The verdict in three sentences
Stacking vertical licenses (scheduling, billing, records) costs ~35,000 EUR/year and fragments your data across 6 sites. A custom core at 55,000-95,000 EUR unifies multi-site scheduling, billing, and patient records on an interoperable HL7/FHIR base, on health-grade hosting. The ROI reads on two lines: 25-40% less administrative time and occupancy up 8-12% thanks to unified scheduling.
Build vs Buy: the 3-year comparison
'Buy' appeals with its low entry cost, but licenses stack site by site and data stays siloed.
| Item | Buy (vertical licenses) | Build (custom core) |
|---|---|---|
| Year 1 cost | ~35,000 EUR/yr | 55,000-95,000 EUR + hosting |
| Recurring cost | ~35,000 EUR/yr | Health hosting 400-800 EUR/mo |
| Maintenance / changes | Included but frozen | 16%/yr of build |
| Data | Siloed by tool | Unified across 6 sites |
| Interop HL7 / FHIR | Partial | Native |
| 3-year cumulative cost | ~105,000 EUR | 85,000-130,000 EUR |
| Optimized occupancy | No | +8-12% |
Over 3 years, the build matches then exceeds Buy in value — especially once the occupancy gain, absent from the license model, is factored in.
Health hosting, FHIR, and unified scheduling: the structural lines
For a multi-site group, three requirements structure the project and budget: health-grade hosting, FHIR interoperability, and unified scheduling.
| Requirement | 2026 detail | Budget impact (order of magnitude) |
|---|---|---|
| Certified health hosting | OVHcloud Healthcare, Azure | 400-800 EUR/mo |
| Interop HL7 / FHIR | Lab, imaging, national records | 8,000-16,000 EUR |
| Unified multi-site scheduling | Consolidated view of 6 centers | Included in build |
| Health data privacy | DPIA, register, DPO | 3,000-6,000 EUR |
| Centralized billing | Third-party payer, e-claims | Included in build |
| Supervision / SLA | 99.9%, on-call | 500-1,000 EUR/mo |
Unified multi-site scheduling is the occupancy lever: routing a patient to the first available slot across all 6 centers, rather than one, fills the calendars.
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Mini case study
Sophie, administrative director of a 6-center health group in Amsterdam, today runs 4 vertical licenses at ~35,000 EUR/year, with fragmented data and ~30% of receptionists' time spent on redundant admin. After a custom core at 78,000 EUR (health hosting 600 EUR/mo, maintenance 12,500 EUR/yr), admin time drops 32% and unified scheduling lifts occupancy by 9 points. On ~48,000 consultations/year at an average 22 EUR margin, 9 extra occupancy points represent ~95,000 EUR/year. The occupancy gain alone pays back the build in under 12 months.
FAQ
Why not stay on vertical licenses? Because they silo your data by tool and site, prevent a consolidated view, and bill each site separately. Across 6 centers, the cumulative cost matches a build while delivering less value.
Is FHIR interoperability essential? For a multi-site group linked to labs, imaging, and national records, yes. Budget 8,000-16,000 EUR for HL7/FHIR connectors, the line that avoids re-keying and firms up records.
How does unified scheduling raise occupancy? By routing each patient to the first available slot across all 6 centers. This smooths load and gains 8 to 12 occupancy points.
What's the real recurring cost? Health hosting 400-800 EUR/month plus maintenance at 16%/year of the build, i.e. ~12,500 EUR/year for a 78,000 EUR project. It's stable and predictable, unlike stacked licenses.
What's the timeline for 6 sites? Plan 14 to 20 weeks: scoping 3 weeks, development 8-12 weeks, FHIR connectors 2-3 weeks, testing and multi-site rollout 3-4 weeks.
Let's scope your project. Describe your sites, consultation volume, and lab/imaging connectors: we'll price a 55,000-95,000 EUR core on health-grade hosting. 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.
