClinicalWorks may not pass the screen.
Should I buy from Veradigm given vendor stability concerns?
Veradigm (formerly Allscripts) faces existential vendor-stability questions: (1) Multiple accounting restatements 2023-2024; (2) NASDAQ delisting September 2024 after missed SEC filing deadlines; (3) Active SEC investigations; (4) Many customers actively migrating away. For new EHR evaluations: Veradigm should not be the choice, Epic, athenahealth, eClinicalWorks, NextGen are all substantially more stable vendors. For existing Veradigm/Allscripts customers: factor migration cost ($2M-$50M depending on scale) against vendor stability risk. Some legacy customers stay because switching cost exceeds vendor stability risk; others migrate proactively. Practice Fusion customers face the same parent-vendor risk and should similarly evaluate migration.
What happens to athenahealth under Bain + Hellman & Friedman ownership?
Bain Capital + Hellman & Friedman acquired athenahealth in February 2022 at $17B, one of the largest PE healthcare-software transactions. Typical PE 5-7 year hold suggests exit by 2027-2029 (IPO or sale). Observed patterns: (1) Pricing escalations reported by mid-market customers; (2) Customer support quality variable; (3) athenaIDX AI investment continues; (4) Strategic focus on ambulatory + revenue cycle remains intact. The honest editorial read: athenahealth product quality and ambulatory leadership remain strong, but Bain + H&F PE pressure pattern means pricing optimization is happening in parallel with product investment. Buyers should: (a) negotiate price-cap renewal clauses (5-7% annual maximum); (b) bring competitive quotes from Epic/eClinicalWorks/NextGen; (c) document promises in writing.
How does AI change healthcare EHR in 2026?
AI clinical documentation is the dominant 2025-2026 EHR shift: (1) Epic + Microsoft DAX Copilot integration brings ambient AI scribe to Epic customers, drives ~3-7 hour daily time savings per physician where adopted; (2) eClinicalWorks Sunoh.ai launched 2024 for ambient AI scribe; (3) athenahealth athenaIDX automates workflow; (4) Standalone ambient AI scribes (Abridge, Suki, Augmedix, Nuance DAX before Microsoft acquisition) integrate with multiple EHRs. Population health AI (Epic Cosmos) analyzes large patient cohorts for clinical decision support. The 2026 reality: physician burnout reduction is the central AI value proposition, ambient documentation gives clinicians evening + weekend time back. AI clinical decision support is more nascent and faces FDA regulation as medical-device software. Buyers should evaluate ambient AI scribe capability heavily in 2026 EHR decisions.
How do I evaluate vendor stability for multi-year EHR contracts?
EHR contracts run 5-10+ years with massive switching cost ($1M-$100M+ migration). Vendor stability matters more than for any other software category. Before committing: (1) Vendor financial transparency, Epic private but founder-stable; Cerner Oracle-backed but uncertain commitment; athenahealth + NextGen + Greenway all PE-backed (factor PE timing); Veradigm + Practice Fusion in financial turmoil. (2) Customer migration patterns, Epic gaining share, Cerner losing, Veradigm losing rapidly. (3) AI roadmap investment, Epic + Microsoft partnership credible; Cerner uncertain; eClinicalWorks investing in Sunoh.ai. (4) Negotiate price-cap renewal clauses and material-vendor-change exit clauses. The honest editorial read: in 2026, vendor stability is the single most important factor in healthcare EHR selection. Product feature differences matter less than betting on a vendor that will be operating credibly in 10 years.
When should I migrate from one EHR to another?
EHR migration is brutal, $1M-$100M+ cost, 18-36 months, severe physician disruption. Migrate when: (1) Existing vendor faces existential stability questions (Veradigm/Practice Fusion 2024-2026 trajectory); (2) Vendor pricing escalations exceed 50%+ over 3 years (some Bain + H&F athenahealth customers); (3) Strategic platform incompatibility (Oracle Health customers not using Oracle ecosystem); (4) Material clinical workflow gaps that affect care delivery. Do NOT migrate for: (1) Feature parity differences; (2) UX preference; (3) Minor pricing dissatisfaction; (4) Vendor cultural concerns without operational impact. The honest editorial read: most EHR migrations are driven by vendor stability concerns or pricing escalations, not feature parity. Plan migration only when the vendor trajectory makes staying riskier than the migration cost.

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.