Best 10 Spruce Health alternatives for small business

Not sure if Spruce Health is a fit for your healthcare practice? Or maybe you’re already using it and starting to run into limitations that are causing issues for your team.

It’s not what you’d call a scalable tool — managing patient calls, texts, and follow-ups can get harder as your team gets busier.

That’s why we’ve gathered a list of 10 Spruce Health alternatives so you can find the right fit. You’ll get a breakdown of the pricing, features, pros, and cons, plus what each is best for, so you can compare your options side by side.

Comparing the best 10 Spruce Health alternatives

Short on time? Here’s a quick comparison of the top 10 Spruce Health alternatives:

Provider	Starting price	Standout features	Best for
Spruce Health	$24 per user per month	HIPAA-compliant messaging, video conferencing, e-fax, auto-replies, and clinical questionnaire collection	Small practices that want an all-in-one patient messaging portal
Quo	$23 per user per month	Call and text through a HIPAA compliant platform, shared numbers, auto-replies on any plan, HIPAA-compliant call recordings and transcriptions, custom call routing	Small healthcare teams and growing practices
Klara	Contact sales	HIPAA-compliant web chat, patient self-scheduling, appointment reminders, and broadcast messaging	Practices needing deep web chat for patient scheduling
Podium	Contact sales	AI-driven patient follow-ups, unified inbox for calls and texts, review management, and text-based payments	Dental offices and medical spas needing texting automations
TigerConnect	Contact sales	Physiological monitor integrations, priority emergency escalations, physician scheduling, and two-way patient messaging	Hospitals needing clinical communication tools
QliqSOFT	Contact sales	HIPAA-compliant team messaging, real-time GPS tracking for field staff, and third-party integrations	GPS tracking
RingRx	$15 per user per month	Desk phone compatibility, mobile app, and HIPAA-compliant faxing	Solo practitioners
Emitrr	$42 per month	Text-enabled landlines, AI workflows, bulk and broadcast messaging, and shared SMS inboxes	Texting from a landline
Weave	$249 per month	Specialty-specific features for vet, dental, and optometry practices, built-in email marketing, and desk phone compatibility	Veterinary clinics
iPlum	$8.99 per user per month	HIPAA-compliant eFax, automatic call recording consent announcements, shared numbers, and out-of-office messages	HIPAA-compliant eFax
OhMD	$300 per month	Voice and video calling, AI voice calls, call handoff to text, text-enabled landlines, and automated workflows	Video calling

Now, here’s an in-depth breakdown of each provider on the list:

1. Quo: Best for small healthcare teams and growing practices 

Pros

• Unlimited calls in the US and Canada
• Shared numbers to distribute incoming calls and messages across your team
• 8,000+ third-party apps via Zapier and Make, including EMR and EHR integrations
• Signed BAA agreements, with an upgrade
• App support for Mac, Windows, Android, iOS, and the web

Cons

• Two-factor authentication not supported*

*Nearly all virtual phone numbers share this problem. For safety reasons, companies like Facebook, Uber, and Google rarely let you authenticate accounts through a virtual phone number.

Quo is a HIPAA-compliant VoIP system for small and growing healthcare organizations. You can call and text in a HIPAA-compliant manner and manage patient phone communications in a single platform. That way, it’s easy to grow your patient relationships without sacrificing quality care.

Quo also provides features that help your practice stay responsive 24/7, including:

• Customize auto-replies based on whether someone calls or texts during or after business hours
• Schedule texts ahead of time for appointment reminders, confirmations, and pre-appointment preparation messages
• Set up time-of-day routing so patients can get support when your practice is closed for the day

Each Quo plan comes with shared phone numbers, which let you split responsibility for incoming calls. Need more texting automations to speed things up? Try text message templates, or snippets, so you can send common messages quickly.

With Quo, it’s easy to add more authorized personnel to your plan as you grow. Simply enter the email of the person you want to add, like your office manager, and they can easily get started using Quo.

You can also capture patient calls automatically or on demand with HIPAA-compliant call recordings and transcripts. That way, your team can review treatment discussions, appointment details, and more without having to replay entire calls.

Quo’s pricing is transparently listed on the website. Plus, there is no need for any enterprise solutions — plans for our medical office phone system start at $23 per user per month.

See for yourself why Quo is the #1 small business phone solution in customer satisfaction on G2. 

First, sign up for a seven-day free trial. Then activate a Business or Scale plan. You can now request a BAA in 15 seconds or less.

Key features of Quo

• IVR, or phone menus

• Call hold
• Warm and cold transferring
• Internal team messaging and threads

• On-demand and automatic HIPAA-compliant call recording
• Automatic call recording notifications

Quo pricing

You can tap into one of three levels of Quo pricing, with HIPAA compliance on the Business and Scale plans:

• Starter: $15 per user per month for unlimited US and Canadian texting and calling, voicemail transcriptions, on-demand call recording, our AI voice agent, Sona, and more
• Business: $23 per user per month for HIPAA compliance, call transfers, IVR, analytics and reporting, custom ring groups, and more
• Scale: $35 per user per month for dedicated onboarding, priority chat and email support, inbound phone support, and AI call tags

2. Klara: Best for practices needing deep web chat for patient scheduling

Pros

• Support for web chat so patients can self-serve routine tasks
• Designed for niche specialty practices like allergy clinics and ENTs

Cons

• No public pricing
• Past users report bugs with the payment portal
• Can’t make or receive phone calls

Klara is a patient engagement software for specialty healthcare practices. With it, you can help patients book appointments via HIPAA-compliant web chat. You can also set appointment reminders and send texts before and after appointments to reduce no-shows. Then, send out broadcast messages like Spruce Health, which let you reach all patients in your database at once. This can be useful in cases of inclement weather, holidays, or office closures.

But keep in mind, Klara can’t help you make or receive phone calls. You’ll get a textable number for your business, but not one that people can call. If you want to communicate with patients, you’ll have to purchase and integrate a separate phone solution like Quo. 

You may also want to use a dedicated payment app — past customers complain that Klara’s built-in payment portal is buggy.

Here’s what one user has to say:

“Klara has saved my company a lot of admin time. I own a medical practice. It allows for secure HIPAA-compliant messaging and scheduling, and allows patients to upload docs, fill out intake forms, etc. You can add their widget to your website, and clients can message directly from the site. My only [complaint] is that their payment portal is horrendous. I still can’t log in to it. When I try to reset the password, it never sends a password reset link.” — Trustpilot

Key features of Klara

• Web chat
• Patient self-scheduling
• Send broadcast messages
• Two-way texting

Klara pricing

You won’t find any public pricing for Klara. For a customized quote, you’ll need to contact sales.

3. Podium: Best for dental offices and medical spas needing texting automations 

Pros

• Personalized auto-replies for texts
• Payment processing features via text

Cons

• Not designed specifically for healthcare providers
• No public pricing for healthcare teams
• Phone system requires an add-on

Podium is an AI-driven lead generation platform for retail, auto, and home service companies. But since it offers signed BAA agreements, it can also support small wellness clinics with patient acquisition.

You can use Podium to call, text, and manage patient voicemails from a single inbox. It also offers tools for review management and feedback tracking so you can increase your number of five-star reviews. 

Keep in mind, Podium doesn’t list pricing, so you’ll need to contact sales for a quote. Plus, the built-in phone system is only available as an add-on. You’ll have to pay extra if you want to make or receive calls — which not even Spruce Health requires.

Key features of Podium

• AI review response suggestions
• Text-based surveys, require an upgrade
• Unified inboxes for voicemails, calls, and texts
• Podium mobile app
• Integrations with electronic health record platforms, or EHRs

Podium pricing

Podium doesn’t offer any public pricing online. Your best bet for a quote is to contact the sales team.

That said, it does publicize the features you get on each Podium pricing plan:

• Core: 200+ integrations, basic automations, AI review response suggestions, and a built-in phone system with an undisclosed add-on fee
• Pro: Lead capture forms, AI review responses, automatic lead routing, text-based surveys, text marketing with images and GIFs, and AI call summaries
• Signature: Advanced branding and customization, multi-location management, quarterly business reviews, and access to a fraud alert system

4. TigerConnect: Best clinical communication tool for hospitals 

Pros

• Physiological monitor integrations for hospitals
• Priority messaging escalations for emergency care

Cons

• The interface is dated and hard to use, according to some users
• No public pricing, with past users reporting high costs
• Provides more features than needed, according to past users

TigerConnect is a clinical collaboration tool for large healthcare organizations like hospitals. It integrates with acute care tools, like physiological monitors. Like Spruce Health, it supports multiple channels, such as messaging, voice, and video. That way, physicians can communicate with patients from anywhere, including phones or laptops.

You can also use TigerConnect to set up schedules for patients and staff members. For patients, you can streamline appointment booking and wellness visits via two-way messaging. For physicians, you can use its HIPAA-compliant scheduling software. The app can help you manage time off and shift swaps, while avoiding potential gaps in patient care.

But since TigerConnect was designed for large medical systems, it’s likely too complex for small or growing practices. You should also know its pricing isn’t public. This makes it hard to budget for and slows down getting started.

Key features of TigerConnect

• Built-in online patient scheduling
• Mobile and desktop apps
• Secure messaging, voice, and video
• Broadcast messaging for emergencies
• Physician scheduling software

TigerConnect pricing

TigerConnect says it “offers a fixed-price, fixed-quantity subscription model,” but it doesn’t list any specific pricing online. To get a quote for your team, contact sales.

5. QliqSOFT: Best for GPS tracking

Pros

• GPS tracking for field staff members
• Bidirectional integrations

Cons

• No publicly available pricing
• Not designed for small or growing teams
• Past users report a buggy interface

QliqSOFT is HIPAA-compliant communication software designed for post-acute care facilities. It offers secure text messaging, called QliqCHAT, on its desktop and mobile apps. That way, you can coordinate care between healthcare teams and their patients.

QliqCHAT can replace standard SMS to better protect patient information, like pictures and documents. It also works alongside QliqSOFT’s GPS tracking, which shows your healthcare staff’s locations in real time. This lets you identify staff members closest to a patient, text to assign visits, and respond faster to urgent care needs.

But QliqSOFT’s pricing isn’t public, so you can’t compare it to  Spruce Health’s pricing. Plus, past user reviews say the app can be buggy, as you’ll see below:

“My hospital uses this for communications between staff. This is the worst application ever. Slow and unresponsive. Constantly crashes, and has very poor synchronization between computes… Not user-friendly.” — App Store

Key features of QliqSOFT

• HIPAA-compliant texting app
• GPS tracking
• Desktop and mobile apps
• Third-party integrations

QliqSOFT pricing

As mentioned, QliqSOFT doesn’t list any pricing online. The only way to get a quote is to contact sales.

6. RingRx: Best for solo practitioners

Pros

• HIPAA compliance on every plan
• Mobile apps are available for staff members

Cons

• Messaging isn’t available on the base plan
• Past users say that messaging can be unreliable
• Basic features, like call recording, require an add-on

RingRx is a HIPAA-compliant phone system that’s a good fit for solo healthcare professionals. It supports secure voice, text, fax, and video communications. It’s even compatible with desk phones if you still use traditional calling hardware.

RingRx also offers a mobile app, making it easier for you to work while on the go. Plus, you’ll get access to auto-reminders to help reduce no-shows and the option to route calls after hours to an on-call provider. This can help automate patient communication and let you run your practice without additional staff.

But what RingRx can’t do is let you send patient texts on the base plan. This is only available on the Grow plan at $19 per user per month. Unlike Spruce Health, you’re forced to upgrade from the base plan just to message patients. Want to record patient calls? You’ll need to purchase a $5-per-month add-on.

Even if you do upgrade or purchase add-ons, past customers say RingRx can be very unreliable.

See for yourself:

“For the entirety of my private practice, I’ve used RingRx for calling and texting with clients. But the texting service has become too unreliable, too many times me not receiving client texts, or clients not receiving mine.” — Reddit

Key features of RingRx

• Video meetings, with an upgrade
• Voicemail transcriptions, with an upgrade
• Call recording, with an add-on
• Compatible with desk phones, requires a lease or purchase
• HIPAA-compliant faxing, requires an upgrade

RingRx pricing

Here’s what to expect from RingRx’s pricing plans:

• Lite: $15 per user per month for one business phone number per user, unlimited inbound and outbound calling to and from North American numbers, and one HIPAA-secure voicemail box
• Grow: $19 per user per month for team and patient texting, voicemail transcriptions, RingRx On-Call to route calls after hours, and web-based faxing
• Clinic: $25 per user per month for free desk phones, two HIPAA-compliant voicemail boxes, virtual conference rooms, and web and machine faxing

Additional features, like call recording and call queues, require add-on fees.

7. Emitrr: Best for texting from a landline

Pros

• Text-enabled landlines are available
• AI workflows for auto responses

Cons

• No public pricing available
• $200 fee for “advanced automations”
• Shared SMS inbox, but no shared calling inbox

Emitrr is a texting software company that lets you sign BAAs for HIPAA compliance. This lets you text-enable your landline with HIPAA-compliant messaging tools. That way, patients can read and reply to messages containing PHI through a secure portal they’ll need to log into. 

That said, Emitrr doesn’t offer clear public pricing beyond a vaguely written blog post. It also claims that healthcare businesses “need to pay an additional $200 fee” for advanced automations. This is both confusing and expensive for organizations that just want to get started with a health communications platform.

Key features of Emitrr

• Chrome extension
• Mass and bulk messaging
• Send appointment reminders to patients
• Webchat
• SMS templates for healthcare

Emitrr pricing

Emitrr doesn’t list pricing on its website. But a  February 2026 article details the following three plans:

• Standard: $42 to $1,820 per month for 500 message credits and maxes out at 100,000 credits
• Pro: $45 to $1,960 per month for everything in the Standard plan plus AI capabilities
• Enterprise: Contact for pricing and features

8. Weave: Best for veterinary clinics

Pros

• Vet, opto, and dental-specific features
• Compatible with traditional desk phones

Cons

• Unnecessary limits on texting
• 1:1 training costs $199 per session
• Not all features are available for all businesses

Weave is a cloud phone system for both physical healthcare practices and telemedicine clinics. It lets you make and receive HIPAA-compliant calls, texts, emails, and digital forms. That way, you can securely communicate with patients across a variety of popular channels.

Weave is ideal for specialty healthcare clinics, as it offers unique features to specific business types. For example:

• Veterinary clinics can send automatic vaccine reminders for animals
• Dental practices have access to insurance verification and practice analytics
• Optometry offices can send out eyewear-ready notifications

But unlike Spruce Health, Weave caps its texting at 1,500 messages on the base plan. You can always purchase additional message bundles as a one-time add-on. But most of Weave’s pricing isn’t public, so there’s no way to know how much this costs. That said, Weave does publicize the cost of its 1:1 training sessions, starting at $199 for just 60 minutes. If ease of use is important to your business, you may want to investigate Weave alternatives like Quo.

Key features of Weave

• Automatic vaccine reminders for veterinarian clinics
• Insurance verification and practice analytics for dental offices, requires an upgrade
• Customer profiles
• Built-in email marketing
• Buy Now, Pay Later for patients

Weave pricing

Weave states that prices for Pro plan start at $249 per month. But beyond this, the rest of Weave’s pricing isn’t public. The only way to get a detailed quote is to contact the sales team.

That said, it does list the features you can expect on each plan:

• Pro: 1,500 messages, appointment reminders, and missed call texting
• Elite: 3,000 messages, digital forms, and insurance verification for dental offices
• Ultimate: 15,000 messages, call intelligence, quarterly one-on-one training, and practice analytics for dental offices

9. iPlum: Best for HIPAA-compliant eFax

Pros

• eFax is available with a $12.99 per month add-on
• Free iPlum accounts for patients

Cons

• No truly unlimited calls or texts
• Call recording requires the most expensive plan
• One year of text archiving requires an upgrade

iPlum is a cloud-based communications platform for healthcare workers. It can help you keep healthcare and personal contacts separate without forcing you to carry two phones. iPlum also offers HIPAA-compliant eFax on every plan, so you can send lab reports to other offices and insurance providers. Just keep in mind this will cost an extra $12.99 per month.

You can also use iPlum to set up automatic recording consent announcements. These notify callers that you’re recording their conversations, which keeps you compliant with US call recording laws. But like with eFax, there’s an added cost. Call recording is only available on the most expensive plan — although Spruce Health alternatives like Quo offer this in every tier.

And while iPlum’s marketing claims it offers unlimited calling and texting, the fine print shows it follows fair usage guidelines. Users get just 2,500 credits per month, which is equal to one minute of a call or each text you send. If you exceed those limits, you can purchase 2,000 credits for $20. This can add up quickly as your call and message volume increases. 

Key features of iPlum

• Set business hours
• Text signatures
• Spam blocking
• Out-of-office messages
• Shared numbers, with an upgrade

iPlum pricing

Pick from one of three iPlum pricing plans:

• Standard: $8.99 per user per month for 2,500 call and SMS credits for the US and Canada, business hours, auto-replies, phone trees, spam blocking, voicemail, and iOS and Android apps
• Professional: $14.99 per user per month for signed BAAs for HIPAA compliance, voicemail transcriptions, calling and texting via the web, scheduled texts, one year of text archiving, and text templates
• Enterprise: $25.99 per user per month for call recording, consent announcements, toll-free numbers instead of local numbers, support via live Zoom calls, and 10-year storage for call recordings and texts

10. OhMD: Best for video calling

Pros

• Supports voice and video calling for telehealth practices
• Call handoffs to text can help manage high call volumes

Cons

• Expensive compared to other Spruce Health alternatives
• Patient calling usage is billed separately
• Integrations are only available on the second tier

OhMD is a patient communication platform that helps physicians reduce call volume via voice and video calling. This can help you handle patient conversations across multiple channels. Upgraded plans also offer AI voice calls. That way, you can spend more time automatically answering patient calls and questions without hiring additional staff.

You can also use OhMD to help modernize your practice. For example, you can create a text-enabled landline so patients can directly message your business. 

But you should know OhMD’s pricing starts at $300 per month, which may be expensive for smaller practices that only need basic messaging features. Plus, its EHR integrations live behind the second tier, the Automate plan. This costs $500 per month — a steep price compared to most Spruce Health alternatives that offer integrations on the base plan.

Key features of OhMD

• Voice and video calling
• Lets patients text landline phones
• SSO, with an upgrade
• Automated workflows
• Website chat

OhMD pricing

There are three tiers of OhMD:

• Communicate: $300 per month for a signed BAA agreement, two-way SMS text messaging, text-enabled landline numbers, team messaging, broadcast messages, voice calls, video calls, and call handoffs to text
• Automate: $500 per month for EHR integrations, appointment scheduling, an AI voice agent with usage billed separately, broadcast voice calling, and early access to new features
• Enterprise: Custom pricing for custom onboarding, dedicated support, multi-location support, reporting and analytics, and API and integration extensions

What you need to know about Spruce Health alternatives

Spruce Health lets you use VoIP desk phones or a mobile app to call, text, and hold video meetings with patients. You can also use Spruce Health to improve the patient experience. For example, you can use it to collect clinical questionnaires from patients, then forward the results through a secure team chat.

But for many reasons we’ll explore below, it’s not always suitable for small and growing teams.

Here’s what pushes healthcare providers to explore Spruce Health alternatives:

Scheduled auto-replies require an upgrade

Want your auto-replies to change based on your business hours? You’ll need to upgrade your plan to unlock schedules first. This requires the Communicator plan that costs $49 per user per month, which is nearly double the cost of the Basic plan.

In contrast, Quo lets you customize auto-replies before and after your business hours on any plan.

Time-of-day call routing requires an upgrade

You can use Spruce Health to set up time-based routing. This lets you send calls to different destinations, depending on whether it’s during or after business hours. But you’ll need to upgrade to the Communicator plan first. 

The good news is, Spruce Health is the exception rather than the rule. Alternatives like Quo let you route calls based on your business hours on any plan — no upgrades required.

Patients must create an account to maintain HIPAA compliance

Spruce Health offers HIPAA-compliant patient messaging on every plan. But to maintain compliance, patients need to create a Spruce Health account.

Some patients may not mind this process. But others might not want to memorize usernames and passwords. This could make it difficult to message your entire client list via in-app messaging.

One mental health professional said this about Spruce’s messaging portal:

“The biggest downside here is that clients MUST make an account for messages to be HIPAA compliant. I get clients who text the number but won’t make an account… Also, when they do make an account, any messages they sent prior do not show up for easy archiving. I can send an invite, but many do not make an account, limiting its functionality.” — G2

Third-party integrations require an upgrade or add-on

Most patient communications platforms let you set up integrations on any plan. But that’s not the case with Spruce Health — even integrations with Dock Health require the most expensive plan. Plus, integrations with apps like Athena require a monthly add-on fee. Pricing isn’t publicly listed, so there’s no way to know how much this costs without contacting the sales team first.

VoIP desk phones are hard to scale

Spruce Health does support VoIP desk phones, but they’re only available on the most expensive plan.

The hardware required isn’t cheap, either. For example, a Yealink W73P handset and base station cost around $161. This adds up fast as your team grows, and — for most healthcare organizations — isn’t worth the expense.

Spruce Health alternatives like Quo, on the other hand, work on existing devices. This lets your team call and text patients without extra hardware. It’s also more scalable since you won’t need to buy or maintain traditional equipment.

Spruce Health pricing

You can pick from one of two Spruce Health pricing plans:

• Basic: $24 per user per month for HIPAA-compliant messaging, video conferencing, auto-replies, dedicated support, user access controls, and e-fax
• Communicator: $49 per user per month for phone menu support, VoIP desk phones, after-hours triage, bulk messaging, API access, integrations, and scheduled auto-replies and call routing

Quo: The best Spruce Health alternative

Spruce Health isn’t quite the evergreen solution it claims to be. Between its high pricing and forced upgrades, it’s not the best solution for growing healthcare brands.

Quo offers the same core capabilities as Spruce Health, but it gives teams more flexibility as communication needs become more complex. You get many other features that scale alongside your practice, like ring orders, group calling, and AI call summaries.

On our Business plan, you can make unlimited HIPAA-compliant calls and texts with patients from devices you already own. Then, create shared phone numbers to split responsibility for calls, texts, and voicemails — all in one place. Use a no-code call flow builder to route callers to the right people and departments. Then tap into workflow automations on every plan, like text message templates and auto-logging data in your CRM.

Start building better patient relationships with Quo by signing up for a seven-day free trial.

FAQs