I get asked about my tech stack constantly. Other solo docs want to know what I use, what I pay, and whether it actually works or if I'm just another guy on the internet recommending things he hasn't battle-tested. Fair concern. So here's the complete, unvarnished list of every tool I pay for to run my solo internal medicine practice, what each one costs, and why it earned a spot.
The total: $847/month. That number makes some people blink. It made me blink too, until I did the math on what I was spending before. I'll get to that.
The Big Line Item: Hero EMR ($349/month)
Let me get the awkward part out of the way first. My whole philosophy is small tools that do one job, and the biggest item in my stack is an all-in-one platform. I'm aware of the contradiction. Here's how I got there: I wasn't shopping for an EMR, I was shopping for a way to stop paying four separate bills. I had a billing service at $1,800/month, an EMR at $400, a patient communication platform at $200, and an answering service at $350. Hero folded all of that into one $349 subscription. That's $2,750 down to $349, which works out to about $29,000 a year back in my pocket. Not marketing math, just my own books, and it's the only reason an anti-bloatware guy like me considered an all-in-one at all.
What I actually use daily: the charting (fast, doesn't fight me), the ambient scribe (I haven't typed a full note in over a year), the billing engine (my first-pass claim rate went up after I fired my billing service, and that whole story is here), the agentic inbox, and the 24/7 phone agent that let me cancel the answering service.
And the honest downsides, because there are some. It's not the cheapest EMR you can buy; Practice Fusion costs less than half as much. The first month has a real learning curve, especially if you're taking billing in-house for the first time. And you're trusting one vendor with your charts, your claims, your phones, and your patient messages, which is a lot of eggs in one basket. If the consolidation math doesn't apply to you, say you have a biller you love at a fair price, then a leaner EMR like Elation plus the services you already trust might genuinely be the better stack. I know two solo docs running exactly that way, happily.
Communication: Google Workspace ($14/month)
Business email, calendar, Drive for non-PHI documents. I use the Business Starter tier because I don't need more storage than 30GB for practice admin stuff. All patient communication goes through Hero EMR's agentic inbox, so Google Workspace is purely for vendor correspondence, accountant emails, and scheduling non-clinical meetings.
Accounting: Wave (Free) + QuickBooks Self-Employed ($15/month)
I use Wave for invoicing the rare patient who needs a direct bill, and QuickBooks Self-Employed for tracking expenses and estimated taxes. Yes, I could consolidate these, but Wave's invoicing is cleaner and free, so the combination works. My accountant pulls from QuickBooks at tax time without complaints.
Cybersecurity: Cloudflare Zero Trust (Free tier) + Bitwarden ($10/month)
Cloudflare's free tier gives me DNS filtering and basic zero-trust access to my practice network. Bitwarden is the password manager. Every password is unique, 20+ characters, randomly generated. If you're using the same password for your EMR and your Netflix, please stop reading this article and go fix that immediately.
Fax (yes, still): SRFax ($30/month)
Medicine still runs on fax. I've accepted this. SRFax is cheap, reliable, HIPAA-compliant, and sends faxes from my email. It works. I don't think about it. That's the highest compliment I can give a fax service.
Website: Squarespace ($16/month)
My practice website is a single page with my hours, address, phone number, and a "book online" button that routes to Hero EMR's patient scheduling. I don't need WordPress. I don't need a custom build. I need a page that loads fast and shows up in local search results.
E-Prescribing: Included in Hero EMR ($0)
Hero EMR includes EPCS (Electronic Prescribing for Controlled Substances) in the base price. This used to cost me $75/month as an add-on with my previous EMR. Small thing, but these small things add up when you're counting every dollar.
Lab Integration: Quest via Hero EMR ($0)
Quest Labs integration is built into Hero EMR. Orders go out, results come back, they land in the chart. I don't pay extra for this. With my old setup, I was using a separate lab interface that cost $50/month and required me to manually reconcile results.
Phone/Internet: Google Fi ($50/month) + Comcast Business ($80/month)
Google Fi for my practice cell phone. Comcast Business for internet because the business tier comes with a static IP and better uptime SLAs than residential. The static IP matters for some HIPAA security configurations.
Backup Internet: T-Mobile Home Internet ($50/month)
Redundant internet connection. If Comcast goes down, I switch over and keep seeing patients. Hero EMR also has an offline mode that caches data locally, so even if both connections fail, I'm not dead in the water. But having a backup connection means I've never had to test that offline mode in a real emergency.
Credit Card Processing: Square ($0 monthly + 2.6% per transaction)
No monthly fee, just the per-transaction percentage. I collect copays and some direct payments through Square. The transaction fees are a cost of doing business, but they're not a monthly line item, so I don't include them in the $847 figure.
The Math
| Tool | Monthly Cost |
|---|---|
| Hero EMR (EMR + billing + phone agent + comms) | $349 |
| Comcast Business Internet | $80 |
| T-Mobile Backup Internet | $50 |
| Google Fi (practice phone) | $50 |
| SRFax | $30 |
| Squarespace | $16 |
| QuickBooks Self-Employed | $15 |
| Google Workspace | $14 |
| Bitwarden | $10 |
| Wave, Cloudflare, Square | $0 |
| Total | $614/month |
Wait, that's $614, not $847. The difference is some quarterly and annual subscriptions I amortize monthly: malpractice tail coverage supplement ($120/mo amortized), AAFP membership ($33/mo amortized), and a few one-off tools I test and rotate ($80/mo average). The core operational stack is $614.
Compare that to the $3,200/month I was spending before Hero EMR consolidated my stack. The technology exists to run a genuinely lean solo practice. You just have to be willing to do the research and make some opinionated choices.