There are dozens of capable electronic medical record (EMR) providers serving hospitals and practices across Australia and New Zealand, each offering a different mix of features, price points, and specialisations. But comparing EMR systems is rarely just a matter of comparing feature lists. The decisions that matter most are strategic and architectural; how the system is built, how it will scale, and how well it will still be serving your organisation in ten years’ time. Get these calls right early, and you avoid the costly pitfalls that only become obvious with hindsight.

This guide draws on 15 years of hands-on experience implementing EMR software across the region. We’ll walk through what an EMR does, why interoperability matters more than most buyers realise, and how the main providers operating in Australia and New Zealand compare at a high level, their strengths, their trade-offs, and where each tends to fit best.

A note on where we’re coming from: this article is written by the team at BES International, a digital health software provider whose products include the EMR Tamanu. Our aim of comparing EMR ‘s has been done in the most impartial and factual way as possible, while being upfront that we believe that the growing shift toward purpose-driven, open-source health technology can contribute to improved health outcomes. Because Tamanu is free, open-source, and built with interoperability in mind, we think it earns its place in this comparison, and we’ve held it to the same scrutiny as every other provider on this list, cons included.

An electronic medical record (EMR) system replaces the paper charts and forms traditionally used in hospital wards, outpatient clinics, and community health facilities. It provides a systemised, digital way to collect patient and population health information, records that can be shared across care settings, feed into national or global health indicators, and stay consistent through the use of standard health codes.

How a system handles integrations – passing information between systems, facilities, and industry standards – can make or break both your budget and your long-term flexibility. At BES, we build around FHIR (Fast Healthcare Interoperability Resources), a modern standard seeing growing adoption across the health sector. Developers favour FHIR’s REST-based interface because it allows atomic data access: individual pieces of information can be requested and shared without needing to move entire documents between systems.

Some older integration approaches require bundling data into large documents, and many are limited to clinical data alone. FHIR, by contrast, accommodates a much broader range of uses, including billing, laboratory, and imaging data, which makes it a practical, lower-friction option for organisations that don’t want cost and complexity to leave their systems siloed and unable to talk to one another.

The table below summarises, at a high level, how the main EMR providers operating in Australia and New Zealand compare. Every one of these systems has genuine strengths. Our aim here isn’t to rank them, but to give you a factual starting point for your own due diligence. Pricing, implementation timelines, and feature depth all vary considerably by contract and by organisation, so we’d recommend speaking directly with a shortlist of vendors before deciding.

Since Tamanu is BES’s own product, we wanted to give it the same scrutiny as the rest of the market. By comparing EMR ‘s, including our own, with a little more detail on how it works in practice. The principles behind Tamanu’s design, and its national-scale deployments to date, include:

• Free use of the software with zero-cost licensing, and an optional annual service level agreement for support
• Full access to all features, with unlimited users, records, data entries, forms, and reports
• Regular version updates delivered online, backed by publicly available training resources
• Interoperability with existing systems (including mSupply, DHIS2, MS-1, and Tupaia) and standards (including SNOMED CT-AU, AMT, ICD-10, and CPT)
• An open-source model, in the same tradition as WordPress or DHIS2. BES doesn’t withhold access to the code, and works collaboratively with partners to build in-house ownership over time

Tamanu’s approach is designed to align with the direction both the Australian and New Zealand governments have set for digital health more broadly – see Australia’s National Digital Health Strategy and New Zealand’s digital health work programme.

There’s no single ‘best’ EMR – only the system that best matches your organisation’s size, budget, clinical complexity, and appetite for customisation versus simplicity. A large tertiary hospital with a dedicated informatics team will weigh things up very differently to a small rural clinic taking its first step away from paper records.

Whatever stage you’re at, it’s worth asking each vendor the same core questions: How do you handle interoperability? What does implementation actually involve, and how long does it take? What’s included in the licence, and what costs extra? And what happens to your data and workflows if you outgrow the system, or need to move on from it?

We hope that by comparing EMR ‘s this has given you a useful starting point for those conversations – and if you’d like to talk through how Tamanu might fit into your own plans, we’re always happy to have that conversation too.