Comparison, as of October 2026
Which software for AI documentation in the practice?
Nine tools, built into the practice system or vendor-independent: prices, PVS integration, billing and data protection, with sources.
As of 8 October 2026. Competitor sources are reviewed quarterly.
There are two kinds of software for AI documentation in a medical practice. Built into the practice system: tomedo.Intelligence (no extra cost for tomedo customers), medatixx x.scribe, CGM DokuAssistent, Doc Cirrus inSuite with Tandem and Doctolib's AI consultation assistant. Vendor-independent, for several practice systems: Nixi AI, Noa Notes, Tandem Health and Heidi. The deciding factor is usually your own PVS: on tomedo, medatixx or CGM, check the built-in option; on another system, or if you need EBM suggestions and long consultations, compare the vendor-independent tools. Nixi AI costs €89 per month including the PVS interface and was evaluated in a peer-reviewed study in rheumatology (EULAR Rheumatology Open 2025).
Overview
Which software is there? Nine tools in two groups.
The first question is your own practice system. Some PVS vendors build AI documentation in; it then runs only in that system. Vendor-independent tools work with several practice systems and hand the note over by interface or copy.
Vendor-independent, for several practice systems
Nixi AI1Ours
- Price (1 clinician)*
- €89 per month or €828 per year (Practice Pro)
- Practice system
- Directly into the record for over 60 practice systems, included
- Billing codes
- EBM suggestions with reasons; GOÄ shown
Noa Notes (jameda)2
- Price (1 clinician)*
- Connect 3.0: €1,507 in year one, then €1,308
- Practice system
- Integration in the plan, €199 one-off setup
- Billing codes
- No code suggestions
Tandem Health3
- Price (1 clinician)*
- Pro: €948 per year
- Practice system
- One click into over 100 PVS and KIS
- Billing codes
- Diagnosis and procedure codes
Heidi4
- Price (1 clinician)*
- Praxis: €900 per year
- Practice system
- x.isynet via the desktop app
- Billing codes
- Medical coding not for EU accounts
Built into the practice system
tomedo.Intelligence5
- Price (1 clinician)*
- No additional cost for tomedo customers
- Practice system
- Only in tomedo
- Billing codes
- –
medatixx x.scribe6
- Price (1 clinician)*
- €99 per month per clinician
- Practice system
- medatixx, psyx, x.isynet, x.vianova, xentro
- Billing codes
- –
CGM DokuAssistent7
- Price (1 clinician)*
- From €49 per month
- Practice system
- Directly from CGM ALBIS, M1 PRO, TURBOMED, Z1.PRO; other systems by copying
- Billing codes
- –
Doc Cirrus inSuite with Tandem8
- Price (1 clinician)*
- –
- Practice system
- In inSuite; transfer to the record after approval
- Billing codes
- –
Doctolib AI consultation assistant9
- Price (1 clinician)*
- €59 per month as an add-on**
- Practice system
- In the Doctolib practice software
- Billing codes
- –
- *
- As of October 2026. Prices change; the vendor's pricing page is authoritative.
- **
- Doctolib does not publish a price. The portals GIGA and Medizinio report €59 per month as an add-on (retrieved 9 October 2026).
- –
- Not published by the vendor.
This comparison is published by Nixi AI. Statements about other vendors come from their own pricing, product and help pages; the sources are listed below.
Sources for the overview
- Nixi AI: own pricing page and data processing agreement version 2.0. Study: Knitza J, Aries P., EULAR Rheumatology Open 2025, full text in PubMed Central (PMC13425160).
- Noa Notes: pricing page, retrieved 20 September 2026 (Connect 3.0, yearly price and setup fee); post “Abrechnungsanforderungen umsetzen mit Vorlagen-System”, 20 August 2026: Noa Notes does not suggest billing codes.
- Tandem Health: pricing page, retrieved 20 September 2026 (Pro, one-click transfer to over 100 PVS and KIS).
- Heidi: pricing page heidihealth.com/de-de and x.isynet integration page, retrieved 20 and 21 September 2026.
- tomedo: “KI in der Arztsoftware”, tomedo.de, retrieved 8 October 2026: AI features for tomedo customers at no additional cost.
- medatixx: x.scribe shop page for doctors, retrieved 21 September 2026: €99 per month per clinician; medatixx, psyx, x.isynet, x.vianova, xentro.
- CGM: CGM DokuAssistent product page, retrieved 8 October 2026: from €49 per month, 17 languages, starts from CGM ALBIS, M1 PRO, TURBOMED and Z1.PRO.
- Doc Cirrus: “Künstliche Intelligenz”, doc-cirrus.com, retrieved 8 October 2026: the AI documentation assistant Tandem is available in the inSuite practice software.
- Doctolib: practice software page, info.doctolib.de, retrieved 8 October 2026 (AI consultation assistant as a practice-software function). Price: GIGA and Medizinio, retrieved 9 October 2026.
Privacy and evidence compared
Six questions data-protection officers and practice owners ask first, for five tools. Every statement comes from the vendor's contract, data-protection impact assessment or help page.
Peer-reviewed study
- Nixi AI
- EULAR Rheumatology Open, December 2025
- Heidi
- –
- Tandem Health
- Capio report as a preprint
- Noa Notes
- –
- Doctolib
- In-house study, September to November 2025
Data location
- Nixi AI
- EU and Switzerland, stored in Frankfurt
- Heidi
- EEA, stored in Frankfurt
- Tandem Health
- EU / EEA
- Noa Notes
- EU / EEA
- Doctolib
- –
Audio
- Nixi AI
- 72 hours, then deleted
- Heidi
- Not stored during the consultation, processed in real time
- Tandem Health
- Deleted after transcription, within 5 minutes
- Noa Notes
- –
- Doctolib
- Deleted after the doctor's review*
Transcripts
- Nixi AI
- Period set by the practice (1–90 days, default 30)
- Heidi
- Period set by the doctor
- Tandem Health
- 30 days in full, then without names and addresses
- Noa Notes
- –
- Doctolib
- 48 hours
Data used to improve the AI
- Nixi AI
- Anonymised data only (DPA § 12)
- Heidi
- Improving the service is a contract purpose
- Tandem Health
- Minimised after 30 days, for statistics and product improvement
- Noa Notes
- –
- Doctolib
- Health data only with consent
Professional secrecy (§ 203 StGB) in the contract
- Nixi AI
- DPA § 4
- Heidi
- German contract, section 4
- Tandem Health
- –
- Noa Notes
- Data processing agreement
- Doctolib
- –
- *
- Doctolib: according to Microsoft's customer story on Doctolib and Azure OpenAI, audio and transcription are deleted shortly after the doctor has reviewed the summary.
- –
- Not published by the vendor.
Sources for the table
- Nixi AI: data processing agreement version 2.0 (§ 4, § 7, § 12) and Knitza J, Aries P., EULAR Rheumatology Open, 19 December 2025, DOI 10.1016/j.ero.2025.12.002.
- Heidi: EU data-protection impact assessment (data location, retention) and German data processing agreement (section 4, professional secrecy), reviewed March 2026.
- Tandem Health: Data Processing Agreement, annex 3.1 (processing and storage time) and section 5 (processing locations), reviewed March 2026.
- Noa Notes: data processing agreement, February 2026 (place of service, confidentiality under § 203 StGB).
- Doctolib: Help Center article 40589528427156 (AI consultation assistant retention); privacy notice in force since February 2025; Microsoft customer story “Doctolib, Azure OpenAI Service”; info.doctolib.de/praxissoftware (in-house study).
Where the vendors substantively diverge
Three differences that matter day-to-day
1. Privacy with clear periods in the contract
Audio deleted after 72 hours, the practice sets the period for transcripts. DPA per practice.
Strengths
- Audio is deleted automatically after 72 hours
- Transcript retention set by the practice (1–90 days, then automatic deletion)
- DPA closed explicitly per practice or hospital
- Stored in Frankfurt, no data centres in the USA
How others compare
- Heidi stores no audio during the consultation; transcripts for as long as the doctor sets
- Tandem deletes audio after transcription; transcripts 30 days in full, then without names and addresses
- Doctolib: transcripts for 48 hours
- Price
- Basic €0 · Practice Pro €89/month, or €69/month billed annually
- Best for
- Practices with strict data-protection requirements (KV, supervisory authority, hospital network)
2. Peer-reviewed clinical evidence in a German specialty
EULAR Rheumatology Open, December 2025. 88 consultations. 0 serious errors, minor errors in 19%.
Strengths
- In 72 of 88 consultations (82%), the treating rheumatologist estimated consultation time as reduced
- 0 serious errors; minor errors (such as typos) in 17 of 88 consultations (19%)
- 100% patient participation rate, no refusals
- 70% of patients rated the AI assistance positive or very positive
How others compare
- Doctolib cites an in-house study (September to November 2025)
- Tandem cites a Capio report, published as a preprint
- Price
- Study open access. DOI 10.1016/j.ero.2025.12.002
- Best for
- Practices that need durable evidence before rollout
3. Built for specialties, not a generalist tool
Templates per specialty, EBM suggestions with reasons, GOÄ shown.
Strengths
- Founded by two clinical pharmacists
- German billing codes (GOÄ, EBM) as standard feature
- Specialty-specific templates, not one-size-fits-all
How others compare
- tomedo customers get tomedo.Intelligence at no extra cost
- For specialties without their own code logic, a general tool is often enough
- Price
- Basic €0 · Practice Pro €89/month, or €69/month billed annually
- Best for
- Specialist practices that need templates and billing suggestions for their field
Frequently asked questions
What to know before switching
- Which AI documentation tool has peer-reviewed evidence in a German specialty?
- Nixi AI. The Knitza and Aries study was published in EULAR Rheumatology Open in December 2025 (DOI 10.1016/j.ero.2025.12.002). Setting: a large rheumatology practice in Hamburg, 88 consultations, 108 patients. Doctolib cites an in-house study (September to November 2025), Tandem a Capio report published as a preprint.
- Who stores transcripts and audio, and for how long?
- Nixi AI: audio for 72 hours, then deleted; transcripts for as long as the practice sets (1–90 days, default 30 days). Heidi: no audio stored during the consultation, transcripts for as long as the doctor sets. Tandem: audio deleted after transcription, transcripts 30 days in full, then without names and addresses. Doctolib: transcripts for 48 hours.
- Which vendors use data to improve their AI?
- Nixi AI: only anonymised data may be used to improve the service; personal data is not used for this (DPA § 12). Tandem: data minimised after 30 days, used for usage statistics and product improvement. Heidi: improving the service is part of the contract purpose. Doctolib: user data for AI training under its privacy notice (since February 2025), health data only with consent.
- Which vendors commit to professional secrecy under § 203 StGB in the contract?
- An explicit commitment to professional secrecy under § 203 StGB is in the contract of Nixi AI (DPA § 4), Noa Notes (data processing agreement) and Heidi (German data processing agreement, section 4).
- Which vendors support German billing (GOÄ / EBM)?
- Nixi AI suggests EBM codes with reasons and shows GOÄ. Tandem produces diagnosis and procedure codes. Noa Notes does not suggest billing codes, and Heidi does not offer medical coding for EU accounts.
- Which vendors process data in the EU?
- Nixi AI: data centres in the EU and Switzerland, stored in Frankfurt. Heidi: processing in the EEA, stored in Frankfurt. Tandem and Noa Notes: processing in the EU / EEA.
Shorter consultations in 72 of 88 cases, as estimated by the clinician
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