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Google Analytics Alternative Self-Hosted

What are top 10 google analytics alternatives if my healthcare practice wants to self-host?

What is the problem with Google analytics and healthcare practices?

Healthcare provider websites cannot use the free version of Google Analytics (GA4) because Google explicitly refuses to sign a Business Associate Agreement (BAA) for its free analytics products, rendering the platform fundamentally non-compliant with the Health Insurance Portability and Accountability Act (HIPAA). 

Under HIPAA regulations, any third-party vendor that creates, receives, maintains, or transmits Protected Health Information (PHI) on behalf of a covered entity is legally classified as a “Business Associate” and must sign a BAA to guarantee data safeguards. Because the free version of Google Analytics automatically collects individual identifiers—such as IP addresses, user IDs, and detailed device data—and pairs them with medical-context page URLs (like browsing a page about cancer treatments or diabetes), it routinely handles data classified as Electronic Protected Health Information (ePHI). 

Here is the comprehensive comparison table for all 10 self-hosted Google Analytics alternatives, organized by their infrastructure requirements and primary use cases:

ToolFocus CategoryDatabase / StackTracking Script SizeKey Standout Feature
MatomoFull GA ReplacementPHP / MySQL~23 KBHeatmaps & session recordings
OpenPanelWeb + Product AnalyticsDocker / ClickHouse~2 KBHighly interactive UI & event timelines
Open Web AnalyticsFull GA ReplacementPHP / MySQL~18 KBBuilt-in DOM click tracking
Plausible (CE)Privacy / LightweightDocker / ClickHouse< 1 KBExtremely clean, single-page UI
UmamiPrivacy / LightweightNode.js / PostgreSQL~1.6 KBNative multi-tenant / multi-site management
SwetrixPrivacy / LightweightNode.js / ClickHouse< 5 KBCustom metric alerts & AI insights
MedamaUltra-MinimalistGo / SQLite< 1 KBNear-zero CPU & RAM server footprint
PostHogProduct AnalyticsDocker / ClickHouseVariesFeature flags & complex user funnels
LitlyxDeveloper-FirstNode.js / MongoDB~1.5 KBFast custom JS event tracking setup
GoatCounterMinimalist / Text-BasedGo / SQLite or PG~3.5 KBWorks perfectly with JavaScript disabled