The gating problem nobody puts in the marketing decks
OpenEvidence reached roughly 20 million clinical consultations per month in January 2026 and approximately US$150 million annualised revenue by end-2025, per Sacra's tracking. None of that growth is reachable by a clinician in Kuala Lumpur. Account creation is gated on the US National Provider Identifier registry; in the UK and EU the platform sits behind a geo-block the company has attributed to EU AI Act uncertainty.
Practitioners in our network in Singapore, Bangkok and Johannesburg have tried the obvious workarounds — VPN, "manual verification" requests — and report queue times measured in months without resolution. The honest read is that OpenEvidence is a US product with US clinical guideline weighting (NCCN, ACC, AAFP), and there is no public timeline for change.
What the working stack looks like in 2026
The substitute is not a single tool. It is three tools doing what OpenEvidence bundles.
Glass Health handles clinical reasoning — differential diagnoses, problem-based assessments, care plans. It is free for individual practising physicians and medical trainees globally; enterprise pricing applies for health systems. Consensus, at US$10/month on annual billing for Premium, indexes 200 million+ papers and delivers a "Consensus Meter" that signals weight of evidence on binary questions. Elicit, at US$10/month on annual Plus, builds structured literature reviews and extracts data tables from papers — closer to a research-assistant workflow than a point-of-care answer. Heidi Evidence, launched 24 February 2026, was built — per Heidi's announcement — "in partnership with HealthPathways, EMGuidance, MIMS, Vidal, NICE, BMJ Group amongst others, to ensure guidance reflects regional standards and formularies," and is free with no NPI gate.
Workflow integration — what practitioners actually do
The pattern from clinics we work with: Heidi or Glass for the in-consult question ("differential for fatigue plus mild anaemia plus elevated ferritin"); Consensus for the patient-asked binary ("does berberine help glycaemic control?"); Elicit when a brand or protocol decision needs a structured review. Total subscription cost runs US$20/month per clinician on annual billing, plus the free tiers. That is roughly 7% of a typical Singapore aesthetic clinic's per-clinician CME budget.
Two practical notes. First, none of these tools are clinical decision support in the regulated sense — they retrieve and synthesise, they do not prescribe. Second, ASEAN clinicians should treat US-weighted guidance with care: SAHPRA's complementary medicines framework and Singapore's MOH Aesthetic Practice Oversight Committee constraints are not represented in any of these databases.