Choosing an EHR as an Independent Practice: What the Vendor Data Shows

The question "which EHR is best" does not have a single answer, because the vendors are not all competing for the same buyer. A platform built to run a 60-provider multispecialty group and a platform built for a solo family physician are solving different problems: the first for interoperability across departments and health-system reporting, the second for a fast install, a predictable monthly fee, and support that does not require an IT department to escalate through. Vendor targeting, review-site data, and market-share reporting all point to a real split along practice size, and that split is the most useful way to organize a comparison.

Two vendors, Epic and Oracle Health, sit clearly on the health-system side of that split. A larger group — athenahealth, eClinicalWorks, NextGen Healthcare, Veradigm, Greenway Health, AdvancedMD, DrChrono, Tebra, and Practice Fusion — competes mainly for independent and small-to-mid-size ambulatory practices. Dentrix sits apart from both groups as a dental-specific platform. What follows groups vendors by that segmentation, using published pricing where a vendor discloses it, third-party estimates where it does not, and review scores from Capterra, Software Advice, and KLAS with source and review counts noted throughout.

Enterprise and health-system platforms

Epic

Epic's core market is hospitals, health systems, and large ambulatory groups. Independent practices reach Epic through two paths: Community Connect, where a practice buys into a host health system's existing Epic instance, or Garden Plot, an Epic-hosted SaaS product aimed at independent groups. Garden Plot fits practices of roughly 40 or more providers better than solo or small offices. Epic does not publish pricing. Third-party estimates put Garden Plot at roughly $2,000 or more per month plus around $10,000 or more in setup costs, with data migration running $5,000 to $20,000. In the 2025 Best in KLAS rankings, EpicCare Ambulatory scored 91.6 among health-system-owned practices and 91.0 among independent practices of 76 or more physicians, the top score in each category. KLAS's 2025 market report also found Epic gaining small health systems even as overall EHR sales declined industry-wide.

Oracle Health (formerly Cerner)

Oracle Health's market is also hospitals and health systems. Its CommunityWorks package adapts the Cerner Millennium platform for smaller or community hospitals, but it is not a product independent physician offices typically buy. KLAS's "Oracle Health 2025" report found the company has lost a substantial number of customers since Oracle's acquisition of Cerner, with a net loss of 56 hospitals and 14,676 beds in 2025, concentrated among small systems and moving mostly to Epic. CommunityWorks users cited weak training and slow support, with some noting unexpected charges, alongside some optimism about the recently added Clinical AI Agent. Oracle closed its $28.3 billion purchase of Cerner in June 2022, shipped the Clinical AI Agent in June 2024, and a breach of a legacy server came to light in February 2025.

Independent and small-to-mid-size ambulatory platforms

athenahealth (athenaOne)

athenahealth serves ambulatory practices of all sizes but shows its strongest KLAS results in the independent 11-75 physician segment, where it won 2025 Best in KLAS for both Ambulatory EMR (athenaClinicals, 86.5) and practice management (athenaCollector, 77.4). Pricing is not published; third-party estimates put it at 3-7% of net collections, with small practices landing toward the high end of that range. On Capterra, athenahealth scores 3.8 out of 5 across 912 reviews. Reviewers praise the integrated platform but raise recurring complaints about support response times, slowness and glitches, pricing that scales upward with collections, a click-heavy interface, and an onboarding period commonly cited at 60 to 90 days before staff reach proficiency. Bain Capital and Hellman & Friedman bought athenahealth for $17 billion in 2022. The company paid $18.25 million in 2021 to settle Department of Justice kickback allegations.

eClinicalWorks

eClinicalWorks targets mostly small and mid-size ambulatory practices, and it is one of the vendors in this comparison with pricing the vendor itself publishes: $449 per provider per month for EHR only, $599 per provider per month for EHR plus practice management, and revenue cycle management billed at 2.9% of collections, with no startup costs for practices of one to nine providers. Capterra scores it 3.3 out of 5 across 396 reviews. Complaints center on a high click count to complete routine tasks, offshore support that is hard to reach, updates that break existing features, and unexpected charges; reviewers praise its broad functionality at a comparatively low price and its patient-engagement tools. eClinicalWorks paid $155 million in 2017 to settle a Department of Justice False Claims Act case over misrepresenting its certification and paying kickbacks.

NextGen Healthcare

NextGen is ambulatory-only, split into NextGen Office for independent practices under 10 providers and NextGen Enterprise for practices of 10 or more. It runs as a cloud product hosted on AWS, and its pricing is not published; quotes are given case by case. On Capterra, NextGen Office scores 4.0 out of 5 across 1,284 reviews, with reviewers praising billing and claims workflows and cloud access, and complaining about inconsistent support, slowness and crashes around update cycles, limited customization, and a patient portal reviewers describe as unfriendly. NextGen Enterprise scores 4.2 out of 5, though on a much smaller base of 34 reviews. In the 2025 Best in KLAS rankings, NextGen appears only for its Behavioral Health Suite, at 77.7. Thoma Bravo took the company private in September 2023 at a $1.8 billion enterprise value.

Veradigm (formerly Allscripts)

Veradigm serves physician practices through Veradigm EHR, formerly sold as Allscripts Professional, and also sells payer and life-science data products; Practice Fusion operates as its small-practice subsidiary, covered separately below. On Capterra, Veradigm EHR scores 3.5 out of 5 across 66 reviews and Veradigm PM scores 2.9 out of 5 across 139 reviews. Reviewers report frequent downtime and crashes, slow performance, poor support, and contracts that make the platform hard to exit; they praise easy e-prescribing and organized charting. The company rebranded from Allscripts to Veradigm in January 2023, then failed to file its 2022 annual report and its 2023 quarterly filings, which drew a Nasdaq delisting notice in February 2024.

Greenway Health

Greenway sells Intergy and Prime Suite to ambulatory practices across specialties, available as either cloud (AWS-hosted) or server-based deployments. Software Advice scores Intergy 4.2 out of 5 across 102 reviews. Reviewers praise its billing and revenue-cycle strength and a quick learning curve for practice-management tasks, while complaints cover system slowness, clinical features that lag behind the billing side, uneven implementation training, and added costs for extra modules. Greenway paid $57.25 million in 2019 to settle Department of Justice allegations that it misrepresented its software's capabilities and paid kickbacks. Vista Equity Partners is the majority owner.

AdvancedMD

AdvancedMD targets small-to-mid-size independent and multi-specialty practices. Its pricing is not published by the vendor; third-party estimates put it around $429 per month for practice management alone, $729 per month for EHR plus practice management, and $999 per month with patient engagement tools added, with implementation running $0 to $6,000 or more, migration $800 to $5,000, and revenue cycle management at 4-8% of collections. Aggregated review scores put it at 3.7 out of 5 across 434 reviews. Reviewers praise real-time data access, integrated billing, and customization, and complain about glitches, downtime, slow performance, click-heavy reporting, and pricing some describe as a 30-50% premium over rival small-practice products. Global Payments sold AdvancedMD back to Francisco Partners for roughly $1.1 billion, in a deal that closed in December 2024.

DrChrono (EverHealth)

DrChrono targets independent practices and had roughly 4,600 practices and 13,000 providers on the platform at the time of its acquisition. It grew out of a 2011 iPad EHR and keeps a mobile-first design. Software Advice scores it 3.9 out of 5 across 492 reviews. Reviewers praise its intuitive layout and deep template customization, and report unresolved support tickets, slowness and glitches, appointment data that disappears, inaccurate financial reports, and weak scheduling. EverCommerce bought DrChrono for roughly $180 million in 2021.

Tebra (formerly Kareo and PatientPop)

Tebra targets independent practices up to roughly 10 providers and reports more than 140,000 providers on its platform as of 2025. Software Advice scores it 3.9 out of 5 across 1,380 reviews, the largest review base among the independent-practice vendors covered here. Reviewers praise the interface, the all-in-one design, and billing reliability, and complain about unexpected charges, data-export and early-termination fees, unresponsive support, and cumbersome billing workflows. Tebra formed in November 2021 from the merger of Kareo and PatientPop, passed a $1 billion valuation in 2022, and raised $250 million in December 2025 for work on AI automation.

Practice Fusion (a Veradigm subsidiary)

Practice Fusion targets small independent practices, and its pricing is also published rather than estimated: $199 per provider per month on an annual commitment, which includes three signing-staff licenses plus unlimited non-signing staff licenses, with a 14-day trial available. Software Advice scores it 3.7 out of 5 across 440 reviews. Reviewers praise easy charting and e-prescribing, and complain about long support waits, billing and scheduling features that lag behind its clinical strengths, added fees, and restrictive contracts. Allscripts bought Practice Fusion for $100 million in 2018; in January 2020 the company paid a $145 million Department of Justice penalty tied to kickbacks connected to opioid-prescribing alerts.

One more small-practice vendor belongs in this segment even without a full pricing and review breakdown: Elation Health won 2025 Best in KLAS for Small Practice Ambulatory EMR/PM in the 1-10 physician segment, with a score of 85.3, the award category most directly relevant to solo and very small independent practices.

Dental-specific: Dentrix

Dentrix, from Henry Schein One, does not compete with the ambulatory-medicine vendors above; it is dental-specific. Classic Dentrix runs on-premise on Windows, while Dentrix Ascend is the cloud version. Software Advice scores it 4.3 out of 5 across 378 reviews, the highest score of any vendor covered here. Reviewers praise easy navigation, a single platform covering scheduling, billing, claims, and imaging, and strong integration with imaging devices such as Dexis. Complaints cover disruptive updates, long support hold times, a dated interface, and reports that reviewers describe as weak or hard to export. Parent company Henry Schein suffered a cyberattack in October 2023 in which roughly 35 terabytes of data were reportedly exfiltrated.

What switching an EHR actually costs and takes

The most-cited academic figure on EHR implementation cost comes from Fleming et al., published in Health Affairs in 2011, based on 26 primary-care practices in north Texas. The study estimated an average implementation cost of roughly $162,000 for a five-physician practice, plus about $85,500 in first-year maintenance, and roughly 611 hours of staff preparation time, with physicians accounting for about 134 of those hours each. These figures predate current SaaS subscription pricing, but they remain the most detailed per-practice cost breakdown in the published literature.

A 2023 systematic review in the Journal of General Internal Medicine, covering 40 studies of EHR-to-EHR transitions, found that a transition "requires nearly every person in the organization to change how they do their work." The review grouped findings into four areas: data migration, effects on clinical care, provider experience, and patient experience, and it noted that the existing literature offers little prescriptive guidance for practices planning a switch.

Current market figures, compiled by Software Finder, put ongoing EHR subscriptions commonly in the $200 to $700 per provider per month range, training budgets at $20,000 or more, and implementation timelines of one to six months, with three to four weeks typically spent on planning alone before go-live.

Review data for individual vendors point to specific exit costs that sit outside the advertised subscription price. Tebra charges data-export and early-termination fees. eClinicalWorks charges for data retrieval on the way out. AdvancedMD's migration runs $800 to $5,000. Epic's Garden Plot migration runs $5,000 to $20,000. athenahealth reviewers commonly cite 60 to 90 days to reach staff proficiency after a switch, and the review data includes at least one solo-practice account of severe billing disruption during the cutover period.

Across vendors and studies, the same pain points recur: the quality and cost of data migration, the time staff need to retrain, a temporary drop in productivity while the new system beds in, and billing disruption during cutover itself. Contract terms, specifically termination and data-export fees, account for much of the cost that catches a practice by surprise after it has already signed.

What to ask a vendor before switching

Given how much of the cost of switching sits outside the advertised subscription price, a practice evaluating a new EHR should get a vendor to answer, in writing, before signing:

• What does full data migration cost, and does that figure cover historical clinical notes, billing history, and scanned documents, or only a subset of them?
• What are the contract termination and data-export fees if the practice needs to leave later, and how are those fees calculated?
• How many hours of staff training does the contract include, and how many additional hours does a practice of this size typically need before reaching normal productivity?
• Can the vendor provide references from current customers at the same practice size and specialty, not only larger flagship accounts?

The pattern across this data is consistent: vendor fit tracks practice size closely, and a review score or KLAS ranking earned in one size segment says little about performance in another. Checking which size segment a vendor's case studies and rankings actually describe, before comparing price or star ratings, filters out most of the wrong-fit options early in the search.