Urgent Care Software: Custom Build vs Experity, Solv and athenahealth

What Experity, Solv and athenahealth genuinely do well

Your regional director rebuilds a spreadsheet every Monday from four exports. That spreadsheet, not the electronic medical record (EMR), is what actually runs your network, and it is the reason you are weighing custom versus off the shelf. Before any of that, give the products their due.

Experity was built for this specialty rather than adapted from primary care, and it shows in the parts that matter clinically: discrete charting fast enough for a fifteen minute visit, e-prescribing with controlled substance workflow, interaction checking, and interfaces to the CLIA waived analysers on your counter. athenahealth brings genuine application programming interfaces and a revenue cycle operation behind them. Epic is the right answer when a health system owns you, because the referral and record continuity is worth more than anything you would build. eClinicalWorks sits reasonably in the middle for operators who grew out of family medicine.

In front of the chart, Solv and Clockwise.MD do online check-in, save-my-spot and a published wait time, and they do it well enough that building your own booking widget is a waste of money. Phreesia handles registration and intake. Waystar and Zotec clear claims. QGenda solves provider credentialing and fairness constraints in scheduling.

If you run one to three clinics on a single EMR instance and your real problem is that patients cannot book online, buy Solv, publish the number and go run your clinics. Below roughly 40,000 annual visits an operations layer will not pay for itself. We say that to operators most weeks.

Where they stop: the queue is per clinic, so the network is blind

Here is the workflow nothing on that list models. It is 5:40pm in the second week of flu season. Your busiest site has 22 people in the lobby, Clockwise is telling the internet 45 minutes, real door to door is past two hours, and six people leave without being seen. Four miles away another of your clinics has two patients and an X-ray technologist reading her phone. Nobody in either building can see the other building.

Solv and Clockwise estimate from recent throughput at one location. That means the published number stays calm right up until the queue is already broken, and it knows nothing about who is on shift at the sister site or whether the next four arrivals are ten minute rashes or fracture work-ups. Neither product moves demand, because neither was designed to. They sell a booking experience, not a network.

The same blindness runs through the money. You find out in the March remittance run that one site's self-pay share went from 9 to 17 percent in January, which is a quarter of revenue you cannot re-bill. The cause is usually mundane: an employer changed carriers, or a registrar hired in December keeps picking the wrong entry from a payer list with four plausible options that route to different payer identifiers. Experity dashboards show visits and charges. Waystar shows denials by reason code. Neither shows denials by registrar, by site hour, or against the insurance card image the front desk photographed, so CO-22 and CO-27 stay anonymous.

And the quiet one: several payers zero out the urgent care facility code S9088 and the after hours code 99051, and in most networks nobody is watching that line by payer.

The arithmetic: cost per visit and per provider against a build

Use your own invoices. EMR and practice management here is typically priced per provider per month, or as a percentage of collections when the vendor also does billing. Check-in products price per location per month plus a fee per booking. Add them, divide by last year's visits, and you have your software cost per visit. Most operators have never seen it.

Now the part the invoice hides. Cost the hours your regional director spends rebuilding reports, the walkouts your busiest site sends home on a Tuesday evening, and the self-pay share that moved before anyone noticed. Those are the numbers a build competes against, not the licence.

The crossover is a visit count and a site count together. Below about 40,000 annual visits across the network, or three sites on one EMR instance, buy and configure. Above roughly 60,000 annual visits, or five sites, or two EMR instances inherited from acquisitions, the operations layer starts returning more than it costs, because a single transfer offer that keeps a patient in your network on a busy evening is worth a contracted visit, and at that volume there are several every week. Two instances is the sharper trigger than volume alone: the day you cannot see one queue across the network, no amount of licence spending fixes it.

What a custom build actually costs, plus migration and year two

In Digital Heroes delivery experience, a focused first release covering a shared arrival ledger across sites, patient transfer between locations and a real payer mix view runs $60,000 to $130,000 and ships in 12 to 16 weeks. A full platform adding occupational medicine, the employer portal and invoicing, demand forecasting and a closed loop results register runs $150,000 to $400,000 phased across 6 to 12 months.

Data migration runs 10 to 25 percent of build cost. In urgent care it is rarely clinical data, which stays in the chart, and almost always employer, contract and historical visit data used for forecasting. The expensive part is normalising three years of check-in timestamps from two acquired systems that recorded arrival differently. Year two and after runs 15 to 20 percent of build cost annually, and here that is not optional, because payer contracts change, sites open and a queue board that dies at 6pm on a Tuesday is worse than no queue board.

Three drivers push the number in this category. Interfaces: Experity generally means HL7 version 2 feeds and nightly extracts rather than modern application programming interfaces, athenahealth has real interfaces with partner and per transaction fees, and Epic means a vendor services process measured in months. Each inherited instance is its own integration, and the interface engine is a line item plus a per site monthly. Second, revenue cycle scope, because reading 835 remittance files and modelling contract rates roughly doubles the data model. Third, compliance as engineering: business associate agreements, row level audit logging on every read of protected health information, environment separation and a penetration test before go live. Budget 10 to 15 percent of the build for it and stop negotiating with yourself about it.

The four situations where building wins

Regulatory fit. Occupational medicine is the clearest case. A Department of Transportation physical, a chain of custody drug screen and a workers compensation injury visit under an employer panel each carry their own documentation and their own payer, and the injury visit prices against a state fee schedule rather than your cash rate. Products treat the employer as a payer record. It is not one.

Scale economics. Past the crossover above, per provider and per booking pricing compounds while the thing you actually need, one view across sites, is not for sale at any price.

A workflow that is your advantage. For a multi-site operator that is load balancing. Offering the patient in position fourteen a text saying the next site is 22 minutes and a nine minute drive, then moving their place in a shared ledger, is not a feature any vendor sells because no vendor has your sites.

Integration sprawl across three or more systems. Count yours: EMR, practice management, check-in, registration, eligibility, clearinghouse, provider scheduling, reference laboratory, teleradiology overread. Once one workflow crosses three, the coordination lives in a person, and in urgent care that person is usually a medical assistant with a clipboard holding a positive culture result for a patient seen on Tuesday.

How to decide in a week, and what discovery leaves you owning

Pick your busiest four hours, which for most operators is 4pm to 8pm midweek in season, and instrument it by hand for five consecutive days. Station one person per site with a printed sheet. Record arrival time, chief complaint category, whether X-ray or laboratory was needed, departure time, and every patient who left before being seen. No software required.

At the end of the week, put the sites side by side hour by hour. If your busiest site was red while another sat under capacity for two or more of those hours, you have a network problem and an operations layer will pay. If all sites moved together, your problem is staffing hours and a forecast, which is a cheaper fix. Then pull the same week's registrations and count how many had an eligibility response that did not match the card. Above five percent, your payer mix leak is at the front desk, not in billing.

Then pay for a discovery phase rather than taking a free proposal. At Digital Heroes that produces a signed product requirements document before any code: the data model separating patient, visit, encounter, employer, claim, authorisation and result, the interface inventory with named vendor contacts, the protected health information boundary, acceptance criteria and a fixed price. You own that document whichever firm builds it.

Who we are wrong for: single site operators, anyone wanting the chart rebuilt, and anyone who needs a billing service rather than software. We work as India LLP, US LLC and UK LTD entities so intellectual property assigns under your own law, you own the repository from the first commit, and you meet the named engineers before signing. More than fifty specialists, over 2,000 projects, checkable on Clutch, Trustpilot, Fiverr Vetted Pro and D-U-N-S.

Book a 30-minute call with Digital Heroes and get a written plan and a fixed quote within 48 hours.