1. Why open‑source telemedicine now?
Telemedicine has evolved from a niche alternative into a core component of modern healthcare. Following a surge in adoption during the pandemic, the industry has settled into a pattern of sustained global expansion as remote care becomes increasingly integrated into standard medical practice.
For NGOs, public health programs and hospitals (especially in low‑ and middle‑income countries), proprietary SaaS telehealth tools often don’t fit:
- Data may have to stay inside the country or a specific health network.
- Offline or low‑bandwidth environments are common.
- Long‑term licensing costs are hard to sustain.
- Local customization and integration with existing EMRs / HIS are essential.
Open‑source telemedicine platforms answer those constraints: you can self‑host, audit the code, adapt workflows and, when needed, work with local or regional tech partners instead of a single vendor.
This guide focuses strictly on open-source software that can support real clinical teleconsultations, rather than general-purpose video-conferencing tools such as Jitsi Meet, BigBlueButton, or Nextcloud Talk. While these platforms work well for meetings or collaboration, they lack the clinical scaffolding required for medical care. A compliant teleconsultation workflow typically requires features such as virtual waiting rooms, patient identification, structured clinical documentation, secure file exchange, and integration with electronic medical records (EMRs). Generic video tools do not provide these capabilities out of the box, which means they cannot, by themselves, deliver a full, auditable, and medically appropriate remote consultation.
2. How to choose an open‑source telemedicine platform
Selecting a telemedicine platform is not just a technical choice — it determines how care is delivered, who can participate, and whether the system will work reliably in your environment. Before looking at specific tools, it helps to clarify what kind of telemedicine you actually need and what constraints your organisation operates under. These factors directly shape which platforms are suitable and which ones should be eliminated early.
2.1 Clarify the clinical model
Do you want to perform direct doctor–patient teleconsultations? You will need software that supports the essential elements of a medical visit, such as virtual waiting rooms, patient identification, secure messaging, and basic clinical documentation.
Are you operating a hub-and-spoke model with community health workers (CHWs)? In this case, the platform must support store-and-forward data collection, offline or low-bandwidth use, simple mobile interfaces, and the ability for CHWs to escalate cases to remote clinicians.
Do you plan to offer remote patient monitoring (RPM)? Then you will need tools that integrate with medical devices, collect vital signs, and present monitoring dashboards for clinicians.
2.2 Assess your existing systems
If you already run an EMR/HIS such as OpenMRS, OpenEMR, GNU Health, ERPNext Healthcare or OpenClinic GA, you may need a dedicated teleconsultation front-end that integrates cleanly with your existing records to avoid duplication and fragmentation.
If you do not have an EMR/HIS, you may prefer a platform with built-in documentation or patient management capabilities.
2.3 Understand your connectivity and device constraints
If you operate in low-bandwidth environments or rely on shared clinic computers, choose a platform optimised for unstable networks and modest hardware.
If CHWs primarily use low-cost Android devices, select tools designed for mobile data capture and simple interfaces.
If patients join from their own phones without installing an app, prioritise browser-based access and one-click entry to consultations.
2.4 Check compliance and hosting requirements
If you must comply with HIPAA, GDPR, PHIPA/PIPEDA, Swiss FADP/LPD or national data-residency rules, ensure the platform allows self-hosting or deployment inside a Ministry of Health or hospital data centre. External routing or foreign hosting may not be legally permissible.
2.5 Consider localisation and support
If your deployment spans multiple languages or non-Latin scripts, choose platforms with robust localisation support.
If your teams rely on local training or support, prioritise software with regional implementation partners or strong community documentation.
The rest of the guide is organised by what the software is primarily built to do, so you can compare like with like.
3. Category A – Teleconsultation‑first platforms
These tools put teleconsultation (video/chat) at the centre. They can usually integrate with EMRs/HIS, but they are not EMRs themselves.
3.1 Snapshot comparison
| Software | Main focus | Typical users | Licence | Notes |
|---|
| HCW@Home | Secure web‑based teleconsultation platform (video, audio, chat, file sharing) optimised for low‑bandwidth environments | NGOs, public health programs, clinics, hospitals needing institution‑level teleconsultations with on‑prem or cloud hosting | GPL‑3.0 | Digital Public Good; self‑host or vendor‑hosted; HL7 FHIR APIs; focuses on institutional, multi‑provider use |
| Intelehealth | CHW‑mediated telemedicine: CHW collects structured data offline/low bandwidth and connects to remote doctor | NGOs, governments running rural or community programs with CHWs | MPL‑2.0 (key components) | Mobile‑first; optimised for rural India/LMIC settings; strong fit when CHWs are the primary workflow owners |
| PAHO All‑In‑One Telehealth (AIOTP) | Open‑source telehealth suite from PAHO with a teleconsultation front‑end and an EMR module based on OpenEMR and Jitsi | Ministries of Health, public health programmes in Latin America & Caribbean | Open‑source under PAHO initiative | Strong option if you are in the Americas and want PAHO‑backed architecture linked to OpenEMR |
| Bisa Health | Mobile/web telehealth app enabling users to access health information and communicate with doctors; DPG recognised | B2C or program‑based teleconsultation, especially in West Africa | MIT | More consumer‑facing; interesting for national or private programmes wanting an app‑based approach |
| OpenTeleRehab | Open‑source rehabilitation‑focused teleconsultation software; DPG recognised | Rehab centres, rehabilitation NGOs, public rehab programmes | Apache‑2.0 | Not a general telemedicine platform; ideal when rehabilitation is a core use case |
3.2 HCW@Home
HCW@Home is an open-source teleconsultation platform built specifically for clinical virtual visits rather than general video conferencing. It is fully open-source under GPL-3.0, with documentation and code available on GitHub.
The platform offers low-bandwidth WebRTC video, secure messaging, file sharing, virtual waiting rooms, multi-participant calls, multilingual support, and HL7 FHIR-based APIs for integration with existing EMRs and digital health systems. It is designed for deployments requiring data residency, internal hosting, or strict control over patient data, and has been recognised as a Digital Public Good.
HCW@Home fits well when:
- you already operate an EMR/HIS and need a dedicated teleconsultation layer
- self-hosting (on-prem or in a national cloud) is required
- bandwidth conditions vary or must accommodate shared devices and mobile access
It may not be the best fit when CHWs drive the consultation workflow or when rehabilitation-focused functionality is needed.
3.3 Intelehealth
Intelehealth is designed for community-based telemedicine programmes, especially in rural and low-resource settings where community health workers (CHWs) play a central role.
Its mobile application allows CHWs to collect structured patient data offline or in low-bandwidth environments, synchronise it with a backend server, and escalate cases to remote clinicians for review, advice, or prescriptions. A live video component can be added when required, but the platform’s strength lies in guided data capture and structured primary care workflows. Source code is publicly available, for example the FHW mobile app.
Intelehealth is a strong choice when:
- CHWs — not patients — are the primary entry point into the system
- consultations need to follow clinical protocols or decision support
- connectivity is unreliable or offline workflows are required
It is not designed to replace a full teleconsultation system for hospitals or clinics but complements them in community-based care models.
3.4 PAHO All-In-One Telehealth Platform (AIOTP)
The PAHO All-In-One Telehealth Platform is an open-source telehealth and EMR stack developed by the Pan American Health Organization for public health deployments across the Americas. It includes:
- a teleconsultation front-end
- an OpenEMR-based EMR back-end
- integrated workflows for patient management and follow-up
- reference implementation guidance aligned with PAHO’s digital health recommendations
AIOTP is particularly relevant for Ministries of Health or regional programmes looking for a ready-made architecture that combines telehealth with a basic EMR under a single governance model. It is a coherent option when:
- a national/regional deployment is needed
- teleconsultation must be tied tightly to clinical record-keeping
- a PAHO-aligned solution provides institutional reassurance
3.5 Bisa Health
Bisa Health is a patient-facing telehealth application originating from Ghana and recognised as a Digital Public Good. It allows users to access health information and communicate with clinicians through a mobile or web interface.
Its focus is direct patient engagement rather than provider workflows. While it includes communication features, it is typically used in B2C or national public health programmes where patients initiate consultations directly from their devices. It fits well when:
- the goal is to offer a public-facing telehealth application
- the programme targets large populations, including those with limited digital literacy
- provider-facing workflow complexity is minimal
It is not intended as a teleconsultation tool for clinical teams needing structured workflows, waiting rooms, or integration with EMRs.
3.6 OpenTeleRehab
OpenTeleRehab is an open-source telerehabilitation platform, recognised as a Digital Public Good, designed specifically for remote physiotherapy and rehabilitation services. It supports remote exercise guidance, follow-up monitoring and rehabilitation protocol management.
Because it is designed for rehabilitation rather than general teleconsultation, it should be selected when therapy workflows are central, not when the goal is general medical consultations.
4. Category B – EMR/HIS systems with telehealth features
These systems are full EMRs or hospital systems that can be extended to do teleconsultations. They are not “just” telemedicine tools; they handle registration, encounters, orders, billing, etc.
4.1 Snapshot comparison
| Software | Type | Telehealth capabilities | Typical scale | Notes |
|---|
| OpenEMR | ONC‑certified EHR + practice management | Integrated Comlink Telehealth module for video visits; also extended by PAHO’s AIOTP | Clinics to multi‑site practices | Strong for US and multi‑specialty clinics; active community; many vendors |
| OpenMRS | EMR platform (building block) widely used in LMICs | Telemedicine via custom modules and distributions; often paired with Jitsi or other video platforms | National / regional implementations | Good if you already invest in OpenMRS; telehealth usually implemented via distributions (e.g. Bahmni) or custom work |
| Bahmni | OpenMRS‑based EMR + hospital system; DPG recognised | Built‑in teleconsultation features using Jitsi; appointment scheduling & notifications for video visits | Hospitals and health centres in low‑resource settings | A strong all‑in‑one for LMIC hospitals needing both EMR and teleconsultations |
| GNU Health | Hospital management / EMR / health information system; DPG recognised | Telemedicine scenarios supported through its HIS + federation | Hospitals, public health systems | Good fit when you want hospital + public health + social medicine in one stack |
| ERPNext Healthcare (Frappe Healthcare) | Healthcare module on top of ERPNext ERP | Supports telemedicine appointment types and can integrate with telemedicine platforms / WebRTC solutions | Private hospitals, multi‑clinic organisations | Interesting if you want full ERP (inventory, billing, HR) plus clinical modules and custom telehealth integration |
| OpenClinic GA | Open‑source hospital information system; DPG recognised | Teleconsultation and tele‑expertise modules integrated with hospital workflows | Hospitals in Africa and other LMICs | Good choice if you need a DPG‑listed HIS with built‑in teleconsultation/tele‑expertise |
4.2 OpenEMR and telehealth
OpenEMR is one of the most widely adopted open‑source EMRs and practice management solutions, with ONC certification and commercial support options. Telehealth options include:
- The Comlink Telehealth module bundled with OpenEMR 7.x, providing integrated video visits from inside the EMR.
- PAHO’s All‑In‑One Telehealth Platform (AIOTP), which extends OpenEMR for telehealth in the Americas and adds a separate telehealth module that can also run independently.
If you already want a full EMR plus billing, labs, prescribing and multi‑language support, OpenEMR is a good starting point, and telehealth becomes a feature rather than a separate product.
4.3 Bahmni and teleconsultation
Bahmni is an open‑source EMR + HIS based on OpenMRS, Odoo and other components, designed for hospitals in low‑resource environments. It is also recognised as a Digital Public Good. Recent work has added a structured teleconsultation feature:
- Teleconsultation appointments scheduled in Bahmni, with links sent to patients.
- Video powered by Jitsi; self‑hosting Jitsi is recommended for production.
- Dockerized deployments and a “Bahmni Standard” distribution that is cloud‑friendly.
If your priority is a hospital‑grade EMR for low‑resource settings and you want teleconsultation as an integrated workflow rather than a separate app, Bahmni is a strong candidate.
4.4 GNU Health
GNU Health is a GNU‑project HIS/EMR with a strong focus on public health and social medicine, used by governments and hospitals and recognised as a Digital Public Good. It provides:
- EMR, hospital management, lab information system and public health surveillance in one ecosystem.
- An architecture that can be used in telemedicine scenarios (e.g. telemedicine pilots in Afghanistan and other countries), usually by integrating communication tools and using GNU Health as the clinical and administrative backbone.
Choose GNU Health when you need hospital + public health + policy data in one unified system, and you’re prepared to design the teleconsultation workflow around it.
4.5 ERPNext Healthcare (Frappe Healthcare)
ERPNext is an open‑source ERP; its Healthcare module (often referred to as Frappe Healthcare) provides patient, appointment, billing and clinical workflows and is designed to be extended. Relevant telehealth points:
- Healthcare deployments often configure “Telemedicine” as a specific appointment type with associated billing codes.
- Implementation partners integrate ERPNext with WebRTC or other telehealth platforms so doctors can start video calls from the appointment record.
ERPNext Healthcare is a good option if you want one ERP for everything (finance, inventory, HR, pharmacy, labs) and are comfortable investing in custom telehealth integration rather than using a pre‑packaged module.
4.6 OpenClinic GA
OpenClinic GA is an open‑source hospital information management system recognised as a Digital Public Good. It covers administrative, clinical, lab, pharmacy, radiology and more, and includes modules for teleconsultation and tele‑expertise. It is particularly relevant if you:
- operate in Africa or Latin America where OpenClinic GA is already in use
- want a DPG‑listed HIS that already includes teleconsultation/tele‑expertise as part of the core design
5. Category C – Patient‑facing telehealth apps
These are projects that primarily address patient‑facing telehealth use cases rather than provider‑centric clinics.
- Bisa Health – Ghana‑origin mobile and web application that lets the public access health information and communicate with doctors; recognised as a Digital Public Good, with source code on GitHub.
These can complement your institutional telemedicine stack, especially if you want a branded patient app for national or regional programmes.
6. Where does HCW@Home fit vs. other solutions?
Without overselling, a realistic positioning looks like this:
- If you need a pure teleconsultation layer you can drop in front of many systems (OpenMRS, OpenEMR, GNU Health, ERPNext, DHIS2, etc.), HCW@Home is well suited: open‑source and DPG‑recognised, low‑bandwidth WebRTC video and encrypted chat, HL7 FHIR‑based APIs for integration.
- If your main problem is “we don’t have an EMR/HIS yet”, it’s often better to choose an EMR/HIS (OpenEMR, Bahmni, GNU Health, OpenClinic GA) as the clinical backbone, then add HCW@Home or a similar teleconsultation layer on top.
- If you’re CHW‑centric with poor connectivity, Intelehealth is usually more appropriate as a primary platform, and you can still integrate later with institutional EMRs or teleconsultation tools.
7. Practical recipes for typical organisations
These are intentionally high‑level patterns; exact choices depend on your country, partners and budgets.
NGO running rural outreach with CHWs and occasional specialist input
- Core: Intelehealth (CHW app + doctor dashboard)
- Optional: HCW@Home as a video layer for cases where live multi‑party consults are needed
- Later: integrate with OpenMRS or Bahmni if you move towards facility‑level EMR
District hospital in a low‑resource setting, needing both EMR and teleconsultation
- Core: Bahmni or OpenClinic GA as the hospital system
- Teleconsultation: Bahmni’s built‑in teleconsultation module (Jitsi‑based) or a separate teleconsultation platform (HCW@Home) bridged via FHIR or custom APIs
National programme in the Americas wanting a reference architecture backed by a multilateral
- Core: OpenEMR adapted to national workflows
- Telehealth: PAHO AIOTP EMR + Telehealth modules, deployed in national infrastructure
- Optionally complement with HCW@Home or other tools where AIOTP is not a perfect fit
University hospital / regional provider with a strong IT team wanting an all‑in‑one ERP + HIS
- Core: ERPNext with Frappe Healthcare and/or GNU Health
- Telehealth: custom integration between ERPNext/GNU Health and HCW@Home or a WebRTC stack
8. Useful links
