Free Electronic Medical Records Software, Compared

The second table keeps the same software in the same order. Confirm that an effective written business associate agreement or arrangement covers the account you will use before adding identifiable information. A sentence that says the product is secure is not that agreement.

Vendor facts are based on public pages checked October 8, 2026. Functionality, prices, and terms can change after publication.

You have two clients and a Thursday that already runs long. Free electronic medical records software helps only if the limit covers those two names, someone else can host the file, and an effective written agreement or arrangement covers the account before a third name goes in.

If you searched for free electronic medical records software, use the two tables as the shortlist. A logo list is not the decision.

Educational content for licensed therapists, counselors, psychologists, and clinical social workers. Not legal, billing, or privacy advice. HIPAA, payer, and board rules vary by jurisdiction, contract, and clinic policy.

What free means before you open a demo

Free EMR programs show up in three shapes. A standing plan repeats. A download is software you install. A hosted chart can still be $0 a month and still be someone else’s server. Free electronic health records software, for this decision, is that same chart. A notes tool is not.

A countdown trial is not one of those shapes. Sessions Health’s signup article, read October 8, 2026, says a 30-day trial needs no card, and the account is permanently deleted if you never add one. The freemium plan is the standing free tier. It requires a card, and the base fee stays at $0 until you pass three active clients. Score the trial as a demo. Score the freemium row as the free program.

If a vendor will create, receive, maintain, or transmit protected health information on your behalf, 45 CFR § 164.502(e) allows that only when you obtain satisfactory assurance, documented through a written contract or other written agreement or arrangement. Encryption, a privacy page, and the words “HIPAA compliant” are not that contract. Put that written agreement or arrangement on the account before a name goes in.

Sessions Health

• Software: Sessions Health, a therapy EHR.

• Free tier includes: The pricing page, read October 8, 2026, lists Freemium at $0 a month for newer practices. The signup article says every plan includes secure records, scheduling with reminders, documentation, reporting, document storage, online payments, and the client portal. Freemium includes Professional features except multi-user access and certain add-ons. Integrated telehealth is $10 a month per practitioner on both plans, up to 4 participants. Electronic claims start at $0.25 a claim on both plans, with lower bands as volume rises, and eligibility reports are $0.15. Card processing is Stripe’s 2.9% plus $0.30, with no extra platform fee from Sessions Health.

• Client or note limit: Up to 3 clients on Freemium, and 1 practitioner. The signup article says a client is active once you create a chart. No administrators on the free plan. Professional is unlimited clients.

• Hosting: Vendor cloud. You do not install a server.

• BAA: The signup article says a signed business associate agreement is included during signup, and the signup steps include agreeing to the terms, the privacy policy, and that agreement. Confirm that agreement covers the account you will keep before a real name goes in.

• Paid upgrade: Professional is $39 a month for the first practitioner. Additional practitioners are $29 a month. Administrators are unlimited on Professional and are not included on Freemium. A fourth active client moves you off the $0 base fee.

CharmHealth

• Software: CharmHealth EHR, a medical chart, not a therapy-only product.

• Free tier includes: The pricing FAQ, read October 8, 2026, says there is a free edition with a limited set of features, and that you can still buy add-ons on that edition. The benefits page, read the same day, says the free edition is full featured at 50 encounters a month and is ad-free. Those two pages do not say the same thing. Open both on the demo and write down which note, which claim, and which portal click you actually got.

• Client or note limit: The pricing FAQ says practices with less than 50 encounters a month can use the free plan. Crossing 50 encounters in a month auto-upgrades the practice to Encounter Plan flexi pricing. That is an encounter cap, not a client cap.

• Hosting: Vendor cloud. The benefits page says CharmHealth is hosted on Zoho cloud at Tier 1 data centers in the United States. The HIPAA page, read the same day, says the service is hosted in Tier 3 Plus data centers in Washington, with disaster recovery in Texas. Ask which contract covers the account you open. Do not guess that the two sentences are the same building.

• BAA: Not stated on the pricing FAQ, and the HIPAA page does not use the words business associate agreement. The benefits page says CharmHealth is HIPAA and HITECH compliant and uses 256-bit encryption. That sentence is not the contract in 45 CFR § 164.502(e). Do not add a client name until that written agreement or arrangement is on the account.

• Paid upgrade: Above 50 encounters, the FAQ says the practice moves to Encounter Plan flexi pricing. One worked example on that page prices 140 consults at $0.50, or $70. The Provider Plan is listed at $200, with 1,000 text messages and 500 electronic faxes included, and at $350, with 2,000 texts and 1,000 faxes. Extra texts are $0.08. Extra faxes are $0.10. Confirm the live invoice. Do not budget from the example alone.

OpenEMR

• Software: OpenEMR, the open source electronic health record you download.

• Free tier includes: The download page, read October 8, 2026, says OpenEMR is free and open source. The features page says it is released under the GNU General Public License and lists integrated records, practice management, scheduling, and electronic billing. It runs on Windows, Linux, and Mac. There is no therapy-note promise on that page. Write a SOAP note and a BIRP note on the demo before you decide the chart matches the note you already file.

• Client or note limit: The download page does not list a numeric client cap.

• Hosting: The download page lists a Docker image and installers for Linux and Windows. The project homepage, read October 8, 2026, also points at a separate hosted offer. That offer is OpenCoreEMR, scored in the next section. Do not treat the download and the hosted chart as one row.

• BAA: The OpenEMR download page does not provide a BAA. Confirm the agreement with the hosting provider you choose. The homepage card for Express Plus says the stack is built on HIPAA-eligible AWS services, and that a properly configured deployment includes executing a business associate agreement with AWS. A community forum is not that agreement.

• Paid upgrade: The costs and support page says free support is doing it yourself, and professional support is hiring someone. It gives an example range of $50 to $150 an hour. That is an example, not a quote. Get the rate from the person you would actually hire.

OpenCoreEMR

• Software: OpenCoreEMR, the hosted chart the OpenEMR homepage points to.

• Free tier includes: The pricing page, read October 8, 2026, lists Clinical Pro at $0 a month, with charting, a patient portal, scheduling, email and SMS reminders, e-prescribing, eFax, and electronic labs. AI scribe, integrated claims, and telehealth are marked not yet available. The pricing page does not list a claims price yet. If you need a claim or a video visit this month, this row does not include them yet.

• Client or note limit: The same page says there are no caps on providers, patient charts, or storage.

• Hosting: They host it. You do not install a server.

• BAA: OpenCoreEMR publishes a business associate agreement, version 2026-08-03, last reviewed August 3, 2026. It names OpenCoreEMR Inc. as the business associate, and it is effective when the covered entity accepts it. The agreement defines de-identified information by pointing at 45 CFR § 164.514(b). Confirm that an effective written business associate agreement or arrangement covers the account you will use before adding identifiable information. A footer link is not that agreement.

• Paid upgrade: Clinical Pro stays at $0 a month. Add-ons on that page include controlled-substance e-prescribing at $150 a year, direct messaging at $159 a year plus a $200 setup, and card processing at 2.9% plus $0.30. Integrated claims stay marked not yet available, and the pricing page does not list a claims price yet. The same page says partnerships with pharma, life sciences, and AI model labs help fund the $0 plan, and that approved research uses only fully de-identified clinical data inside secure, hosted environments. Read that sentence next to the agreement before you accept it.

OpenMRS

• Software: OpenMRS, an open source electronic health record platform, not a therapy signup.

• Free tier includes: The homepage, read October 8, 2026, says there are no license fees and no vendor lock-in, and that the source code is open. It describes adaptation for primary care, noncommunicable disease, maternal care, HIV, TB, malaria, and COVID. It does not describe a solo counseling week.

• Client or note limit: The homepage does not list a numeric client cap.

• Hosting: The homepage describes an open-source EMR and does not present a vendor cloud plan. Confirm hosting and implementation with the provider you choose.

• BAA: Not stated on the homepage. If someone else will create, receive, maintain, or transmit protected health information for you, the written agreement in 45 CFR § 164.502(e) is with that person or company, not with a homepage link.

• Paid upgrade: The homepage says there are no license fees and no vendor lock-in, and that the source code is open.

If your week is talk therapy, stop on this row. It answers “open source electronic health record.” It does not answer “what do I open Monday.”

The test a therapy chart still has to pass

The tables score free electronic medical records software on price, limit, hosting, and the agreement. They do not score the note you already write.

45 CFR § 164.501 defines psychotherapy notes as notes recorded by a mental health professional documenting or analyzing the contents of conversation during a private counseling session, or a group, joint, or family counseling session, and that are separated from the rest of the individual’s medical record. The definition excludes medication, session start and stop times, modalities and frequencies, test results, and any summary of diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date. None of the five pages above say they keep that separation. On the demo, ask for a place that is separated from the rest of the record. If the answer is a workaround, the chart is the wrong shape, even at $0.

Write the note you already file. If that note is BIRP or GIRP, a SOAP-only shell is a miss. Have a second person open the chart and find the treatment-plan goal without calling you. If you are still the only clinician, skip that click and do not pretend you tested a group.

Video is a separate line. Sessions Health prices integrated telehealth as a $10 add-on even on the free plan. OpenCoreEMR marks telehealth as not yet available. If most of your week is video, score that on the telemedicine EHR page after this chart test, not instead of it.

A notes tool is not this chart. Free clinical notes software compares standing note allowances, trials, and where a draft can hold identifiable material. Emosapien is not an electronic health record. Do not put it in the table above. Keep the signed note in the record you chose here.

If you still need the wider stack after the chart is chosen, use the behavioral health software shortlist. If the free limit is already too small and you are shopping paid therapy EHRs, that is a different page: the best EHR for private practice shortlist. Do not use that shortlist to fill a blank cell in the tables above.

A solo start, scored

Print the cost sheet from the Therapy Software Buying Pack and write those six lines on it while the demo is open. A memory of the pricing page is not the score.

Copy this before the demo

A blank cell is a no until someone shows you the click. Do not fill it from a roundup.

Download the Therapy Software Buying Pack

Bring the six fields from the free electronic medical records software tables to the demo. The Therapy Software Buying Pack is the paper you mark while you click: a cost model by team size and note volume, a native-versus-standalone worksheet, a supervision scorecard, and a scheduling test. Use the cost model for the paid upgrade. Use the native-versus-standalone sheet if you are also comparing a notes layer beside this chart.

References

• CharmHealth. (n.d.). Benefits of CharmHealth EHR. Retrieved October 8, 2026.
• CharmHealth. (n.d.). EHR pricing FAQ. Retrieved October 8, 2026.
• CharmHealth. (n.d.). HIPAA privacy policy. Retrieved October 8, 2026.
• Electronic Code of Federal Regulations. (n.d.). 45 C.F.R. § 164.501. Cornell Law School Legal Information Institute.
• Electronic Code of Federal Regulations. (n.d.). 45 C.F.R. § 164.502. Cornell Law School Legal Information Institute.
• Electronic Code of Federal Regulations. (n.d.). 45 C.F.R. § 164.514. Cornell Law School Legal Information Institute.
• OpenCoreEMR. (2026, August 3). Business associate agreement (Version 2026-08-03).
• OpenCoreEMR. (n.d.). Pricing. Retrieved October 8, 2026.
• OpenEMR. (n.d.). Download OpenEMR. Retrieved October 8, 2026.
• OpenEMR. (n.d.). OpenEMR costs and support options. Retrieved October 8, 2026.
• OpenEMR. (n.d.). OpenEMR features. Retrieved October 8, 2026.
• OpenEMR. (n.d.). OpenEMR home. Retrieved October 8, 2026.
• OpenMRS. (n.d.). OpenMRS. Retrieved October 8, 2026.
• Sessions Health. (n.d.). Pricing and signup. Retrieved October 8, 2026.
• Sessions Health. (n.d.). Pricing for therapy EHR plans. Retrieved October 8, 2026.