5 Easy Steps to Pick the Ideal Free or Open Source EMR

Deciding whether free or open source electronic medical records (EMR) systems are the right choice for your practice? Whether you’re implementing new software or replacing your current EMR, it can take hours of research to choose the right one.

Luckily, we’re here to save you some time.

By the end of this article, you’ll know whether a free or open source solution is best for your healthcare organization, which products are getting great user reviews and how to make your final selection.

Here’s what we’ll cover:

(Click on a link below to jump to that section.)

When Are Free or Open Source EMRs the Right Choice?
Free EMRs: Popular Products and User Reviews
Open Source EMRs: Popular Systems
Picking Your Ideal EMR: 5 Easy Steps

When Are Free or Open Source EMR the Right Choice?

I know what you may be thinking: “Why would I pay hundreds (or thousands!) of dollars for an EMR when I can easily get one for free?”

That’s a good point. Implementing an EMR can be tricky and time consuming—in fact, some health IT experts actually recommend that first-time users adopt a free system so they can adapt to the technology without making a big investment.

Open source solutions, which aren’t necessarily free, are nevertheless appealing because they’re much more customizable than the average EMR.

This lets you format the system to fit your exact needs, though the additional customization options can mean it’s more complex for users to set up.

Before fully committing to a free or open source EMR, you should pause to consider if it’s the best choice.

Many practices find the benefits of paid software are worth every penny, and you’d be closing the door on hundreds of great vendors if you disregarded paid solutions right off the bat.

Here’s some helpful research to better understand free, open source and paid EMRs:


The lowdown: Free EMR companies have different ways of earning revenue, including: selling ads that appear in their system, selling anonymized patient data, charging patients for access to some applications (e.g., the patient portal) and/or enticing practices to purchase premium expansions.

The target customer: Solo, small and midsize practices.

Major pros: No upfront costs—need I say more?

Major cons: Some systems cap the number of users and there can be integration limitations.


The lowdown: Open source EMRs are like blueprints that let you build your own electronic records system. Practices can download the software source code and customize it to their exact specifications. Depending on the EMR, you may have to get a licensing agreement from the original creator. While the source code is often free or low-cost, practices may end up having to hire software developers or consultants to help with their EMR’s design, implementation and training.

The target customer: Providers with access to tech-savvy staff, contractors or consultants.

Major pros: The open source community is widely known as a collaborative group that constantly works on improving the software and sharing their results so you can benefit from their additions.

Major cons: The technical know-how required to set up and maintain these systems can be intimidating for the average practice.


The lowdown: What you pay for this type of EMR depends on your practice size and preferred deployment model (on-premise vs. cloud-based). On-premise systems typically require fees for licenses, servers, implementation, training and ongoing technical support.

Web-based systems typically have lower upfront costs, but include monthly fees for licensing, technical support and/or upgrades. Training and ongoing technical support is usually easier if you have paid software (versus open source). If something goes wrong, you have someone to call instead of doing it yourself.

The target customer: Midsize-to-large practices and hospitals.

Major pros: More robust functionalities and the ability to easily scale with growing practices.

Major cons: If you end up disliking your system, you may be stuck with it for years until you get enough money for a different one. This is a real concern, considering EMR replacement rates are on the rise.

Now, ask yourself the following questions to see which type of EMR would likely benefit you most:


What Type of EMR Is Right For You?


Still trying to figure out which type of EMR is right for you? Email me at gaby@softwareadvice.com for free and personalized guidance.

Free EMRs: Popular Products and User Reviews

If you’ve decided on a free system, it’s just a matter of evaluating your options. To help you do this, we’ve profiled some of the most popular free EMRs out there.

In the section below, you can view screenshots, read what users like best and least about each system (based on their most recent reviews) and see customer success stories.

Practice Fusion

Software rating: (26 reviews)

Functionalities include: Customizable charting templates, e-prescribing, patient portal, ICD-10 compliant superbills and more.

What users like best: Reviewers praise Practice Fusion’s “one-on-one training,” “ease of use” and “the regular release of new features.”

What users like least: There are some complaints about “long” waits for customer service.

Customer success story: Dr. Daniel Singleton of Marion Family Medicine in Buena Vista, California, says his practice saves eight hours a week just by ordering lab tests from the EMR.


Star Rating: (21 reviews)

Functionalities include: Chart notes, claim creation, e-prescribing, patient portal, scheduling and more.

What users like best: Reviewers describe this EMR as “comprehensive” and appreciate “access to [training] videos and webinars.”

What users like least: A provider laments that “adjustments need to be made to our browser settings in order to get full use out of the software.”

Customer success story: Dr. Christopher Bojrab, president of Indiana Health Group, says their support staff is more efficient since they no longer have to spend time pulling and re-filling charts. This allowed the practice to hire 12 more clinicians without needing additional support staff.

Want to see more? Here are three additional, highly rated free EMR products:

Highly-Rated Free EMR Systems

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Open Source EMRs: Popular Systems

If you’re certain you want to implement an open source EMR, below are some systems worth considering.

Since up-to-date information on open source solutions can be scarce, we’ve profiled two of the most common ones and will list additional products that could also go on your software shortlist.


OpenEMR is considered the most popular open source EMR by many, and with good reason: This ONC-ATCB certified system also includes practice management functionalities, such as scheduling and billing.

Hundreds of providers have downloaded OpenEMR and there’s a pretty big community of developers sharing patches, tools, guides and tutorials for it.


OpenMRS is another common open source option. Its creators describe it as a “software platform and a reference application, which enables design of a customized medical records system with no programming knowledge (although medical and systems analysis knowledge is required).”

You can think of OpenMRS as a toolkit for users with medical and systems analysis knowledge to build their own custom EMR without needing specialized experience with specific programming languages.

Want to see more? Here are the names of some additional open source EMR options. Many of these solutions don’t have dedicated websites, so we’ve also included links to online resources that can help you become more familiar with them:

Open Source EMR Options:

  • FreeMED
  • VistA
  • SmartCare
  • XChart
  • ClearHealth

Additional Open Source EMR Resources:

Picking Your Ideal EMR: 5 Easy Steps

Regardless of whether you’re going with a free, open source or paid EMR, there are five steps you should always take before picking a vendor:

1. Determine which functionalities are important to you. You should separate the “must-have” functionalities from the “nice-to-haves” early on, so you don’t spend time considering solutions that don’t fit your needs.

For example: A free EMR may come with a patient portal, but charge a fee for the scheduling application.

2. Consider your staff’s workflow. It’s never too early to start thinking about staff buy-in for your new EMR. The implementation process will be much smoother if you take into consideration your office’s current workflow and focus on solutions that align with it.

For example, your staff might request extra customizations in your EMR’s charting templates if they’re worried about spending too much time entering data.

This is especially important as you decide between paid and open source solutions. Open source options allow for more customization, but require more technical skills to set up. Paid EMRs are generally easier to use but offer less customizations.

3. Make a shortlist of five products. Use this list as a starting point for making a shortlist of free or open source EMRs, and call our team of expert medical Software Advisors at (855) 998-8505 to get free and personalized advice for narrowing down the hundreds of paid systems available.

4. View product demos, screenshots and reviews. Learn everything you can about the systems on your shortlist so you can ask vendors well-informed questions later on (e.g., “I read that some of your users would like more frequent product updates—how often do you currently release these updates?”).

You can see video demos, multiple screenshots and real user reviews in the product profiles on our site.

5. Meet with vendors and pick a product. Set up a phone or in-person meeting with the vendors on your shortlist to truly compare the pros and cons of each solution.

Note: if you’ve decided on open-source software, there may not be a vendor to meet with. Instead, speak with whomever is helping you implement the system and set milestones for when it will be ready for use.

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