At Velammal Hospitals, we are using SKY-HMS software provided by Skysoft. It was an easy decision; it took us at-least 6 to 8 weeks, several rounds of meeting with 3 or 4 shortlisted vendors before we finalized Skysoft. There were 3 main reasons for this decision: One, the HMS had an integrated accounts module. Second the developers were very keen to prove their product's worth in a hospital our size 65-beds. Third, they were willing for any degree of customization. Implementing the HMS was not easy - we had several modules for the different functional areas in the hospital. The staff in each of these areas had to be trained. Skysoft was with us all the during the implementation phase.. We were also using Ubuntu, a linux based software in our system. When we had issues due to this for example, in network printing Skysoft helped us to sort it out. The SKY-HMS has several modules all integrated with one another. Their accounting module is very extensive and has made the use of accounting software superfluous. Their user rights capability is very good. I would recommend Skysoft for any organization or individual - I'm very happy with their domain knowledge, willingness to customize, support during implementation phase and after that and their reasonable cost.