“Free EHR” and “Bahmni” go together in a lot of Indian clinic searches, and the licence really is free. Bahmni is open source under the AGPL, with no per-doctor fee. But free-to-licence isn’t free-to-run: you pay in hosting, implementation, staff training, and ongoing support, and Bahmni doesn’t include AI documentation, so you still write every note yourself. An AI-native EHR flips that trade. Patient Square bundles the AI Copilot EHR with an ambient scribe at ₹2,399 per doctor per month, ex-GST, with no infrastructure to manage. The India pricing is one click away.
So the real question isn’t “free versus paid.” It’s whether you’d rather own and run the system, or subscribe and have the documentation done for you. Both cost money. They just cost it in different places.
Key takeaways
- Bahmni’s licence is free (open source, AGPL), but hosting, setup, training, and support are real recurring costs, per Bahmni’s own FAQ.
- A real Bahmni implementation is a project. Open-source EHR deployments commonly run consultant-led installs in the ₹4 to ₹15 lakh range, plus config and hosting.
- Bahmni has no AI scribe or ambient documentation. You still write every note yourself.
- Patient Square bundles an AI EHR and ambient scribe at ₹2,399/doctor/mo, annual, ex-GST, with no setup fee and no hosting to run.
- Bahmni wins for hospitals wanting self-hosted control with technical staff; an AI-native EHR wins for clinics whose drain is documentation time.
Bahmni software licence (open source, AGPL)
Typical consultant-led open-source EHR implementation, plus hosting and support (estimate)
Patient Square Copilot: bundled AI EHR + scribe, per doctor, annual, ex-GST
What does “free” mean with Bahmni?
The licence, and only the licence. Bahmni is a mature open-source EMR and hospital-information system, built on OpenMRS and proven across many countries and hundreds of sites. Under the AGPL there’s no software licence fee, which is a genuine advantage over subscription EHRs. Per Bahmni’s FAQ, the software is free, but anyone may charge for implementation services, and that second half is where the money goes.
Running Bahmni means someone installs it, configures it to your workflows, hosts it (cloud or on-premise), trains your staff, and supports it through upgrades. For most clinics that’s an implementation partner with an invoice. A hands-on hospital IT team can do it in-house, trading cash for staff time. Either way, the licence being ₹0 tells you almost nothing about what the system costs to operate.
If your reason for looking at free EHRs is the documentation burden rather than the licence line, book a demo and see what an ambient scribe removes that a records system doesn’t touch.
What does Bahmni really cost to run?
Budget for a project, not a subscription. Precise numbers depend on scope and who does the work, so treat these as estimates: consultant-led installation of an open-source EHR commonly falls in a rough ₹4 to ₹15 lakh range for a real deployment, with configuration and customization on top and ongoing hosting and support after that. A 50-bed hospital’s Bahmni go-live is typically a one-to-two-month implementation, per Bahmni’s own guidance, not a same-day signup.
Here’s the honest cost shape, Bahmni versus a bundled AI EHR:
| Cost line | Bahmni (self-hosted, open source) | Patient Square (AI-native, cloud) |
|---|---|---|
| Software licence | ₹0 | Included in subscription |
| Setup / implementation | ₹4-15L (consultant) or your team’s time | ₹0 (no setup fee) |
| Hosting | You provision and pay for it | Included |
| Ongoing support / upgrades | Paid partner or in-house staff | Included |
| Recurring price | Hosting + support, ongoing | ₹2,399/doctor/mo, ex-GST |
| AI documentation | None | Ambient scribe included |
The DIY column can look cheaper in cash if you have the technical skill and the time. It rarely stays cheaper once you count the hours. And none of it buys you the one thing an AI-native EHR includes by default: a scribe that writes the note.
What does Bahmni not do?
Documentation. Bahmni stores and organizes records well; it doesn’t reduce the time you spend creating them. Its FAQ describes no ambient scribe or AI documentation feature, and that’s not a knock, it’s just a different category of tool. With Bahmni, every note is still yours to type or dictate, patient after patient.
An AI-native EHR is built around closing exactly that gap. AI Medical Scribe by Patient Square is one module inside Practice Copilot: it listens during the visit and hands back a structured SOAP note, ICD-10 suggestions, and a prescription draft, ready to review and sign about two minutes after the visit. The record that scribe produces lives in the bundled AI Copilot EHR, so the documentation and the storage are one system, not two you have to wire together.
That matters against the NMC’s 2023 conduct rules, which expect outpatient records kept for three years and produced within days on request. A records system helps you store the note. An AI-native EHR helps you actually write it, on a two-minute Tuesday and a hundred-patient one alike. For the broader free-versus-paid picture, our honest look at free EMR software covers OpenEMR and others too. And if you want to understand what the paid EHR market in India actually costs before you commit to the free route, EHR software cost guide names every setup fee and AMC that rival vendors bury in their quotes. For the hospital-side picture specifically, HMS software cost in India decodes what a full quote-only hospital system really runs.
What does the AI-native EHR cost?
Published and flat, with the documentation included. Patient Square’s bundled AI Copilot EHR ships in the Copilot plan at ₹2,399 per doctor per month, annual, ex-GST. No setup fee, no hosting to run, no implementation project.
| Plan | Price (annual, per doctor, ex-GST) | With 18% GST | EHR included? |
|---|---|---|---|
| Assist | ₹1,599/mo | ₹1,887/mo | No, scribe + scheduling only |
| Copilot | ₹2,399/mo | ₹2,831/mo | Yes, bundled AI Copilot EHR |
| Autopilot | ₹3,999/mo | ₹4,719/mo | Yes, plus receptionist and follow-ups |
You’re paying a recurring subscription in exchange for zero infrastructure work and an ambient scribe. Confirm current figures on the pricing page. One honest note on our side: ABDM integration is on our roadmap, not live yet. If ABHA linking is a hard requirement today, factor that in. Our cloud versus on-premise guide weighs the hosting question in more depth.
When is Bahmni the better choice?
When you want to own the system and can support it. A hospital or large clinic with technical staff, a preference for self-hosting, and a real value on open-source flexibility and no licence fee is exactly who Bahmni is built for. It’s proven at national scale in several countries, it handles records, labs, and hospital operations in one stack, and the control it gives is genuine. If customization and ownership matter more to you than AI documentation, and you have the hands to run it, Bahmni is the right call, not a compromise.
Choose an AI-native EHR when documentation time is your bottleneck and you’d rather not run infrastructure at all. A solo doctor or small clinic that wants records plus an ambient scribe, no hosting to manage, and a price on a page is better served by the bundle. You give up self-hosting control. You get a note drafted from every consult and your evenings back.
How to decide in a week
- Decide who runs your infrastructure. If you have technical staff and want ownership, Bahmni is viable. If you don’t, a cloud subscription removes the whole question.
- Price Bahmni as a project: get an implementation partner’s quote for setup, hosting, training, and annual support in writing. Add them up.
- Ask the question free-versus-paid hides: does the system write the note, or just store it?
- If documentation is your real drain, trial an AI-native EHR on real visits and watch the note quality.
- Confirm Patient Square’s current price and GST on the pricing page, then book a short demo to see the bundled EHR and scribe together.
The security and data-ownership receipts are on the security page. Notes belong to the clinic; export or delete any visit anytime. Free-to-licence is a real advantage if you can run the system. If your problem is the time you spend writing notes, that’s the one thing the free option leaves on your desk.