The line between open-source and cloud-based electronic health records (EHRs) is growing increasingly nuanced. While open-source EHRs once seemed reserved for organizations willing to host and customize their systems, many now offer web-based access and modular features that rival commercial cloud solutions.

At the same time, cloud-based EHRs have begun embracing greater flexibility and interoperability, once seen as hallmarks of open-source platforms. In this evolving space, OpenEMR and Practice Fusion represent two significant approaches, each offering competitive benefits tailored to the needs of healthcare practices.

This comparison of Practice Fusion vs OpenEMR will explore where these solutions overlap, their core features, differences in pricing, and user experiences to help you make an informed decision for your organization.

Head-On Comparison

Practice Fusion is designed for independent practices with integrated billing services. The software offers features like e-prescription, telehealth, and patient engagement. Its focus on ease of use and streamlined workflows allows practices to manage clinical and administrative tasks efficiently.

In contrast, OpenEMR offers an open-source framework that can be extensively tailored to meet individual practice needs, providing both on-premises and cloud-hosted deployment options. It offers various features, including electronic prescribing, medical billing, patient scheduling, and a customizable patient portal.

OpenEMR Vs Practice Fusion: At A Glance

Features	Practice Fusion	OpenEMR
Practice Management	✓	✓
Revenue Cycle Management	✓	✗
Voice Recognition	✗	✗
Interoperability	✓	✓
Telehealth	✓	✓
Chart Retrieval Service	✓	✗
Predictive Scheduler	✗	✗
Integrated Clearinghouse	✓	✓

Comparing Strengths And Weaknesses

Side-By-Side Feature Comparison

Electronic Prescribing

Practice Fusion delivers built-in electronic prescribing as part of its cloud-based platform, enabling providers to quickly send prescriptions, check for drug interactions, and manage refill requests without the need for separate installations. It also supports e-prescribing controlled substances (EPCS) and offers integrated medication management tools directly within the workflow, contributing to greater ease of use.

Whereas OpenEMR offers electronic prescribing through third-party integrations, allowing providers to send prescriptions electronically to pharmacies nationwide. Its ePrescribe solution supports controlled substances (EPCS), formulary checks, and medication history retrieval. However, it typically requires an additional subscription and additional configuration to activate, which can introduce added complexity for practices.

Winner: Practice Fusion wins for offering a seamless, fully integrated e-prescribing solution with fewer setup requirements.

Patient Scheduling

Practice Fusion provides a streamlined online patient scheduling system that allows patients to request appointments via a secure booking page. It offers ‘Online Check-In' for patients to fill out customizable intake forms online, which automatically flow into their chart notes. It saves time and provides more accurate information about a patient’s health history.

On the other hand, OpenEMR offers a detailed scheduling module featuring color-coded calendars, support for multiple facilities, recurring appointments, and drag-and-drop functionality. The system includes a ‘Patient Flow Board’ to track real-time patient status and integrates SMS and email notifications for appointment reminders. The calendar is highly configurable and supports resource-based scheduling for rooms, providers, and equipment.

Winner: OpenEMR stands out due to its more efficient and customizable scheduling capabilities, which are tailored for multi-provider and multi-facility environments.

Telehealth

Practice Fusion offers telehealth via a third-party platform called Updox. The feature allows in-practice messaging to enhance communication between patients and practitioners. It also helps improve patient engagement using HIPAA-compliant text messaging, video chats, and appointment reminders.

OpenEMR offers telehealth through its Comlink Telehealth Module, allowing practices to conduct HIPAA-compliant video visits integrated directly within the EHR. Providers can schedule, initiate, and document telehealth sessions without leaving the OpenEMR interface. The module supports customizable video room settings and patient notifications.

Winner: OpenEMR wins for its extensive features and customizable settings, making it easy to adapt.

Patient Portal

Practice Fusion delivers a cloud-based patient portal that enables patients to view health records, lab results, and medication lists, as well as send secure messages to providers. It also offers tools for patient adherence, encouraging engagement with care plans and improving treatment outcomes. The portal is integrated directly into Practice Fusion’s interface, promoting ease of use without complex setup.

OpenEMR provides a patient portal that allows patients to securely access medical records, review lab results, request appointments, and communicate with providers. It offers the flexibility to customize portal features to align with individual practice workflows and integrates seamlessly with OpenEMR’s clinical data.

Winner: Practice Fusion edges ahead due to its seamless integration, patient engagement tools, and user-friendly experience requiring minimal technical setup.

Pricing Plans For Practice Fusion And OpenEMR

Practice Fusion offers a straightforward pricing structure, starting from $199/provider/month* with a required annual commitment. This model also includes three signing staff licenses and unlimited non-signing staff licenses.

On the other hand, OpenEMR is an open-source free software that doesn’t require businesses to pay any fee for downloading, using, or customizing.

Overall, if your practice requires an affordable open-source platform, then OpenEMR can be an ideal choice. However, for practices that have a budget and need an EHR with an integrated billing system, Practice Fusion can be a great fit.

*Disclaimer: Pricing is subject to change.

What Users Have To Say?

Practice Fusion earns praise for its ease of use, cloud accessibility, and quick patient check-in process. Users often highlight its intuitive layout, making it suitable for independent practices seeking minimal IT maintenance. Many users have also found its access to patient information easy and hassle-free.

However, it has also received some criticism regarding its lack of an integrated practice management solution, which can require users to rely on third-party software. Additionally, others have reported that charting and notes can be time-consuming at times.

In contrast, OpenEMR is valued by many users for its flexibility and the ability to customize forms, templates, and workflows. It is mainly appreciated for being an open-source platform with a free subscription. Several users also find its customer support quite responsive and helpful during the setup process. While some also find the patient check-in process relatively seamless.

On the downside, multiple users have encountered issues with the insurance verification process. While some face challenges with reporting and accessing medical records.

Practice Fusion Vs OpenEMR: Which Platform Wins?

Choosing between Practice Fusion and OpenEMR ultimately comes down to your practice budget, requirements, and priorities for customization.

Practice Fusion excels in user-friendliness and rapid deployment. Its cloud-based infrastructure reduces the IT burden, while features like e-prescribing and a patient portal enhance daily workflows.

On the other hand, OpenEMR is a strong choice for practices seeking a highly flexible, open-source solution with extensive customization. It offers efficient scheduling tools and a powerful telehealth solution.

The choice, however, depends on aligning your EHR selection with practice size, technical capabilities, and operational goals to ensure smooth workflows and improved patient outcomes.


Monthly Price: Starts at $199/provider/month*	Monthly Price: Free
Best for: Cardiology, Orthopedics	Best for: N/A
Mobile App: N/A	Mobile App: N/A
Rating: 3.6	Rating: 4.2


PROS
Enhanced efficiency with dot phrases Ability to color-code the appointments Effortless medication and lab ordering	Customizable forms and templates Efficient patient check-in process Flexible third-party system integration
CONS
Automated check-in forms may not work Unreliable real-time authorization	Barcode may lack patient details Dispensing module usability issues

Practice Fusion Vs OpenEMR: A 2025 Comparison For Open-Source And Cloud-Based EHRs