NextGen Healthcare EHR Review (2026)

Overview

NextGen Healthcare is one of the longest-standing names in ambulatory EHR, tracing its origins to Quality Systems, Inc. (QSI), founded in 1974. Now publicly traded on NASDAQ under the ticker NXGN and headquartered in Atlanta, Georgia, the company serves more than 100,000 providers across the United States. Its core strength is specialty medicine: NextGen offers 26 specialty-specific clinical content templates, more than any other major ambulatory EHR vendor.

Where competitors like athenahealth and eClinicalWorks emphasize breadth and primary care, NextGen has carved out a defensible position in specialty practices -- orthopedics, dermatology, cardiology, gastroenterology, rheumatology, and behavioral health among them. The platform is built around two product lines: NextGen Enterprise for mid-size to large practices and NextGen Office (formerly MediTouch) for smaller groups.

In recent years, NextGen has invested heavily in AI-powered ambient documentation through its Ambient Assist product, interoperability via its Mirth Connect integration engine, and a full migration to cloud-based delivery. The company's fiscal 2025 revenue was approximately $680 million, and it continues to compete primarily in the ambulatory mid-market against athenahealth, eClinicalWorks, and AdvancedMD.

Key Features

NextGen Enterprise EHR

The flagship product is a highly configurable EHR and practice management platform designed for multi-specialty and single-specialty groups with 10 or more providers. Enterprise includes structured clinical content for 26 specialties, configurable workflow automation, embedded clinical decision support, and a template engine that allows practices to customize documentation to match their clinical processes without custom development.

Ambient Assist (AI Documentation)

NextGen Ambient Assist uses artificial intelligence to listen to patient-provider conversations during clinical encounters and automatically generate structured clinical notes. NextGen reports that Ambient Assist saves clinicians an average of 2.5 hours per day on documentation, directly addressing the documentation burden that drives physician burnout. The technology is integrated natively into the Enterprise EHR workflow, so providers review and sign notes within the same interface they already use. For a broader look at how ambient AI is reshaping clinical documentation, see our guide to AI in EHR.

Specialty Clinical Content

NextGen's 26 specialty templates go beyond simple note templates. Each specialty module includes relevant order sets, clinical decision support rules, specialty-specific workflows (such as injection tracking for rheumatology or lesion management for dermatology), diagnosis-specific documentation fields, and pre-built quality measure reporting. This depth of specialty content is a primary differentiator and the reason many specialty groups choose NextGen over generalist competitors.

Population Health and Analytics

NextGen Health Data Hub aggregates clinical, claims, and social determinants of health data to support population health management, risk stratification, and quality reporting for value-based care contracts. The platform includes care gap identification, patient registries, and performance dashboards aligned to MIPS/MACRA measures.

Patient Engagement

NextGen Patient Experience Platform includes a patient portal, online scheduling, digital intake forms, automated appointment reminders, two-way secure messaging, and mobile check-in. The platform also supports online reputation management and patient satisfaction surveys to help practices manage their public presence.

NextGen Office (Smaller Practices)

NextGen Office is a separate, cloud-native EHR and practice management product designed for practices with 1 to 10 providers. It offers a simpler interface, faster deployment, and a lower price point than Enterprise. Office is a good fit for small specialty or primary care practices that need a functional, affordable EHR without the depth of configurability that Enterprise provides. However, it shares limited code with Enterprise, which can create confusion during the sales process.

Interoperability (Mirth Connect)

NextGen owns Mirth Connect, one of the most widely deployed open-source health data integration engines in the industry. This gives NextGen a structural advantage in interoperability, supporting HL7v2, FHIR R4, CCD/C-CDA, and Direct messaging. Mirth Connect is used not only within NextGen's own products but also by thousands of organizations worldwide as a standalone integration platform.

Pros

• Unmatched specialty depth. With 26 specialty-specific clinical content templates, NextGen offers more purpose-built specialty workflows than any other major ambulatory EHR. Specialty practices get documentation, order sets, and decision support tailored to how they actually practice.
• Ambient AI documentation saves real time. Ambient Assist's reported 2.5 hours/day savings per clinician is among the highest in the industry and addresses the single biggest driver of physician burnout.
• Strong interoperability via Mirth Connect. Owning one of the most widely adopted integration engines in healthcare gives NextGen a genuine structural advantage in data exchange -- not just marketing claims.
• Configurable without custom development. Enterprise's template engine and workflow builder allow practices to tailor clinical workflows, documentation, and order sets without needing custom code or professional services for every change.
• Population health and value-based care tools. Health Data Hub provides meaningful analytics for practices transitioning to value-based contracts, with care gap identification, risk stratification, and MIPS/MACRA dashboards.
• Comprehensive patient engagement. The Patient Experience Platform covers the full patient journey from online scheduling and digital intake through portal access and reputation management.
• Mature revenue cycle management. NextGen's integrated PM and billing tools support multi-payer billing, electronic remittance, denial management, and coding assistance across specialties.
• Long track record and financial stability. As a publicly traded company with 50 years of history and $680M+ in revenue, NextGen offers a level of vendor stability that smaller competitors cannot match.
• ONC-certified and MIPS-ready. Full ONC 2015 Edition Cures Update certification ensures regulatory compliance, and built-in quality reporting simplifies MIPS participation.

Cons

• UI modernization is still in progress. While NextGen has been updating its interface, parts of the Enterprise product still reflect older design patterns. The user experience does not feel as polished as newer cloud-native competitors like athenahealth or DrChrono.
• Reporting and analytics have a steep learning curve. The reporting tools are powerful but not intuitive. Many practices need dedicated report writers or additional training to extract the data they need without relying on NextGen professional services.
• NextGen Office vs. Enterprise creates market confusion. The two products share a brand name but differ significantly in architecture, capabilities, and target audience. Buyers sometimes purchase Office expecting Enterprise-level specialty depth, or vice versa. This dual-product strategy muddies the buying process.
• Customer support quality varies. User reviews consistently cite inconsistent support experiences. While some practices report responsive, knowledgeable support teams, others describe long resolution times and difficulty reaching staff who understand their specialty-specific configurations.
• Implementation can be lengthy for Enterprise. A full NextGen Enterprise deployment with specialty content, data migration, and interface builds typically takes 4 to 8 months -- longer than cloud-native alternatives that target faster go-live timelines.
• Third-party module dependencies. Some capabilities that competitors include natively (such as advanced analytics or certain patient engagement features) require add-on modules or third-party integrations with NextGen, increasing the total cost of ownership.
• Not a fit for hospitals or large health systems. NextGen is purpose-built for ambulatory practice. Organizations that need inpatient, surgical, or enterprise hospital workflows will need to look at Epic or Oracle Health instead.

Pricing

NextGen Healthcare does not publish standard pricing. All contracts are customized based on practice size, product selection, and module configuration. Based on industry data and user reports, expect the following ranges:

Contracts are typically multi-year (3 to 5 years) with annual escalators. NextGen may offer discounts for longer commitments or bundled product packages. For a broader perspective on EHR pricing models and negotiation strategies, see our EHR cost guide.

Who Should Use NextGen

NextGen is a strong fit for:

• Mid-size to large specialty practices (10-200+ providers) in orthopedics, dermatology, cardiology, gastroenterology, rheumatology, or other supported specialties that need deep clinical content out of the box.
• Multi-specialty groups that operate across several specialties and need a single platform with specialty-specific templates for each department.
• Practices prioritizing ambient AI documentation that want a natively integrated ambient listening solution without relying on a third-party vendor.
• Organizations with complex integration requirements that benefit from Mirth Connect's enterprise integration engine for connecting to labs, imaging centers, HIEs, and other systems.
• Practices transitioning to value-based care that need population health analytics, care gap management, and quality measure reporting within their EHR platform.

NextGen is not the best fit for:

• Solo practitioners or very small practices that need a simple, low-cost EHR. Consider DrChrono or Tebra instead.
• Hospitals and health systems that need inpatient workflows, surgical suites, or enterprise-wide integration. Epic and Oracle Health serve this market.
• Practices that prioritize a modern, consumer-grade UI above all else. NextGen Enterprise's interface, while improving, is not as visually polished as newer platforms.
• Organizations that need rapid deployment. If you need to go live in under 60 days, NextGen Enterprise's implementation timeline may not meet your needs. NextGen Office or cloud-native alternatives like athenahealth may be faster.
• Behavioral health-only practices. While NextGen supports behavioral health, purpose-built BH platforms like Netsmart, TherapyNotes, or AZZLY Rize offer deeper behavioral health-specific workflows. See our behavioral health EHR comparison for details.

Implementation

NextGen Enterprise implementations follow a structured methodology that typically spans 4 to 8 months. The process includes the following phases:

1. Discovery and planning (2-4 weeks). NextGen's implementation team conducts a detailed assessment of current workflows, specialty requirements, integration needs, data migration scope, and organizational readiness. This phase produces a project plan with milestones and resource assignments.
2. System configuration (4-8 weeks). Specialty templates, order sets, clinical decision support rules, and workflow automation are configured based on practice requirements. This is where NextGen's 26 specialty content libraries provide the most value -- practices start with pre-built specialty content and customize from there rather than building from scratch.
3. Interface builds and data migration (4-8 weeks, often parallel). Connections to labs, imaging, pharmacies, HIEs, and other external systems are built using Mirth Connect. Historical patient data is extracted, mapped, validated, and imported from the legacy system.
4. Testing and validation (2-4 weeks). End-to-end workflow testing, interface testing, data migration validation, and user acceptance testing ensure the system works correctly before go-live.
5. Training (2-3 weeks). Role-based training for physicians, nurses, medical assistants, billing staff, and administrators. NextGen offers both in-person and virtual training options.
6. Go-live and stabilization (2-4 weeks). NextGen provides on-site or remote support during the initial go-live period. Most practices run a short parallel operation period before fully cutting over.

NextGen Office implementations are substantially faster, typically completing in 4 to 8 weeks. For a complete checklist of what to expect during an EHR implementation, see our EHR implementation checklist.

Frequently Asked Questions

How much does NextGen EHR cost per month?

NextGen Healthcare pricing typically ranges from $150 to $500 per provider per month, depending on the product tier and modules selected. NextGen Office starts around $150/provider/month for smaller practices, while NextGen Enterprise with full specialty content, population health analytics, and ambient AI documentation can reach $400-$500/provider/month. Implementation fees, data migration, and training are additional. NextGen does not publicly list pricing, so all quotes are customized.

What is the difference between NextGen Enterprise and NextGen Office?

NextGen Enterprise is the flagship product designed for mid-size to large multi-specialty and specialty practices. It offers deep specialty content with 26 clinical templates, advanced population health tools, robust reporting, and extensive configurability. NextGen Office (formerly MediTouch) is a lighter, cloud-native product aimed at smaller practices (1-10 providers) with simpler workflows and faster deployment. Enterprise offers more customization and specialty depth, while Office prioritizes ease of use and lower cost.

Does NextGen Healthcare support ambient AI documentation?

Yes. NextGen Ambient Assist uses AI-powered ambient listening to capture patient-provider conversations and automatically generate structured clinical notes. According to NextGen, Ambient Assist saves clinicians an average of 2.5 hours per day on documentation. The feature integrates directly into the NextGen Enterprise EHR workflow.

Is NextGen EHR ONC-certified?

Yes. NextGen Healthcare is ONC 2015 Edition Cures Update certified, meeting all federal requirements for Meaningful Use, MIPS/MACRA quality reporting, and information blocking prevention under the 21st Century Cures Act.

What specialties does NextGen EHR support?

NextGen offers 26 specialty-specific clinical content templates covering orthopedics, dermatology, cardiology, gastroenterology, rheumatology, behavioral health, OB/GYN, ophthalmology, pulmonology, urology, pain management, neurology, podiatry, and more. Each template includes specialty-relevant workflows, order sets, clinical decision support, and documentation fields.

How long does NextGen EHR implementation take?

NextGen Enterprise implementations typically take 4 to 8 months depending on practice size, number of specialties, data migration complexity, and workflow customization. NextGen Office deployments are faster, often completing in 4 to 8 weeks.

Verdict

NextGen Healthcare occupies a well-defined niche in the ambulatory EHR market: it is the strongest option for mid-size to large specialty and multi-specialty practices that need deep, purpose-built clinical content without the cost and complexity of an enterprise hospital system like Epic. The 26 specialty templates, native ambient AI documentation, and Mirth Connect integration engine form a compelling product stack for its target buyer.

The weaknesses are real but manageable. The UI is aging (though improving), reporting requires investment in training, and the Enterprise vs. Office branding creates unnecessary buyer confusion. Support quality remains inconsistent based on user reports.

For specialty practices in the 10-200 provider range that prioritize clinical workflow depth over visual polish, NextGen Enterprise deserves serious evaluation alongside athenahealth and eClinicalWorks. Practices should request specialty-specific demos, confirm which product line (Enterprise vs. Office) is being quoted, and negotiate implementation support terms before signing. For guidance on structuring your evaluation, see our EHR cost guide and switching EHR systems guide.