The verdict in three sentences
For a group of doctors in Dublin, the question is no longer "do we need a booking and teleconsultation tool" but "do we rent or own it". A platform costs 110 to 330 EUR/practitioner/month, a bespoke tool 40 000 to 100 000 EUR once. Beyond 8 to 10 practitioners, bringing it in-house pays off within 3 years while removing commissions and keeping control of health data.
Rent vs own: the 3-year calculation
The trap with platforms is the per-head cost that swells with every new practitioner. Here are the 2026 orders of magnitude for a 10-practitioner group.
| Item | SaaS platform | Bespoke |
|---|---|---|
| Initial cost | 0 - 2 200 EUR | 40 000 - 100 000 EUR |
| Monthly cost (10 practitioners) | 1 100 - 3 300 EUR | Hosting 330 - 780 EUR |
| 3-year cost | 40 000 - 120 000 EUR | 52 000 - 128 000 EUR |
| Commission per teleconsultation | 0 - 1.70 EUR | 0 EUR |
| Patient data ownership | Shared | You |
| Pathway customisation | Limited | Full |
From the 3rd or 4th added practitioner, the gap in favour of bespoke widens, because its marginal cost per user is near zero.
The hidden gain: fewer missed appointments
The real return of a booking tool comes not from the licence price but from lower no-shows. A well-designed automatic reminder cuts missed appointments by 20 to 35 %.
| Lever | 2026 effect (order of magnitude) | Financial impact |
|---|---|---|
| SMS + email reminder D-1 | No-show -30 % | Recovered slots |
| One-click confirmation | -10 % late cancellations | Better fill rate |
| Automatic waiting list | +5 to 8 % fill rate | Recovered revenue |
| Integrated teleconsultation | +12 % capacity | New encounters |
| Cost of a no-show (visit) | 55 - 65 EUR lost | Multiplied by volume |
For a practice running 6 000 consultations a year with 12 % no-shows, moving to 8 % means 240 recovered slots, roughly 14 000 EUR a year per practitioner.
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Mini case study
Dr Byrne runs a 9-doctor group in Dublin paying 2 400 EUR/month for a platform, i.e. 28 800 EUR a year, plus 1.40 EUR commission per teleconsultation (about 5 500 EUR/year). By bringing it in-house with a bespoke tool at 68 000 EUR (hosting 520 EUR/month), the group removes commissions and freezes the per-practitioner cost. Net annual savings: around 27 000 EUR from year 2, full payback in 30 months, with the no-show rate cut from 13 % to 8 % thanks to automatic reminders.
FAQ
Isn't a platform simpler? At the start yes, but its cost grows linearly with practitioner count and you control neither the data nor the patient pathway. Bespoke reverses this logic from 8 to 10 practitioners.
Is teleconsultation data sensitive? Yes, it is health data: hosting must be compliant and secure (330 to 780 EUR/month), with end-to-end encryption of video consultations.
How long to build the tool? Expect 3 to 5 months for a booking + teleconsultation + reminders core, including integration with your calendars and existing medical software.
Do reminders really cut no-shows? Yes, a well-configured SMS + email setup cuts missed appointments by 20 to 35 %, which is often the main return on investment.
Can we keep our current medical software? Yes, the tool connects via API to your existing patient record; integration is priced separately (5 000 to 15 000 EUR depending on the software).
Let's scope your project. Tell us your practitioner count, current platforms and consultation volumes, and we will compare rent vs own with hard numbers. Detailed quote within 48 h. WhatsApp +221 77 596 93 33.
Mohamed Bah
Fondateur, Kolonell
Passionate about digital and entrepreneurship in Africa, Mohamed has been helping Sénégalese businesses with their digital transformation since 2020. Founder of Kolonell, he believes every SME deserves a professional and accessible online présence.