Compare · Plugins and open-source systems
PixelCare and OpenEMR
A free, open-source electronic health record and practice management system, aimed mainly at outpatient practices and shaped around US billing and certification.
How OpenEMR is delivered
Installed on the clinic's own server or its own cloud account.
Its published price
Free to download and use. Hosting, set-up and support are the clinic's own cost or bought from third parties.
Its pricing page →On our 28 questions
OpenEMR’s website confirms 15 in full and 6 in part or as a paid add-on. PixelCare is built to answer all 28 in one product.
OpenEMR’s website →Worth knowing
What a buyer should check about OpenEMR.
Each point is from OpenEMR’s own material, read on 3 October 2026.
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Billing is built around US standards (X12 5010, CPT/HCPCS, UB-04, US clearinghouses).
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Twilio SMS reminders require copying modified PHP files into the install and setting up a cron job.
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Telehealth depends on the third-party Comlink module rather than core OpenEMR.
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The free fully hosted offer on the home page is only for U.S.-based providers; others host and run it themselves.
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Install on shared hosting involves manual database creation, collation matching and host IP settings, which the wiki says often trip users up.
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Side by side
All 28 questions.
“Not stated” means we found nothing either way on OpenEMR’s website. Check with the vendor before you decide.
| Capability | PixelCare | OpenEMR |
|---|---|---|
| Appointments by doctor | Yes Each doctor’s hours, slot length, leave and holidays | Yes Calendar with appointment categories, repeating events, open-slot search, colour coding, multiple facilities. Source |
| Patients book online | Yes Under the clinic’s own name, with booking rules | Yes Patient portal has an 'Allow Online Appointments' setting so patients can request or book visits. Source |
| Walk-ins and token queue | Yes Tokens, one queue, waiting-room screen | In part Patient Flow Board tracks arrival, room and status with alert timers; no token numbers found. Source |
| Reminders by SMS, WhatsApp or email | Yes In the clinic’s own words and sender name | Yes Email and SMS appointment notifications plus a recall board; some SMS gateways need code changes. Source |
| Visit record and vitals | Yes Structured record, vitals with trends, templates | Yes Encounters with vitals and growth charts, SOAP, review of systems, template-driven and custom forms. Source |
| Prescriptions | Yes Written from the pharmacy’s own shelf, printed or sent | Yes Create, print, fax, email or e-prescribe; e-prescribing relies on third-party services. Source |
| Lab and imaging orders | Yes Orders, results and abnormal-value flags | Yes Lab orders sent electronically with results filed into the chart; manual result entry also documented. Source |
| Phone and video visits | Yes Booked, noted and billed like any visit | Paid add-on Video visits via the Comlink Telehealth module, a third-party module; its cost was not found. Source |
| Billing, discounts and refunds | Yes Limits per role, part payments, credit | Yes Fee sheet, payment posting, adjustments and patient statements; built around US claim coding. Source |
| Online and card payments | Yes Local gateways, wallets, QR and card machines | In part Portal has an 'Allow Online Payments' option; the wiki page on card gateways is old and says still in development. Source |
| Company and insurer billing | Yes Agreed rates, monthly invoice, ageing | Yes X12 5010 claims, UB-04, clearinghouses, eligibility queries, EOB entry; designed for US insurers. Source |
| Doctor’s share and payouts | Yes Any arrangement, a ledger per doctor, payout runs | Not stated |
| Pharmacy stock by batch and expiry | Yes Earliest expiry first, never an expired batch | In part In-house dispensary tracks lots, expiry dates and warehouses; stock drops on dispensing; earliest-expiry-first not documented. Source |
| Pharmacy till | Yes Barcode, shifts, returns, works offline | Not stated |
| Suppliers and purchasing | Yes Orders, goods received, returns, supplier balances | In part Lot entries record purchases from vendors, returns and transfers; no purchase orders or supplier balances documented. Source |
| Full accounts inside the product | Yes Ledger, trial balance, profit and loss, balance sheet | Not stated |
| Reports | Yes Financial and operational, PDF and spreadsheet | Yes Appointments, encounters, prescriptions and dispensing, sales, collections, insurance, clinical quality measures. Source |
| Several clinics and branches | Yes Separate books, combined reports | Yes Multiple facilities in one install; a multi-site module also runs separate installs from one codebase. Source |
| Roles and permissions | Yes Per-person switches and money limits | Yes Fine-grained per-user access control objects plus role-based and custom menus. Source |
| The clinic’s own brand | Yes Name, logo, colours and web address on every screen | Not stated |
| Custom fields and forms | Yes On patient, booking and visit forms | Yes Customisable demographics, layout-based forms and form-creation tools. Source |
| Languages and right-to-left | Yes Per clinic, per user and per patient | Yes Over 30 languages, UTF-8, community translation sheet, and RTL support stated. Source |
| Works without internet | Yes Till and day list carry on; work posts itself later | Not stated |
| Mobile apps | Yes For patients, doctors and the desk | Not stated |
| API and integrations | Yes Documented interface and webhooks | Yes FHIR (US Core, SMART on FHIR), CCDA, Direct messaging, API for third-party portals. Source |
| Audit trail | Yes Permanent, with every record opening logged | Not stated |
| Export of all data | Yes Every list, restricted and logged | In part CCDA and FHIR exchange documented; general bulk export not checked. Source |
| Patient portal | Yes Bookings, receipts, prescriptions and results | Yes Appointments, secure messaging, online payments, forms, self-registration, labs, medications, allergies, document download. Source |
Also compared: KiviCare, Bahmni, Odoo with basic_hms. See every product in one table.
See what PixelCare does that OpenEMR does not.
The live demo is a working clinic with sample patients, stock and seven weeks of history. Enter as the owner, the receptionist, the doctor, the pharmacist or a patient.