Faster setup initially – you’re working inside the existing system.
Less risk of breaking API compatibility – you’re not decoupling anything.
Keeps access control, session management, and permissions intact.
Cons:
OpenEMR’s frontend uses a mix of Smarty templates, outdated jQuery, Knockout.js, and minimal CSS, which can be hard to modernize.
No theme support, so customizations are manual and scattered.
Harder to maintain and upgrade – updates might overwrite your changes.
UI structure is rigid – adding modern components (like charts, modals, tabs) is time-consuming.
Verdict: Best if you only need minor visual improvements, like changing colors, fonts, layout tweaks.
Option 2: Create a New Frontend with OpenEMR APIs
Pros:
You get complete control over design, layout, responsiveness, and user experience.
You can use modern stacks (React, Vue, or even PHP/HTML/JS) for maintainability and performance.
Makes it easy to integrate dashboards, role-based views, and mobile-friendly UIs.
Cons:
Initial development time is higher.
You’ll need to handle login/authentication securely (though OpenEMR supports external login APIs).
Might need to build some custom APIs if OpenEMR’s existing ones are not sufficient.
Verdict: Best if you want a clean, modern UI and are okay with a moderate setup time. Great for long-term scalability and professional look.
Recommendation (Based on Your Context)
Since:
OpenEMR doesn’t support themes,
UI is not great,
You’re concerned about time and ease of implementation,
Hybrid Option (Recommended):
Start with creating a new frontend (Option 2), but begin with only patient-facing or frequently-used admin modules (like Dashboard, Appointment, Billing). Leave lesser-used OpenEMR screens with their default UI for now. Gradually expand based on usage and feedback.
This gives you a modern-looking, fast-loading interface without redoing everything at once.