The verdict in three sentences
A health group whose specialties do not fit a vendor's boxes can commission a custom electronic health record (EHR) for 60,000-150,000 EUR. The premium over a specialised vendor is justified by fitting real care pathways and by owning the system, but it demands absolute rigour on security, traceability and HL7/FHIR interoperability. Certified health-data hosting and national-record links are not optional: they shape the budget from scoping.
What a custom EHR is made of
An EHR is not just another database: it is the clinical nervous system. Every block must be traced, secured and interoperable to talk to the lab, imaging and national registries.
| Clinical block | Detail | Range |
|---|---|---|
| Structured medical record | History, allergies, notes | 15,000-35,000 EUR |
| Prescribing & medication | Decision support, interactions | 12,000-28,000 EUR |
| HL7/FHIR interoperability | Lab, imaging, national record | 15,000-35,000 EUR |
| Access rights & traceability | Logs, GDPR, consent | 8,000-18,000 EUR |
| Reports & documents | Templates, signature | 6,000-15,000 EUR |
| Patient portal / sharing | Secure document access | 8,000-20,000 EUR |
Add certified hosting (1,500-3,500 EUR/month by redundancy) and 6-12 months for a full EHR, delivered by modules to secure clinical adoption.
Custom vs specialised vendor
A specialised vendor covers a specialty's standard fast; custom wins as soon as the group combines specialties or wants to steer its own roadmap without depending on an external one.
| Criterion | Specialised vendor | Custom EHR |
|---|---|---|
| Upfront cost | 20,000-60,000 EUR | 60,000-150,000 EUR |
| Subscription / maintenance | 1,500-6,000 EUR/mo | 12,000-25,000 EUR/yr |
| Pathway fit | Limited | Total |
| HL7/FHIR interoperability | Vendor-dependent | Native, controlled |
| Code ownership | No | Yes |
| Implementation time | 3-6 months | 6-12 months |
| Vendor lock-in | High | Low |
The right instinct: reserve custom for organisations whose value lies in specific pathways or deep IT integration. Elsewhere, the vendor stays faster and lower-risk.
Need a professional website?
Kolonell builds websites that attract clients, optimized for the Sénégalese market. Free quote in 2 minutes.
Mini case study
Dr Renaud runs IT for a 3-clinic group (cardiology, imaging, surgery) and pays 5,000 EUR/month for a vendor EHR that cannot handle cross-site pathways. Over 5 years that subscription is 300,000 EUR with no ownership or adaptation.
He opts for a custom EHR at 120,000 EUR, plus 20,000 EUR/year maintenance and 30,000 EUR/year certified hosting. Over 5 years: 120,000 + 100,000 + 150,000 = 370,000 EUR, slightly higher, but with a system that eliminates inter-clinic double entry (estimated at 1,500 h/year, ~52,000 EUR/year) and returns control of the roadmap. Custom becomes clearly the winner from year 2.
FAQ
What does a custom EHR cost in 2026? From 60,000 to 150,000 EUR depending on specialty count, interoperability level and patient portal. Add certified hosting (1,500-3,500 EUR/month) and annual maintenance.
What does HL7/FHIR interoperability bring? It lets the EHR talk to the lab, imaging and national registries, avoiding re-keying and securing continuity of patient data. It is a prerequisite, not an option.
Is certified hosting mandatory for an EHR? Yes, without exception once health data is hosted for a third party. The certified host and redundancy level drive the monthly cost.
How long to deploy? Expect 6-12 months for a full EHR, delivered by modules. Phasing enables a progressive go-live and controlled clinical adoption.
Custom or vendor, how to decide? If your pathways are standard, the vendor is faster. If your value lies in specific pathways or deep IT integration, custom pays back and makes you independent.
Let's scope your project. Detail your specialties, interoperability needs (lab, imaging, national record) and data volumes, and we will frame a custom EHR, hosting and an indicative budget. 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.