Offices of physicians

What this category is. The layer of software the patient touches: the portal and app, digital intake and check-in, reminders and two-way texting, online bill pay and the personal health record. It sits on top of the chart and writes back into it. The coded customer is the physician's office (6211), but the biggest buyers are health systems and clinic networks, and the same products are sold to dentists, optometrists and specialists. How it differs from the neighbouring records. Electronic health records and practice management (6211) sells the record itself. Patient booking and doctor marketplaces (6211) sells patient acquisition: a marketplace of competing practitioners. Telehealth and remote patient monitoring (6219) sells the visit. This record covers what happens between a practice and the patients it already has. Two names the brief proposed fall into those neighbours. TELUS Health MyCare is a direct-to-consumer virtual clinic (telehealth, 6219). Medeo, owned by Loblaw through QHR Technologies, does offer booking, messaging and video visits for a patient's own clinic, so it stays on this record. The incumbent is the record vendor, not a portal company. Epic's MyChart says it serves over 190 million patients [A, mychart.org]. It comes with the Epic record, so a health system on Epic does not buy a separate patient portal. The ambulatory record vendors have done the same thing. eClinicalWorks ships healow. ModMed bought Klara in February 2022, and klara.com now redirects to ModMed's patient-engagement page [A/B]. Tebra sells patient experience alongside its record. In Canada, WELL Health bought CognisantMD's Ocean platform (booking, messaging, reminders, digital forms, kiosks and eReferral) in December 2021. At the time Ocean supported about 8,000 physicians and had about $4M of annual SaaS revenue [B, WELL release]. The independents that have scale. Phreesia (NYSE: PHR) earned $480.6M of revenue in fiscal 2026, its first full year of GAAP net income. It averaged 4,514 healthcare-services clients that year [B]. Part of that revenue comes from pharmaceutical manufacturers who pay to reach patients at intake, not from the practices. Phreesia cut its fiscal 2027 outlook to $510–520M because of reduced visibility into that spending [B]. Weave (NYSE: WEAV) earned $239.0M in 2025, up 17%, from 39,625 customer locations. Most are small dental, optometry and medical practices [A, Weave release]. Luma Health raised a $130M Series C led by FTV Capital in November 2021, $160M in total, and claimed 550+ health systems and clinic networks [B]. Artera (formerly WELL Health Inc., renamed October 2022) had raised just under $100M by then and is reported to have added a $65M Series D led by Lead Edge Capital in December 2025 [B/C]. Relatient has been majority-owned by Brighton Park Capital since November 2019 and raised more than $100M of growth equity before buying Radix Health in 2021 [B]. Kyruus Health (provider search plus scheduling; it bought HealthSparq and Epion Health) and Solutionreach (Summit Partners since 2012) complete the field [B/C]. PocketHealth (Toronto; $33M Series B led by Round13 Capital in March 2024) is a niche: patients' access to their own medical images [B]. Why a newcomer cannot get in. The patient's login belongs to whoever holds the chart. For a health system on Epic, MyChart is already paid for, and any standalone tool must integrate with the record and justify itself on top of what is bundled. For a small practice, the record vendor bundles reminders and a portal, and Weave and Solutionreach already sell texting and payments. The standalone vendors with scale have found a second payer (Phreesia's pharma network) or a payments attach (Weave). That tells you a practice will not pay much for engagement on its own. Canada. Ocean (WELL Health) leads physician-office engagement and eReferral, Medeo is bundled with Loblaw's Accuro record, and portals from the provincial systems and hospitals cover the rest. The paying customer is a publicly funded practice with limited budget for add-ons, which is analyst judgment, not sourced. Incumbent vulnerability decides it: the record vendor owns the patient's login and bundles the layer, and the independent field is crowded and funded.

Epic holds 43.7% of acute hospitals and 56.9% of beds, and was the only vendor chosen by large health systems in 2025. Its position is reinforced by clinician training investment rather than contract terms, and certification (ONC in the US, provincial conformance in Canada) is a multi-year floor before a single seat is sold. There IS visible instability — roughly 30% of Oracle Health customers say the platform is not in their long-term plans and another 35% are considered vulnerable — but that displaced demand flows to Epic and Meditech, not to a new entrant. Note also that EHR purchase decisions fell 40% in 2025: the buying window itself is narrowing.

The control set is public, the regulator gives the artefact away, and the platforms that sell a dozen frameworks throw this one in — there is no ground here that can be held. The floor is zero: ONC, with OCR, publishes the Security Risk Assessment Tool free (v3.7, a 72.5MB Windows installer plus an Excel workbook), aimed in its own words at "medium and small providers" — the exact buyer a HIPAA-only vendor sells to — and NIST SP 800-66 Rev. 2 (February 2024) maps every Security Rule standard to CSF subcategories and SP 800-53r5 controls, machine-readable through NIST's CPRT. The ceiling is the multi-framework platform: Vanta, Secureframe and Scytale each list HIPAA as one item on a menu beside SOC 2, ISO 27001, PCI DSS, GDPR, ISO 42001 and CMMC (vendor pages opened 2026-09-20). A health-tech buyer who needs SOC 2 to close enterprise deals gets HIPAA out of the same control set, at no separate line on the quote. Between floor and ceiling sits a thin, transparent price: Accountable HQ publishes $2,028 to $8,148 a year for 15–20 employees, and its own navigation carries comparison pages against Vanta, Sprinto, Secureframe, consultants and spreadsheets — the pure-play conceding the squeeze on its own site. The one pure-play that ever reached a public market settles it. CynergisTek's revenue fell from $21.36M (2019) to $16.30M (2021); Clearwater Compliance, an Altaris portfolio company, took it private at $1.25 cash a share on 2022-09-01 — about $16.6M for the equity, roughly one times revenue, and below every outstanding option strike, so all options were cancelled for nothing. The honest screening outcome is that this is a framework inside a broader compliance product, not a standalone market.

What this category is. These are online booking marketplaces. A patient searches by specialty, location and insurance, reads reviews and books a slot. The practice pays a subscription that bundles its public profile, an online calendar, reminders that cut no-shows and light practice-management software. The coded customer is the physician's office (6211), but the same product is sold to dentists, physiotherapists, psychologists and other independent practitioners. How it differs from the neighbouring records. Electronic health records and practice management (6211, Epic and the ambulatory EHRs) sell the clinical record. A booking marketplace sells patient acquisition, and scheduling is the hook that gets it into the practice. The marketplace holds the patient demand, not the chart. Telehealth (6219) sells the visit itself. The dental (621210), chiropractic (621310) and behavioural-health (621330) records cover single-profession practice software. Jane appears there as a multi-discipline clinic system, and its online booking serves the clinic's own patients rather than a marketplace of competing practitioners. The leaders are regional, and each holds its own geography. Docplanner (Warsaw) runs ZnanyLekarz in Poland, Doctoralia in Spain and Latin America, MioDottore in Italy and jameda in Germany across 13 countries. It claims 300,000 active doctors and 100 million monthly patient visits [C, vendor]. It merged with Doctoralia in 2016 alongside a $20M Series C led by Target Global, raised a €15M Series D in 2017 (ENERN lead) and an €80M Series E in 2019 (One Peak and Goldman Sachs Private Capital), then took a 2021 round at more than $1B whose amount was not disclosed [B]. By its own account it had raised about €300M by November 2021, when it bought jameda from Hubert Burda Media [B]. Its Polish subsidiary filed PLN 212.5M of 2024 revenue and PLN 50.7M of net profit, and management talks of about $300M of group revenue in 2026 and a listing in two to three years [B, wirtualnemedia.pl]. Doctolib (Paris) holds France, Germany and Italy. It raised €150M at $1.13B in 2019 (General Atlantic) and €500M of equity and debt at €5.8B in 2022 (Eurazeo lead), about $815M in all [B]. It now claims 520,000 health professionals [C, vendor], and a reported 2026 secondary priced it near €3.6B [C, via secondary report]. Zocdoc (New York) holds the US: $130M at $1.8B in 2015 (Baillie Gifford and Atomico) and $150M of growth financing from Francisco Partners in 2021, when it said it was profitable after moving from flat subscriptions to a fee per booking [B]. Practo (Bengaluru) holds India and sells its Ray clinic software alongside the marketplace [A for the product; B for the $55M 2017 and $32M 2020 rounds]. Why a newcomer cannot get in. The practice pays for patients, so a marketplace with no patient traffic has nothing to sell. Building that traffic means years of consumer search and review content, and each incumbent's moat is one country's patients. Below the marketplaces the field is crowded with scheduling-and-reminder software that has no demand side of its own: Jane (North Vancouver, valued at about $1.8B), Cliniko (Melbourne, bootstrapped, $45 to $395 a month), Tebra (Kareo plus PatientPop), NexHealth ($125M Series C at $1B) and Solv (urgent care, over $80M raised) [B/C]. The Canadian gap is structural, not open. No national doctor-booking marketplace leads in Canada. Medically necessary physician services are publicly insured, so a GP cannot pay a marketplace to buy demand the way a private practice in Warsaw, Paris or New York can. The paying customers are allied-health and private clinics, and Jane already serves them. This is analyst judgment, not sourced. Distribution decides it: the asset is the patient audience, and every geography that pays for one already has a funded owner.

What this category is. The back office between a care provider and whoever pays: eligibility checks, claims and the clearinghouse that carries them, coding, denials and appeals, payer-to-provider payments, patient statements and collections, and the credentialing and enrolment that let a clinician bill a plan at all. The coded customer is ambulatory care (621): physician groups, clinics, labs and home health. But the largest buyers of several segments are hospitals and health systems (outsourced revenue cycle, inpatient coding) and health plans (payer payments, provider data, credentialing). How it differs from the neighbouring records. Electronic health records and practice management (6211) sells the chart and scheduling; athenahealth appears here only for its revenue-cycle business, and its funding is not re-researched. EHR+ patient engagement (6211) sells the portal and intake. Patient booking (6211) sells patient acquisition. HIPAA compliance (6211) sells security and audit. Medical imaging (621510) sells PACS. This record is the money and paperwork layer. Who owns the rails. Optum completed its combination with Change Healthcare on 3 October 2022 [A, Optum]. The February 2024 ransomware attack on Change touched about 192.7 million individuals, the largest US healthcare breach on record [B, CyberInsider citing the HHS OCR filing], and stopped claims for providers across the country. That shows how much of the network runs through one company. Availity says it connects over two million providers to every US health plan and handles over 13 billion transactions a year; its shareholders include Anthem (Elevance), Humana, HCSC and GuideWell, and Novo Holdings bought Francisco Partners' stake in July 2021 [A, Novo Holdings]. Waystar (Nasdaq: WAY) earned $1,099M of revenue in 2025, up 17%, from about 30,000 clients representing over 1 million providers [A, Waystar release]. Experian Health sells patient access, eligibility and identity inside Experian plc. Zelis runs the payer-to-provider payment side: 725 payer clients, 850K+ providers and $300B+ of payment volume by its own count [C]. Bain Capital and Parthenon sold a minority stake to a Mubadala-led group that closed on 26 November 2024 [A, Kirkland & Ellis]; the reported $17B valuation is Bloomberg's, not opened here. Who owns the outsourced work. R1 RCM was taken private by TowerBrook and CD&R at about $8.9B, closing 19 November 2024 [A, CD&R]. Ensemble Health Partners began as Bon Secours Mercy Health's revenue-cycle arm; Golden Gate Capital bought 51% in 2019 in a deal reported at about $1.2B [B, Becker's]. athenahealth, bought by Bain Capital and Hellman & Friedman for $17B [B, Healthcare Dive], bundles billing with its ambulatory record. The AI wave is already funded. AKASA (inpatient coding for 500 hospitals, by its own count) raised a $60M Series B led by BOND in 2021 [A]. Adonis raised a $40M Series C led by Quadrille Capital in March 2026, over $95M in total, and claims more than 4x revenue growth in 2025 [A, company release]. Candid Health raised a $52.5M Series C led by Oak HC/FT, $99.5M in total [B, HLTH]. Infinitus raised a $51.5M Series C led by Andreessen Horowitz, $102.9M in total, for AI agents that call payers [B, Pulse 2.0]. In credentialing, Medallion has raised $130M (latest $43M led by Acrew Capital, August 2025) and has acquired Andros [A]. CertifyOS raised a $40M Series B led by Transformation Capital in June 2025 [A]. Uno Health (Medicaid and benefits enrolment) was bought by Findhelp in October 2025 [B]. Canada. Provincial plans pay physicians, so the US claims-and-denials problem mostly does not exist. Billing is bundled with the record: more than 40,000 Canadian health professionals use a TELUS Health EMR [A, TELUS], and TELUS's CHR files OHIP claims through MDBilling [A, TELUS help centre]. mdbilling.ca now redirects to Dr.Bill, which claims 13,000+ physicians across OHIP, MSP and AHCIP [C]. TELUS eClaims covers direct billing to private insurers for allied health. Why a newcomer cannot get in. The clearinghouse and payment rails are owned by Optum, Availity (owned by payers), Waystar and Zelis. Each depends on connections to thousands of payers and on volume pricing. The outsourced hospital work is owned by private-equity platforms worth billions. Every point task an AI startup might attack (coding, denials, payer calls, credentialing, patient billing) already has a venture-backed player with $50M–$130M raised, and the incumbents are buying or building the same AI. Waystar's acquisition of Iodine is one example. In Canada the pain is small and the record vendors bundle it. Incumbent vulnerability decides it.