The verdict in three sentences
For a 4-modality imaging centre, the real cost is not the software but the lost MRI and CT slots: at a 25% no-show rate, the loss often exceeds EUR 30,000 per month. An off-the-shelf RIS (EUR 20,000 to 60,000) covers the radiology record, but rarely an exam-specific online booking flow with preparation and smart reminders. A custom module at EUR 30,000 to 60,000 excl. VAT, connected to your RIS and hosted on HDS-certified infrastructure, ships in 4 months and usually pays for itself in under six months.
Off-the-shelf RIS or custom module: what each option covers
The RIS (Radiology Information System) remains the backbone: patient record, DICOM worklist to the modalities, dictation and reports, billing. The problem sits upstream. Generic booking platforms do not know that a knee MRI takes 20 minutes, that an arthro-CT needs a radiologist slot, or that a contrast MRI requires a recent creatinine test.
| Criterion | Off-the-shelf RIS only | RIS + generic booking tool | RIS + custom module |
|---|---|---|---|
| Upfront cost | EUR 20,000 to 60,000 | + EUR 0 | + EUR 30,000 to 60,000 excl. VAT |
| Recurring cost | EUR 800 to 2,500 / month | EUR 129 to 199 / practitioner / month | EUR 400 to 900 / month (HDS hosting + SMS) |
| Durations per exam and modality | Internal settings | No | Yes, per protocol |
| Preparation questionnaire (MRI contraindications, pregnancy, iodine allergy) | No | Partial | Yes, blocking before confirmation |
| SMS reminders D-2 and D-1 with confirmation | Paid option | Yes, basic | Yes, with follow-up and automatic slot release |
| Waiting list and cancellation backfill | No | No | Yes |
| Implementation time | 3 to 6 months | 2 weeks | 4 months |
The real cost of no-shows
The maths is harsh. An MRI bills around EUR 150 to 250 all-in (procedure fee, technical fee, possible supplement), a CT scan around EUR 100 to 180. Every empty slot on a machine worth more than a million euros is a pure loss.
| Modality | Planned exams / day | Average revenue per exam | Loss at 25% no-shows / month (21 days) | Loss at 8% / month |
|---|---|---|---|---|
| MRI | 32 | EUR 200 | EUR 33,600 | EUR 10,750 |
| CT | 40 | EUR 140 | EUR 29,400 | EUR 9,400 |
| Ultrasound | 45 | EUR 60 | EUR 14,175 | EUR 4,535 |
| X-ray | 70 | EUR 30 | EUR 11,025 | EUR 3,530 |
| Total | 187 | EUR 88,200 | EUR 28,215 |
These are 2026 orders of magnitude to adjust with your own revenue. Not every lost slot can be recovered, but an SMS reminder with mandatory confirmation and an active waiting list commonly bring the no-show rate below 8 to 10%.
HDS compliance and technical architecture
In France, any health data hosted on behalf of a third party must sit with an HDS-certified host (OVHcloud, Scaleway, Outscale, AWS or Azure certified French regions). Budget EUR 250 to 600 per month for a booking module's infrastructure. The module does not replace the RIS: it pushes confirmed appointments through an HL7 interface or an API and pulls available slots back.
| Component | Recommended choice | Indicative 2026 cost |
|---|---|---|
| Hosting | HDS-certified cloud, France | EUR 250 to 600 / month |
| RIS interface | HL7 v2 or vendor API | EUR 6,000 to 15,000 excl. VAT (one-off) |
| Transactional SMS | French operator | EUR 0.045 to 0.07 per SMS |
| Patient authentication | SMS code + date of birth | Included |
| Logging and traceability | Access logs kept at least 1 year | Included |
| Pentest before go-live | External provider | EUR 4,000 to 8,000 excl. VAT |
Mini case study
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Dr Laurent, partner radiologist at a centre in Nantes equipped with an MRI, a CT scanner, two ultrasound rooms and an X-ray room, faces 25% no-shows. He invests EUR 48,000 excl. VAT in a custom module (exam-specific booking, preparation questionnaire, SMS reminders, waiting list) plus EUR 650 per month to run it. Six months later, the no-show rate falls to 9%. On MRI and CT alone, the monthly gain is about (33,600 + 29,400) x (16 / 25) = EUR 40,320 of recovered revenue. Even counting only half of that gain, the project pays back in just over 2 months. The front desk also saves nearly 30 hours of phone calls per week.
FAQ
Do we need to replace our RIS to get effective online booking?
No, in most cases. The custom module connects to your RIS through HL7 or an API, for EUR 6,000 to 15,000 excl. VAT of interface work. Replacing a RIS costs EUR 20,000 to 60,000 and 3 to 6 months of migration.
How long does delivery take?
Plan for 4 months: 3 weeks of scoping with radiographers and front desk staff, 10 weeks of development, 3 weeks of acceptance testing and pentest. Rollout can happen one modality at a time.
Are SMS reminders enough to cut no-shows?
A simple reminder gains 5 to 8 points. Mandatory confirmation with automatic slot release at D-1 and an active waiting list can deliver up to a 15-point drop.
Is HDS hosting really mandatory?
Yes in France, as soon as identifiable health data is stored on behalf of the centre. The extra cost is modest, EUR 250 to 600 per month, compared with the legal risk.
Can reports be published online for patients?
Yes, through a secure patient portal with a one-time code. It is an add-on of EUR 8,000 to 15,000 excl. VAT that also reduces calls to the front desk.
Let's scope your project. Send us your modalities, current RIS and no-show rate: we will price an HDS booking module between EUR 30,000 and 60,000 excl. VAT, deliverable in 4 months. 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.
