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Healthcare · head to head

OpenMRS vs Paige

OpenMRS logo

OpenMRS

Healthcare

Open source electronic medical record platform for low-resource settings, with no vendor and paid implementers instead

From
Free
Rated
-
Paige logo

Paige

Healthcare

Digital pathology AI holding the first FDA De Novo authorisation for a pathology algorithm, now part of Tempus

From
On request
Rated
-

The short version

  • Only OpenMRS has a free tier, so it costs nothing to try first.
  • Each has a real cost: OpenMRS there is no vendor and no support contract from OpenMRS itself, so a procurement that requires a named supplier with a service level must instead contract an implementer, and the quality of that implementer determines the outcome more than the software does; Paige the FDA authorisation is confined to prostate core needle biopsies, on compatible scanners, viewed through FullFocus, as an adjunct only; every other tissue type and every grading claim is outside that authorisation in the United States.
  • They diverge on capability: OpenMRS covers Concept dictionary, Paige covers Paige Prostate Detect.
  • Prices and features above were last checked on 1 September 2026.

Where they differ

Only the attributes on which OpenMRS and Paige actually diverge.

Attributes where OpenMRS and Paige differ
AttributeOpenMRSPaige
Starting priceFreeOn request
Pricing modelOpen source, no licence feequote
Free tierYesNo
PlatformsLinux, Web, WindowsWeb, Cloud, On-premise

Identical on both: user rating (Not yet rated), category (Healthcare).

What each one covers

Drawn from each product's published feature list. An absence here means we hold no record of it - not that the product lacks it.

Only in OpenMRS

  • Concept dictionary
  • Modular architecture
  • Modern front end
  • FHIR support
  • Offline tolerance
  • Patient matching and registration
  • Distributions

Only in Paige

  • Paige Prostate Detect
  • Paige Prostate Grade and Quantify
  • Perineural invasion detection
  • Breast and lymph node applications
  • FullFocus viewer
  • Foundation models
  • OmniScreen
  • Paige Alba

What people use each for

The jobs each tool is most often brought in to do.

OpenMRS

  • A ministry of health standardising HIV treatment records across hundreds of facilities where per-patient licensing would be unaffordablenot Paige
  • A hospital network in a country where no commercial vendor supports the local language, clinical forms or reporting requirementsnot Paige
  • An NGO running a tuberculosis programme that must report into DHIS2 and needs the clinical record beneath it to be modifiablenot Paige
  • A health system that wants to own its clinical data model outright rather than depend on a vendor to extend itnot Paige

Paige

  • A reference laboratory processing high volumes of prostate core needle biopsies where a second read on every case is not staffablenot OpenMRS
  • A pathology department already digitised that wants a documented safety net against missed small foci of cancernot OpenMRS
  • A hospital laboratory struggling to recruit uropathology subspecialists and needing consistency across generalist reportingnot OpenMRS
  • A pharmaceutical company needing consistent biomarker scoring across trial sites rather than site-by-site pathologist variabilitynot OpenMRS

Where each one falls short

Documented limitations, not opinions. Every one is a constraint you would hit in normal use.

OpenMRS

  • There is no vendor and no support contract from OpenMRS itself, so a procurement that requires a named supplier with a service level must instead contract an implementer, and the quality of that implementer determines the outcome more than the software does
  • It is a framework rather than a ready product, so a deployment requires clinical content, form design, concept dictionary work and integration before a single patient is registered, and that work is months of skilled effort
  • Funding comes largely from donor programmes, which makes the pace of core development dependent on grant cycles rather than on a commercial roadmap, and priorities can shift when a funder does
  • Distribution choice, core OpenMRS against Bahmni against Ozone, locks in a different set of components and a different implementer pool, and migrating between distributions later is close to a fresh implementation
  • The people cost never goes away: a national deployment needs permanent internal informatics capacity or a permanent support contract, and organisations that budget only the zero licence fee run out of money at the point the system becomes clinically critical

Paige

  • The FDA authorisation is confined to prostate core needle biopsies, on compatible scanners, viewed through FullFocus, as an adjunct only; every other tissue type and every grading claim is outside that authorisation in the United States.
  • The algorithm is worthless without a digital pathology programme already running, and slide scanning, storage and workflow typically cost far more than the software licence.
  • Tempus acquired Paige in 2025, so the roadmap now competes for attention inside a genomics-led business, and the pathology-only buyer is no longer the primary customer.
  • Scanner compatibility is a hard constraint rather than a preference, and a laboratory with an unsupported scanner fleet cannot use the authorised indication at all.
  • Pricing is per case or per slide and unpublished, so a laboratory cannot model cost per reported case without entering a sales process.

Pricing, plan by plan

OpenMRS

Free
  • OpenMRSFree
    • Openly licensed, no licence fee and no seat limits
    • Community support through forums and the OpenMRS Talk platform
    • No support contract available from OpenMRS itself

Paige

On request
  • Paige clinical applications$undefined/year
    • Priced per case or per slide analysed under annual agreement
    • Prostate, breast and other applications licensed separately
    • Requires compatible whole slide scanner and the FullFocus viewer for the authorised indication

Which should you pick?

Choose OpenMRS if

  • You need concept dictionary.
  • You want to start without paying.
  • You work on Linux, Web, Windows.
  • You also want modular architecture.

Choose Paige if

  • You need paige prostate detect.
  • You work on Web, Cloud, On-premise.
  • You also want paige prostate grade and quantify.

Questions people ask

Is OpenMRS or Paige better?
Neither clearly leads. OpenMRS starts at Free and Paige at On request, and user ratings are close enough to be indistinguishable. Choose on capability and platform support.
Which is cheaper, OpenMRS or Paige?
OpenMRS has a free tier; the other does not. Paid plans start at Free for OpenMRS and On request for Paige.
Does OpenMRS or Paige run on more platforms?
OpenMRS runs on Linux, Web, Windows. Paige runs on Web, Cloud, On-premise.
Can I use OpenMRS for free?
Yes. OpenMRS has a free tier, so you can try it without paying. Paige starts at On request.
What is OpenMRS best used for?
OpenMRS is most often used for a ministry of health standardising hiv treatment records across hundreds of facilities where per-patient licensing would be unaffordable, a hospital network in a country where no commercial vendor supports the local language, clinical forms or reporting requirements, an ngo running a tuberculosis programme that must report into dhis2 and needs the clinical record beneath it to be modifiable, a health system that wants to own its clinical data model outright rather than depend on a vendor to extend it. Of those, a ministry of health standardising hiv treatment records across hundreds of facilities where per-patient licensing would be unaffordable and a hospital network in a country where no commercial vendor supports the local language, clinical forms or reporting requirements are not what Paige is typically brought in for.
What can OpenMRS do that Paige cannot?
OpenMRS covers Concept dictionary, Modular architecture, Modern front end, FHIR support. Paige covers Paige Prostate Detect, Paige Prostate Grade and Quantify, Perineural invasion detection, Breast and lymph node applications.

Answered from the vendors’ own pages

OpenMRS: Who supports OpenMRS if it breaks?

Not OpenMRS itself. Support is bought from implementers such as Mekom Solutions, which offers long-term production service level agreements for OpenMRS, Bahmni and Ozone deployments, or from regional partners.

Paige: What exactly is FDA authorised?

Paige Prostate Detect, as an adjunct for identifying areas of interest on digitised prostate core needle biopsy slides, viewed through the Paige FullFocus viewer on a compatible scanner. Nothing else in the portfolio holds that authorisation in the United States.

OpenMRS: Is it really free?

The software has no licence fee. Hosting, configuration, clinical content, integration and support are the real cost, and they are ongoing.

Paige: Is the European position broader?

Yes. The Paige Prostate suite including grading and quantification received IVDR certification in 2025, which covers more than the United States authorisation.

OpenMRS: What is the difference between OpenMRS, Bahmni and Ozone?

OpenMRS is the core platform. Bahmni and Ozone are distributions that package it with billing, laboratory and inventory components. Choosing a distribution constrains your implementer options.

Paige: What did the pivotal study measure?

Pathologist cancer detection on individual slide images improved, with reported reductions in false negative and false positive readings. It measured pathologist performance with the tool, not standalone algorithm accuracy.

OpenMRS: Does it support FHIR?

Yes. FHIR support is the standard route for integrating laboratory, pharmacy and national reporting systems.

Paige: Who owns Paige now?

Tempus AI acquired Paige in 2025. Products remain branded Paige.

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