“Free clinic management software” can mean source code you operate, an ongoing free tier, a temporary trial, or programme software with eligibility rules. Only the first two can remain free after evaluation, and neither makes the clinic’s operating cost zero.
Decision summary
- Open-source licence cost and total operating cost are different questions.
- A trial is not a free plan; read the current first-party pricing page.
- Keep hosting, implementation, backup, support, and labour as separately quoted lines.
- Patient Square’s 7-day free trial lets a clinic test documentation on its own workflow before choosing a paid plan. Assist is ₹1,599 per clinician as the monthly equivalent on annual billing, ex-GST plus 18% GST.
Open-source licence can be zero; operating cost still needs a written quote
Patient Square free trial before choosing a paid Practice Copilot plan
Cost rows in the operating-cost worksheet below
Sources: OpenEMR, Bahmni, Practo Ray, KiViHealth, and Patient Square first-party pages, checked 11 August 2026.
Four different meanings of free
Start by naming the model. A search result can put open-source code, a capped free tier, a trial, and programme software in the same list even though their costs and access rules differ.
Open source can remove the proprietary licence fee for the core code. It does not provide a maintained clinic service by itself. Two current examples are:
| Project | First-party description used here |
|---|---|
| OpenEMR | Open-source medical-record and practice-management project |
| Bahmni | Open-source hospital and clinic system with a wider operational footprint |
Trials are temporary access to a paid product. Practo Ray, KiViHealth, and Patient Square each publish a seven-day trial on the referenced first-party pages. A trial can be useful, but it is not an ongoing free plan.
Free tiers are ongoing hosted access within published caps. Programme software depends on eligibility, scope, rollout, and support. Keep those two categories separate from open source and trials.
| Label | What you receive | What happens after evaluation |
|---|---|---|
| Open source | Code under an open-source licence | You or a partner operate, secure, update, and support it |
| Free tier | Ongoing hosted access within stated caps | You stay inside the limits or move to a paid tier |
| Free trial | Temporary access to a paid product | Access expires or converts according to the terms |
| Programme software | Access subject to eligibility and programme scope | Rollout, support, and limits follow the programme rules |
Current trials are paid products
The following first-party pages were checked on 11 August 2026:
| Product | Trial | Paid price signal |
|---|---|---|
| Practo Ray | Seven days | CM Atom ₹999 per month and Clinic Management ₹1,499 per month on one-year plans |
| KiViHealth | Seven-day trial | ₹12,000 plus GST for one year |
| Patient Square | Seven days | Assist ₹1,999 month to month or ₹1,599 monthly equivalent on annual billing per clinician, plus 18% GST |
Use synthetic data first. Decide whether the paid economics work before importing patient history.
Test coverage instead of assuming it
Do not infer the exact clinic workflow from the project name. Ask the implementation owner to demonstrate registration, scheduling, notes, prescriptions, billing, reports, downtime, backup, restore, and bulk export on the version you would deploy. A module listed on a project page is not proof that it is configured for your clinic.
Keep integrations equally specific. Ask for the exact ABDM milestone and production status, not an “ABDM-ready” badge. Patient Square’s ABDM integration is roadmap-only and must not receive credit for a live workflow.
Our free EMR software guide goes deeper on OpenEMR versus Bahmni specifically, and the EMR software buyer guide covers the cloud-versus-on-premise and DPDP Act 2023 decisions that sit underneath any clinic system, free or paid.
The real operating-cost sheet
The licence can be zero. Total cost depends on work that must be owned and priced. Use this sheet for a self-hosted option, a managed open-source offer, and a hosted subscription:
| Cost row | Year one | Later annual | Owner | Evidence |
|---|---|---|---|---|
| Licence or subscription | ||||
| Hosting, domain, certificates, storage | ||||
| Installation and configuration | ||||
| Data cleaning and migration | ||||
| Forms, templates, masters, roles | ||||
| Messaging, payment, lab, other interfaces | ||||
| Security review and patching | ||||
| Backup, restore test, disaster recovery | ||||
| Training and user support | ||||
| Upgrade testing and correction | ||||
| Internal doctor and staff time | ||||
| Export, termination, transition | ||||
| GST and other applicable tax |
Unknown is not zero. Keep it visible until a vendor, implementation partner, or named employee supplies the answer.
Test the exit before the import
Ask for a sample export before loading live data. Check patient identity, encounters, notes, authorship, prescriptions, attachments, appointments, billing data if used, and audit information. Find out which fields remain structured, which arrive as documents, and how bulk export works.
Then test a restore. A backup file that nobody has restored is not continuity evidence. Record the recovery time, missing fields, responsible person, and correction process.
The operating-owner decision
Open source is sensible when a named technical owner can operate it, the clinic values deployment control, and the buyer has budgeted implementation and continuity. It is a poor shortcut when the clinic expects community code to arrive with local configuration, support, security, migration, and a contractual recovery time.
Run a peak-day acceptance test. Time registration, note completion, prescription review, billing correction, backup, restore, and export. The result is evidence for your own clinic; a universal patient-volume threshold is not.
A documentation layer alongside free software
You don’t have to choose between free records software and complete notes. They solve different problems, and they stack.
Practice Copilot’s AI Medical Scribe drafts a structured SOAP note, ICD-10 suggestions, and a prescription draft for clinician review. A clinic can use Patient Square EHR from the Copilot tier or keep its existing record system and run Practice Copilot alongside it.
The prescription is a draft, not a pharmacy transmission. Visit audio is processed in memory and discarded when the note is drafted. The product lists EHR-ready export (PDF · HL7 · FHIR); that is an export claim, not certified interoperability or automatic write-back. Patient Square’s ABDM integration remains roadmap-only.
Practice Copilot’s Assist tier is ₹1,999 per clinician month to month or ₹1,599 monthly equivalent on annual billing, ex-GST plus 18% GST. Put that paid row beside the buyer-entered operating costs above. The seven-day trial is for testing the workflow, not evidence that Patient Square is free software.
A one-pass decision
Three questions get most clinics to an answer without a month of vendor calls.
Can someone on your staff install, update, secure, back up, restore, and support the system? If not, obtain a managed-service quote before calling the open-source path free.
What breaks on your busiest day? Test the exact workflow. If documentation is the bottleneck, compare a documentation layer alongside the record system you keep.
Is ABDM linking a near-term need? If live ABHA record sharing is a near-term need, ask the vendor to demonstrate the exact production transaction, consent flow, failure path, and audit evidence. Patient Square’s ABDM integration remains roadmap-only.
Sort those out and the choice mostly makes itself. If your real problem is thin notes on a busy OPD, test the documentation workflow alongside the record system you keep. Start your 7-day free trial or read the pricing first.