The verdict in three sentences
For a Montreal private clinic, a vertical SaaS (40-90 CAD/user/mo) launches fast but hits a ceiling once multi-practitioner scheduling, billing and patient flows leave the standard mold. Custom software (60 000-130 000 CAD) becomes worthwhile past 8 practitioners, multiple specialties and clinic-specific admin workflows. In both cases, Law 25 compliance is non-negotiable: patient data governance, consent and breach notification are legal obligations in Quebec.
Vertical vs custom: the real comparison
Vertical vendors bill a subscription per practitioner or per site. Custom is an upfront investment followed by maintenance. Here are 2026 orders of magnitude for a mid-sized clinic.
| Criterion | Vertical SaaS | Custom |
|---|---|---|
| Upfront cost | 0 to 6 000 CAD (setup) | 60 000 to 130 000 CAD |
| Monthly cost | 40 to 90 CAD/practitioner | Maintenance 15-18 %/yr of build |
| Time to go live | 2 to 6 weeks | 5 to 8 months |
| Compliant hosting | included | 1 100 to 3 400 CAD/mo |
| Scheduling customization | limited | total |
| Code ownership | no | yes |
| Integrations (lab, LIS, accounting) | standard connectors | custom |
For 10 practitioners, a vertical runs 4 800-10 800 CAD/mo, or 58 000 to 130 000 CAD over 3 years excluding add-ons. Custom amortizes once cumulative subscriptions exceed the build cost.
What the functional scope must cover
A full clinic system is more than a calendar. Here are the modules to price, with a 2026 order-of-magnitude development effort for custom.
| Module | Effort (days) | Indicative cost (CAD) |
|---|---|---|
| Multi-practitioner and room scheduling | 15 to 25 | 12 000 to 20 000 |
| Electronic patient record (EPR) | 20 to 35 | 16 000 to 28 000 |
| Online appointment booking | 10 to 15 | 8 000 to 12 000 |
| Automated SMS/email reminders | 5 to 8 | 4 000 to 6 400 |
| Billing and third-party payer | 15 to 25 | 12 000 to 20 000 |
| Secure patient portal | 12 to 18 | 9 600 to 14 400 |
| Management dashboard | 8 to 12 | 6 400 to 9 600 |
The SMS reminders module is often the fastest payback: it attacks no-shows, a clinic's top revenue leak.
Mini case study
Dr. Tremblay, director of a multidisciplinary clinic in Montreal (11 practitioners, 3 500 appointments/mo), invests 92 000 CAD in custom software plus 1 900 CAD/mo hosting and maintenance. Over 8 months: slot fill rises from 71 % to 85 % (+14 points), about 490 extra appointments monthly. The front desk saves 12 h/mo through online booking, and SMS reminders cut no-shows by 30 %. At an average 70 CAD per recovered visit, gross monthly gain exceeds 19 000 CAD, so the investment pays back in under 7 months.
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FAQ
Is compliant hosting really mandatory?
Yes. Under Quebec's Law 25 and health data rules, patient data must be hosted with appropriate safeguards and, ideally, in-jurisdiction. Budget 1 100 to 3 400 CAD/mo depending on volume and redundancy.
How long to deploy custom software?
Between 5 and 8 months for a full scope (scheduling, EPR, billing, portal). An MVP focused on scheduling and reminders can ship in 3 months to deliver value faster.
Can we keep an existing booking tool?
Yes, via API. Many clinics keep their booking channel for acquisition and connect the rest (EPR, billing, analytics) to a custom core. Budget 8 000 to 13 000 CAD for the integration.
What annual maintenance should we plan?
Maintenance of 15 to 18 % of build cost per year, or 9 000 to 23 000 CAD/yr for a 60 000-130 000 CAD project. It covers fixes, regulatory updates and support.
Does Law 25 change the project scope?
Yes: consent, access logging, encryption, retention limits and the right to erasure must be built in from design. Allow 5 to 10 % of budget for compliance.
Let's scope your project. Tell us about your clinic (practitioner count, specialties, appointment volume, hosting and billing needs) and we will define a scope with 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.
