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Healthcare · head to head

OpenMRS vs Signant Health

OpenMRS logo

OpenMRS

Healthcare

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

From
Free
Rated
-
Full reviewWebsite
Signant Health logo

Signant Health

Healthcare

eCOA-first clinical trial platform that has grown outward into EDC, eConsent and televisits

From
On request
Rated
-
Full reviewWebsite

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; Signant Health no pricing is published, and the software licence is a minority of the real bill once instrument licensing, translations, device provisioning and services are added, so early budget estimates are routinely too low.
  • They diverge on capability: OpenMRS covers Concept dictionary, Signant Health covers eCOA and ePRO.
  • Prices and features above were last checked on 1 September 2026.

Where they differ

Only the attributes on which OpenMRS and Signant Health actually diverge.

Attributes where OpenMRS and Signant Health differ
AttributeOpenMRSSignant Health
Starting priceFreeOn request
Pricing modelOpen source, no licence feequote
Free tierYesNo
PlatformsLinux, Web, WindowsWeb, iOS, Android

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 Signant Health

  • eCOA and ePRO
  • Unified platform
  • eConsent
  • Randomisation and supplies
  • TeleVisits
  • Rater training
  • Data surveillance
  • Instrument library

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 Signant Health
  • A hospital network in a country where no commercial vendor supports the local language, clinical forms or reporting requirementsnot Signant Health
  • An NGO running a tuberculosis programme that must report into DHIS2 and needs the clinical record beneath it to be modifiablenot Signant Health
  • A health system that wants to own its clinical data model outright rather than depend on a vendor to extend itnot Signant Health

Signant Health

  • A central nervous system or psychiatry trial where the primary endpoint is a rated scale and rater consistency decides the readoutnot OpenMRS
  • A global study needing an outcome instrument translated and linguistically validated across a dozen languagesnot OpenMRS
  • A decentralised or hybrid protocol combining televisits, eConsent and at-home patient reported outcomesnot OpenMRS
  • A sponsor consolidating separate eCOA, eConsent and randomisation vendors onto one platform to cut reconciliation worknot 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

Signant Health

  • No pricing is published, and the software licence is a minority of the real bill once instrument licensing, translations, device provisioning and services are added, so early budget estimates are routinely too low.
  • Linguistic validation is charged per instrument per language and is on the critical path to first patient in, so adding a country late in start-up produces both a cost and a schedule hit.
  • Provisioned participant devices bring logistics, replacement, shipping and cellular connectivity obligations that persist for the life of the trial and are frequently underestimated.
  • The EDC component is newer than the eCOA heritage, so sponsors with complex data management requirements often keep an incumbent EDC and lose the single-database benefit that justifies the platform.
  • It is priced and scoped for sponsor-grade trials, which makes it a poor fit for investigator-initiated or academic studies that need outcome collection without the services layer.

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

Signant Health

On request
  • SmartSignals Unified Platform$undefined/year
    • Priced per study through a sales process
    • Modules selected per protocol: EDC, eCOA, randomisation, eConsent, TeleVisits
    • Instrument licensing paid to scale owners on top of platform cost

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.
OpenMRS review

Choose Signant Health if

  • You need ecoa and epro.
  • You work on Web, iOS, Android.
  • You also want unified platform.
Signant Health review

Questions people ask

Is OpenMRS or Signant Health better?
Neither clearly leads. OpenMRS starts at Free and Signant Health at On request, and user ratings are close enough to be indistinguishable. Choose on capability and platform support.
Which is cheaper, OpenMRS or Signant Health?
OpenMRS has a free tier; the other does not. Paid plans start at Free for OpenMRS and On request for Signant Health.
Does OpenMRS or Signant Health run on more platforms?
OpenMRS runs on Linux, Web, Windows. Signant Health runs on Web, iOS, Android.
Can I use OpenMRS for free?
Yes. OpenMRS has a free tier, so you can try it without paying. Signant Health 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 Signant Health is typically brought in for.
What can OpenMRS do that Signant Health cannot?
OpenMRS covers Concept dictionary, Modular architecture, Modern front end, FHIR support. Signant Health covers eCOA and ePRO, Unified platform, eConsent, Randomisation and supplies.

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.

Signant Health: What is Signant best at?

Electronic clinical outcome assessment, particularly rated scales in central nervous system and psychiatry trials, together with rater training and endpoint quality services.

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.

Signant Health: Is pricing published?

No. Everything is quoted per study, and instrument licences, translations and devices sit on top of the platform cost.

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.

Signant Health: Can I use it only for eCOA?

Yes. The modules are selected per protocol, and many sponsors take eCOA and eConsent while keeping an existing EDC.

OpenMRS: Does it support FHIR?

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

Signant Health: What drives the timeline?

Translation and linguistic validation of outcome instruments, which is per language per instrument and sits on the critical path to study start.

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