The verdict in three sentences
For a multi-site private clinic group, custom management software runs 60,000 to 140,000 EUR ex. VAT in 2026, delivered in 18 to 28 weeks. The non-negotiable line item is HDS-certified hosting (health data) plus documented GDPR compliance. The payback comes from the slot fill rate climbing from 85% to 93%, recovering tens of thousands of euros in revenue per site each year.
What a multi-site project really costs
A custom build stacks the technical core (authentication, per-site roles, synchronisation), the business modules and certified hosting. Here are 2026 orders of magnitude for a three-site group.
| Item | 2026 range (EUR ex. VAT) | Note |
|---|---|---|
| Scoping & multi-site UX | 6,000 – 14,000 | Workshops, journeys, mockups |
| Technical core & roles | 12,000 – 26,000 | Multi-tenant, per-site roles |
| Booking & shared calendar | 9,000 – 20,000 | Slots, resources, rooms |
| Light EHR & patient record | 12,000 – 30,000 | History, documents, timeline |
| Billing & third-party payer | 10,000 – 24,000 | e-billing, transmission, dunning |
| Cross-site reporting (BI) | 6,000 – 16,000 | Consolidated dashboards |
| Testing, training, migration | 5,000 – 10,000 | QA, cutover, data import |
| Build total | 60,000 – 140,000 | Depending on scope |
Annual maintenance then runs 15-20% of the build, i.e. 9,000 to 28,000 EUR ex. VAT/year.
HDS vs standard hosting: the game-changing line
Hosting health data requires an HDS-certified provider. The premium over standard cloud is real but bounded, and it covers you legally.
| Criterion | Standard hosting | HDS-certified hosting |
|---|---|---|
| Monthly cost (3 sites) | 250 – 500 EUR | 700 – 1,500 EUR |
| Health-data certification | No | Yes (mandatory) |
| Documented GDPR compliance | Partial | Full (registry, DPA) |
| Encrypted backups | Optional | Included, redundant |
| Contractual reversibility | Variable | Guaranteed |
| Liability during an audit | On you | Shared, traceable |
Budget 8,400 to 18,000 EUR/year for HDS hosting: plan it at scoping, not after.
The impact on fill rate
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The real gain is operational. A shared calendar, automated reminders and smart re-allocation of cancelled slots lift the fill rate.
| Metric | Before | After |
|---|---|---|
| Slot fill rate | 85% | 93% |
| Lost slots / week / site | 42 | 18 |
| No-show rate | 9% | 4% |
| Front-desk time / day / site | 3h30 | 1h45 |
Mini case study
Dr. Fabre, director of a 3-clinic private group in Lyon, runs 24,000 consultations/year per site at an average 55 EUR each. Lifting fill from 85% to 93% (+8 points) recovers roughly 1,900 consultations/year/site, i.e. 104,500 EUR of extra revenue per site. Across three sites, the annual gain exceeds 310,000 EUR. Against a 110,000 EUR build + 15,000 EUR/year HDS, the investment pays back in under six months.
FAQ
Is HDS hosting mandatory? Yes, as soon as you store personal health data on behalf of a professional. The 2026 premium is 8,400 to 18,000 EUR/year for three sites, but it protects you during a data-authority audit.
Can we keep existing software and connect it? Yes, via APIs and connectors. Budget 8,000 to 20,000 EUR ex. VAT depending on the number of integrations (calendar, accounting, e-billing).
How long to roll out all three sites? Between 18 and 28 weeks, with a pilot site first, then generalisation. Migrating historical data is the most sensitive step.
What maintenance budget should I plan? 15-20% of the build per year, i.e. 9,000 to 28,000 EUR ex. VAT, covering fixes, regulatory updates and support.
Is custom worth it versus an off-the-shelf tool? Beyond two sites and specific flows (third-party payer, consolidated reporting), custom pays off over 3-4 years, chiefly through the fill-rate gain.
Let's scope your project. Tell us your number of sites, priority modules (booking, EHR, billing) and 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.
