<?xml version="1.0" encoding="US-ASCII" standalone="no"?>
    <!-- Field: Doc-Info; Name: Generator; Value: GoXBRL; Version: 5.2a -->
    <!-- Field: Doc-Info; Name: VendorURI; Value: http://www.novaworks.co -->
    <!-- Field: Doc-Info; Name: Source; Value: oprx%2D20191231.xfr; Date: 2020%2D03%2D25T23:08:04Z -->
    <!-- Field: Doc-Info; Name: Status; Value: 0x00000000 -->
<link:linkbase xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:link="http://www.xbrl.org/2003/linkbase" xmlns:xbrli="http://www.xbrl.org/2003/instance" xsi:schemaLocation="http://www.xbrl.org/2003/linkbase http://www.xbrl.org/2003/xbrl-linkbase-2003-12-31.xsd">
    <link:roleRef roleURI="http://OPRX/role/DocumentAndEntityInformation" xlink:href="oprx-20191231.xsd#DocumentAndEntityInformation" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/ConsolidatedBalanceSheets" xlink:href="oprx-20191231.xsd#ConsolidatedBalanceSheets" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/BalanceSheetsParenthetical" xlink:href="oprx-20191231.xsd#BalanceSheetsParenthetical" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/ConsolidatedStatementsOfOperations" xlink:href="oprx-20191231.xsd#ConsolidatedStatementsOfOperations" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/StatementOfStockholdersEquity" xlink:href="oprx-20191231.xsd#StatementOfStockholdersEquity" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/ConsolidatedStatementsOfCashFlow" xlink:href="oprx-20191231.xsd#ConsolidatedStatementsOfCashFlow" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/OrganizationAndNatureOfBusiness" xlink:href="oprx-20191231.xsd#OrganizationAndNatureOfBusiness" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/SummaryOfSignificantAccountingPolicies" xlink:href="oprx-20191231.xsd#SummaryOfSignificantAccountingPolicies" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/Acquisition" xlink:href="oprx-20191231.xsd#Acquisition" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/PrepaidExpenses" xlink:href="oprx-20191231.xsd#PrepaidExpenses" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/PropertyAndEquipment" xlink:href="oprx-20191231.xsd#PropertyAndEquipment" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/IntangibleAssets" xlink:href="oprx-20191231.xsd#IntangibleAssets" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/DeferredRevenue" xlink:href="oprx-20191231.xsd#DeferredRevenue" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/RelatedPartyTransactions" xlink:href="oprx-20191231.xsd#RelatedPartyTransactions" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/ContingentPurchasePrice" xlink:href="oprx-20191231.xsd#ContingentPurchasePrice" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/StockholdersEquity" xlink:href="oprx-20191231.xsd#StockholdersEquity" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/StockCompensation" xlink:href="oprx-20191231.xsd#StockCompensation" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/Warrants" xlink:href="oprx-20191231.xsd#Warrants" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/Leases" xlink:href="oprx-20191231.xsd#Leases" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/MajorCustomersAndVendors" xlink:href="oprx-20191231.xsd#MajorCustomersAndVendors" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/IncomeTaxes" xlink:href="oprx-20191231.xsd#IncomeTaxes" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/CommitmentsAndContingentLiabilities" xlink:href="oprx-20191231.xsd#CommitmentsAndContingentLiabilities" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/RetirementPlan" xlink:href="oprx-20191231.xsd#RetirementPlan" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/SubsequentEvents" xlink:href="oprx-20191231.xsd#SubsequentEvents" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/SummaryOfSignificantAccountingPoliciesPolicies" xlink:href="oprx-20191231.xsd#SummaryOfSignificantAccountingPoliciesPolicies" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/SummaryOfSignificantAccountingPoliciesTables" xlink:href="oprx-20191231.xsd#SummaryOfSignificantAccountingPoliciesTables" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/AcquisitionTables" xlink:href="oprx-20191231.xsd#AcquisitionTables" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/PrepaidExpensesTables" xlink:href="oprx-20191231.xsd#PrepaidExpensesTables" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/PropertyAndEquipmentTables" xlink:href="oprx-20191231.xsd#PropertyAndEquipmentTables" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/IntangibleAssetsTables" xlink:href="oprx-20191231.xsd#IntangibleAssetsTables" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/RelatedPartyTransactionsTables" xlink:href="oprx-20191231.xsd#RelatedPartyTransactionsTables" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/ContingentPurchasePriceTables" xlink:href="oprx-20191231.xsd#ContingentPurchasePriceTables" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/StockCompensationTables" xlink:href="oprx-20191231.xsd#StockCompensationTables" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/WarrantsTables" xlink:href="oprx-20191231.xsd#WarrantsTables" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/LeasesTables" xlink:href="oprx-20191231.xsd#LeasesTables" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/MajorCustomersAndVendorsTables" xlink:href="oprx-20191231.xsd#MajorCustomersAndVendorsTables" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/IncomeTaxesTables" xlink:href="oprx-20191231.xsd#IncomeTaxesTables" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/SummaryOfSignificantAccountingPoliciesDetails" xlink:href="oprx-20191231.xsd#SummaryOfSignificantAccountingPoliciesDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/SummaryOfSignificantAccountingPoliciesDetails1" xlink:href="oprx-20191231.xsd#SummaryOfSignificantAccountingPoliciesDetails1" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/SummaryOfSignificantAccountingPoliciesDetails2" xlink:href="oprx-20191231.xsd#SummaryOfSignificantAccountingPoliciesDetails2" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/SummaryOfSignificantAccountingPoliciesDetails3" xlink:href="oprx-20191231.xsd#SummaryOfSignificantAccountingPoliciesDetails3" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/SummaryOfSignificantAccountingPoliciesDetailsTextual" xlink:href="oprx-20191231.xsd#SummaryOfSignificantAccountingPoliciesDetailsTextual" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/AcquisitionDetails" xlink:href="oprx-20191231.xsd#AcquisitionDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/AcquisitionDetails1" xlink:href="oprx-20191231.xsd#AcquisitionDetails1" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/AcquisitionDetailsTextual" xlink:href="oprx-20191231.xsd#AcquisitionDetailsTextual" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/PrepaidExpensesDetails" xlink:href="oprx-20191231.xsd#PrepaidExpensesDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/PropertyandEquipmentDetails" xlink:href="oprx-20191231.xsd#PropertyandEquipmentDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/PropertyAndEquipmentDetailsTextual" xlink:href="oprx-20191231.xsd#PropertyAndEquipmentDetailsTextual" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/IntangibleAssetsDetails" xlink:href="oprx-20191231.xsd#IntangibleAssetsDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/IntangibleAssetsDetails1" xlink:href="oprx-20191231.xsd#IntangibleAssetsDetails1" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/IntangibleAssetsDetails2" xlink:href="oprx-20191231.xsd#IntangibleAssetsDetails2" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/IntangibleAssetsDetailsTextual" xlink:href="oprx-20191231.xsd#IntangibleAssetsDetailsTextual" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/DeferredRevenueDetails" xlink:href="oprx-20191231.xsd#DeferredRevenueDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/RelatedPartyTransactionsDetails" xlink:href="oprx-20191231.xsd#RelatedPartyTransactionsDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/RelatedPartyTransactionsDetailsTextual" xlink:href="oprx-20191231.xsd#RelatedPartyTransactionsDetailsTextual" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/ContingentPurchasePriceDetails" xlink:href="oprx-20191231.xsd#ContingentPurchasePriceDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/ContingentPurchasePriceDetailsTextual" xlink:href="oprx-20191231.xsd#ContingentPurchasePriceDetailsTextual" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/StockholdersEquityDetails" xlink:href="oprx-20191231.xsd#StockholdersEquityDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/StockOptionsDetails" xlink:href="oprx-20191231.xsd#StockOptionsDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/StockOptionsDetails1" xlink:href="oprx-20191231.xsd#StockOptionsDetails1" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/StockCompensationDetailsTextual" xlink:href="oprx-20191231.xsd#StockCompensationDetailsTextual" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/WarrantsDetails" xlink:href="oprx-20191231.xsd#WarrantsDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/LeasesDetails" xlink:href="oprx-20191231.xsd#LeasesDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/LeasesDetails1" xlink:href="oprx-20191231.xsd#LeasesDetails1" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/LeasesDetailsTextual" xlink:href="oprx-20191231.xsd#LeasesDetailsTextual" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/MajorCustomersAndVendorsDetails" xlink:href="oprx-20191231.xsd#MajorCustomersAndVendorsDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/MajorCustomersAndVendorsDetailsTextual" xlink:href="oprx-20191231.xsd#MajorCustomersAndVendorsDetailsTextual" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/IncomeTaxesDetails" xlink:href="oprx-20191231.xsd#IncomeTaxesDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/IncomeTaxesDetails1" xlink:href="oprx-20191231.xsd#IncomeTaxesDetails1" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/IncomeTaxesDetailsTextual" xlink:href="oprx-20191231.xsd#IncomeTaxesDetailsTextual" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/CommitmentsAndContingentLiabilitiesDetails" xlink:href="oprx-20191231.xsd#CommitmentsAndContingentLiabilitiesDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/RetirementPlanDetails" xlink:href="oprx-20191231.xsd#RetirementPlanDetails" xlink:type="simple" />
    <link:roleRef roleURI="http://OPRX/role/SubsequentEventsDetails" xlink:href="oprx-20191231.xsd#SubsequentEventsDetails" xlink:type="simple" />
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/DocumentAndEntityInformation" xlink:title="00000001 - Document - Document and Entity Information">
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_DocumentAndEntityInformationAbstract" xlink:label="loc_oprxDocumentAndEntityInformationAbstract" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityRegistrantName" xlink:label="loc_deiEntityRegistrantName" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiEntityRegistrantName" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityCentralIndexKey" xlink:label="loc_deiEntityCentralIndexKey" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiEntityCentralIndexKey" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_AmendmentFlag" xlink:label="loc_deiAmendmentFlag" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiAmendmentFlag" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_CurrentFiscalYearEndDate" xlink:label="loc_deiCurrentFiscalYearEndDate" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiCurrentFiscalYearEndDate" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_DocumentType" xlink:label="loc_deiDocumentType" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiDocumentType" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_DocumentPeriodEndDate" xlink:label="loc_deiDocumentPeriodEndDate" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiDocumentPeriodEndDate" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_DocumentFiscalPeriodFocus" xlink:label="loc_deiDocumentFiscalPeriodFocus" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiDocumentFiscalPeriodFocus" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_DocumentFiscalYearFocus" xlink:label="loc_deiDocumentFiscalYearFocus" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiDocumentFiscalYearFocus" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityWellKnownSeasonedIssuer" xlink:label="loc_deiEntityWellKnownSeasonedIssuer" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiEntityWellKnownSeasonedIssuer" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityVoluntaryFilers" xlink:label="loc_deiEntityVoluntaryFilers" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiEntityVoluntaryFilers" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityCurrentReportingStatus" xlink:label="loc_deiEntityCurrentReportingStatus" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiEntityCurrentReportingStatus" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityFilerCategory" xlink:label="loc_deiEntityFilerCategory" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiEntityFilerCategory" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityShellCompany" xlink:label="loc_deiEntityShellCompany" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiEntityShellCompany" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntitySmallBusiness" xlink:label="loc_deiEntitySmallBusiness" />
      <link:presentationArc order="130" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiEntitySmallBusiness" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityEmergingGrowthCompany" xlink:label="loc_deiEntityEmergingGrowthCompany" />
      <link:presentationArc order="140" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiEntityEmergingGrowthCompany" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityInteractiveDataCurrent" xlink:label="loc_deiEntityInteractiveDataCurrent" />
      <link:presentationArc order="150" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiEntityInteractiveDataCurrent" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityIncorporationStateCountryCode" xlink:label="loc_deiEntityIncorporationStateCountryCode" />
      <link:presentationArc order="160" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiEntityIncorporationStateCountryCode" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityFileNumber" xlink:label="loc_deiEntityFileNumber" />
      <link:presentationArc order="170" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiEntityFileNumber" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityPublicFloat" xlink:label="loc_deiEntityPublicFloat" />
      <link:presentationArc order="180" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiEntityPublicFloat" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityCommonStockSharesOutstanding" xlink:label="loc_deiEntityCommonStockSharesOutstanding" />
      <link:presentationArc order="190" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDocumentAndEntityInformationAbstract" xlink:to="loc_deiEntityCommonStockSharesOutstanding" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/ConsolidatedBalanceSheets" xlink:title="00000002 - Statement - Consolidated Balance Sheets">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementOfFinancialPositionAbstract" xlink:label="loc_us-gaapStatementOfFinancialPositionAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AssetsAbstract" xlink:label="loc_us-gaapAssetsAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfFinancialPositionAbstract" xlink:to="loc_us-gaapAssetsAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AssetsCurrentAbstract" xlink:label="loc_us-gaapAssetsCurrentAbstract" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAssetsAbstract" xlink:to="loc_us-gaapAssetsCurrentAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:label="loc_us-gaapCashAndCashEquivalentsAtCarryingValue" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAssetsCurrentAbstract" xlink:to="loc_us-gaapCashAndCashEquivalentsAtCarryingValue" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountsReceivableNetCurrent" xlink:label="loc_us-gaapAccountsReceivableNetCurrent" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAssetsCurrentAbstract" xlink:to="loc_us-gaapAccountsReceivableNetCurrent" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PrepaidExpenseCurrent" xlink:label="loc_us-gaapPrepaidExpenseCurrent" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAssetsCurrentAbstract" xlink:to="loc_us-gaapPrepaidExpenseCurrent" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AssetsCurrent" xlink:label="loc_us-gaapAssetsCurrent" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAssetsCurrentAbstract" xlink:to="loc_us-gaapAssetsCurrent" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentNet" xlink:label="loc_us-gaapPropertyPlantAndEquipmentNet" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAssetsAbstract" xlink:to="loc_us-gaapPropertyPlantAndEquipmentNet" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherAssetsAbstract" xlink:label="loc_us-gaapOtherAssetsAbstract" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAssetsAbstract" xlink:to="loc_us-gaapOtherAssetsAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_Goodwill" xlink:label="loc_us-gaapGoodwill" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOtherAssetsAbstract" xlink:to="loc_us-gaapGoodwill" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_TechnologyAssetsNet" xlink:label="loc_oprxTechnologyAssetsNet" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOtherAssetsAbstract" xlink:to="loc_oprxTechnologyAssetsNet" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsNet" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsNet" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOtherAssetsAbstract" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsNet" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeaseRightOfUseAsset" xlink:label="loc_us-gaapOperatingLeaseRightOfUseAsset" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOtherAssetsAbstract" xlink:to="loc_us-gaapOperatingLeaseRightOfUseAsset" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherIntangibleAssetsNet" xlink:label="loc_us-gaapOtherIntangibleAssetsNet" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOtherAssetsAbstract" xlink:to="loc_us-gaapOtherIntangibleAssetsNet" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OtherAssetsAndDeposits" xlink:label="loc_oprxOtherAssetsAndDeposits" />
      <link:presentationArc order="130" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOtherAssetsAbstract" xlink:to="loc_oprxOtherAssetsAndDeposits" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherAssets" xlink:label="loc_us-gaapOtherAssets" />
      <link:presentationArc order="140" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOtherAssetsAbstract" xlink:to="loc_us-gaapOtherAssets" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_Assets" xlink:label="loc_us-gaapAssets" />
      <link:presentationArc order="150" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAssetsAbstract" xlink:to="loc_us-gaapAssets" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:label="loc_us-gaapLiabilitiesAndStockholdersEquityAbstract" />
      <link:presentationArc order="160" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfFinancialPositionAbstract" xlink:to="loc_us-gaapLiabilitiesAndStockholdersEquityAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LiabilitiesCurrentAbstract" xlink:label="loc_us-gaapLiabilitiesCurrentAbstract" />
      <link:presentationArc order="170" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesAndStockholdersEquityAbstract" xlink:to="loc_us-gaapLiabilitiesCurrentAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountsPayableTradeCurrent" xlink:label="loc_us-gaapAccountsPayableTradeCurrent" />
      <link:presentationArc order="180" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesCurrentAbstract" xlink:to="loc_us-gaapAccountsPayableTradeCurrent" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccruedLiabilitiesCurrent" xlink:label="loc_us-gaapAccruedLiabilitiesCurrent" />
      <link:presentationArc order="190" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesCurrentAbstract" xlink:to="loc_us-gaapAccruedLiabilitiesCurrent" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_RevenueSharePayableCurrent" xlink:label="loc_oprxRevenueSharePayableCurrent" />
      <link:presentationArc order="200" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesCurrentAbstract" xlink:to="loc_oprxRevenueSharePayableCurrent" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeaseLiabilityCurrent" xlink:label="loc_us-gaapOperatingLeaseLiabilityCurrent" />
      <link:presentationArc order="210" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesCurrentAbstract" xlink:to="loc_us-gaapOperatingLeaseLiabilityCurrent" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CurrentPortionOfContingentPurchasePricePayable" xlink:label="loc_oprxCurrentPortionOfContingentPurchasePricePayable" />
      <link:presentationArc order="220" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesCurrentAbstract" xlink:to="loc_oprxCurrentPortionOfContingentPurchasePricePayable" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredRevenueCurrent" xlink:label="loc_us-gaapDeferredRevenueCurrent" />
      <link:presentationArc order="230" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesCurrentAbstract" xlink:to="loc_us-gaapDeferredRevenueCurrent" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LiabilitiesCurrent" xlink:label="loc_us-gaapLiabilitiesCurrent" />
      <link:presentationArc order="240" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesCurrentAbstract" xlink:to="loc_us-gaapLiabilitiesCurrent" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LiabilitiesNoncurrentAbstract" xlink:label="loc_us-gaapLiabilitiesNoncurrentAbstract" />
      <link:presentationArc order="250" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesCurrentAbstract" xlink:to="loc_us-gaapLiabilitiesNoncurrentAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeaseLiabilityNoncurrent" xlink:label="loc_us-gaapOperatingLeaseLiabilityNoncurrent" />
      <link:presentationArc order="260" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesNoncurrentAbstract" xlink:to="loc_us-gaapOperatingLeaseLiabilityNoncurrent" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ContingentConsiderationClassifiedAsEquityFairValueDisclosure" xlink:label="loc_us-gaapContingentConsiderationClassifiedAsEquityFairValueDisclosure" />
      <link:presentationArc order="270" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesNoncurrentAbstract" xlink:to="loc_us-gaapContingentConsiderationClassifiedAsEquityFairValueDisclosure" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LiabilitiesNoncurrent" xlink:label="loc_us-gaapLiabilitiesNoncurrent" />
      <link:presentationArc order="280" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesNoncurrentAbstract" xlink:to="loc_us-gaapLiabilitiesNoncurrent" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_Liabilities" xlink:label="loc_us-gaapLiabilities" />
      <link:presentationArc order="290" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesNoncurrentAbstract" xlink:to="loc_us-gaapLiabilities" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommitmentsAndContingencies" xlink:label="loc_us-gaapCommitmentsAndContingencies" />
      <link:presentationArc order="300" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesNoncurrentAbstract" xlink:to="loc_us-gaapCommitmentsAndContingencies" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockholdersEquityAbstract" xlink:label="loc_us-gaapStockholdersEquityAbstract" />
      <link:presentationArc order="310" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesAndStockholdersEquityAbstract" xlink:to="loc_us-gaapStockholdersEquityAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PreferredStockValue" xlink:label="loc_us-gaapPreferredStockValue" />
      <link:presentationArc order="320" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStockholdersEquityAbstract" xlink:to="loc_us-gaapPreferredStockValue" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockValue" xlink:label="loc_us-gaapCommonStockValue" />
      <link:presentationArc order="330" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStockholdersEquityAbstract" xlink:to="loc_us-gaapCommonStockValue" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AdditionalPaidInCapital" xlink:label="loc_us-gaapAdditionalPaidInCapital" />
      <link:presentationArc order="340" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStockholdersEquityAbstract" xlink:to="loc_us-gaapAdditionalPaidInCapital" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RetainedEarningsAccumulatedDeficit" xlink:label="loc_us-gaapRetainedEarningsAccumulatedDeficit" />
      <link:presentationArc order="350" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStockholdersEquityAbstract" xlink:to="loc_us-gaapRetainedEarningsAccumulatedDeficit" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockholdersEquity" xlink:label="loc_us-gaapStockholdersEquity" />
      <link:presentationArc order="360" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStockholdersEquityAbstract" xlink:to="loc_us-gaapStockholdersEquity" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LiabilitiesAndStockholdersEquity" xlink:label="loc_us-gaapLiabilitiesAndStockholdersEquity" />
      <link:presentationArc order="370" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesAndStockholdersEquityAbstract" xlink:to="loc_us-gaapLiabilitiesAndStockholdersEquity" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/BalanceSheetsParenthetical" xlink:title="00000003 - Statement - Consolidated Balance Sheets (Parenthetical)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementOfFinancialPositionAbstract" xlink:label="loc_us-gaapStatementOfFinancialPositionAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PreferredStockParOrStatedValuePerShare" xlink:label="loc_us-gaapPreferredStockParOrStatedValuePerShare" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfFinancialPositionAbstract" xlink:to="loc_us-gaapPreferredStockParOrStatedValuePerShare" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PreferredStockSharesAuthorized" xlink:label="loc_us-gaapPreferredStockSharesAuthorized" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfFinancialPositionAbstract" xlink:to="loc_us-gaapPreferredStockSharesAuthorized" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PreferredStockSharesIssued" xlink:label="loc_us-gaapPreferredStockSharesIssued" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfFinancialPositionAbstract" xlink:to="loc_us-gaapPreferredStockSharesIssued" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PreferredStockSharesOutstanding" xlink:label="loc_us-gaapPreferredStockSharesOutstanding" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfFinancialPositionAbstract" xlink:to="loc_us-gaapPreferredStockSharesOutstanding" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockParOrStatedValuePerShare" xlink:label="loc_us-gaapCommonStockParOrStatedValuePerShare" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfFinancialPositionAbstract" xlink:to="loc_us-gaapCommonStockParOrStatedValuePerShare" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockSharesAuthorized" xlink:label="loc_us-gaapCommonStockSharesAuthorized" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfFinancialPositionAbstract" xlink:to="loc_us-gaapCommonStockSharesAuthorized" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockSharesIssued" xlink:label="loc_us-gaapCommonStockSharesIssued" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfFinancialPositionAbstract" xlink:to="loc_us-gaapCommonStockSharesIssued" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockSharesOutstanding" xlink:label="loc_us-gaapCommonStockSharesOutstanding" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfFinancialPositionAbstract" xlink:to="loc_us-gaapCommonStockSharesOutstanding" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/ConsolidatedStatementsOfOperations" xlink:title="00000004 - Statement - Consolidated Statements of Operations">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeStatementAbstract" xlink:label="loc_us-gaapIncomeStatementAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RevenuesAbstract" xlink:label="loc_us-gaapRevenuesAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeStatementAbstract" xlink:to="loc_us-gaapRevenuesAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_Revenues" xlink:label="loc_us-gaapRevenues" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRevenuesAbstract" xlink:to="loc_us-gaapRevenues" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CostOfRevenue" xlink:label="loc_us-gaapCostOfRevenue" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRevenuesAbstract" xlink:to="loc_us-gaapCostOfRevenue" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GrossProfit" xlink:label="loc_us-gaapGrossProfit" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeStatementAbstract" xlink:to="loc_us-gaapGrossProfit" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingCostsAndExpensesAbstract" xlink:label="loc_us-gaapOperatingCostsAndExpensesAbstract" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeStatementAbstract" xlink:to="loc_us-gaapOperatingCostsAndExpensesAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AllocatedShareBasedCompensationExpense" xlink:label="loc_us-gaapAllocatedShareBasedCompensationExpense" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOperatingCostsAndExpensesAbstract" xlink:to="loc_us-gaapAllocatedShareBasedCompensationExpense" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DepreciationAndAmortization" xlink:label="loc_us-gaapDepreciationAndAmortization" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOperatingCostsAndExpensesAbstract" xlink:to="loc_us-gaapDepreciationAndAmortization" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherGeneralAndAdministrativeExpense" xlink:label="loc_us-gaapOtherGeneralAndAdministrativeExpense" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOperatingCostsAndExpensesAbstract" xlink:to="loc_us-gaapOtherGeneralAndAdministrativeExpense" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingExpenses" xlink:label="loc_us-gaapOperatingExpenses" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOperatingCostsAndExpensesAbstract" xlink:to="loc_us-gaapOperatingExpenses" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingIncomeLoss" xlink:label="loc_us-gaapOperatingIncomeLoss" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeStatementAbstract" xlink:to="loc_us-gaapOperatingIncomeLoss" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherIncomeAndExpensesAbstract" xlink:label="loc_us-gaapOtherIncomeAndExpensesAbstract" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeStatementAbstract" xlink:to="loc_us-gaapOtherIncomeAndExpensesAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_InvestmentIncomeInterest" xlink:label="loc_us-gaapInvestmentIncomeInterest" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOtherIncomeAndExpensesAbstract" xlink:to="loc_us-gaapInvestmentIncomeInterest" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ChangeInFairValueOfContingentConsideration" xlink:label="loc_oprxChangeInFairValueOfContingentConsideration" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOtherIncomeAndExpensesAbstract" xlink:to="loc_oprxChangeInFairValueOfContingentConsideration" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherNonoperatingIncomeExpense" xlink:label="loc_us-gaapOtherNonoperatingIncomeExpense" />
      <link:presentationArc order="130" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOtherIncomeAndExpensesAbstract" xlink:to="loc_us-gaapOtherNonoperatingIncomeExpense" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:label="loc_us-gaapIncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" />
      <link:presentationArc order="140" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeStatementAbstract" xlink:to="loc_us-gaapIncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="loc_us-gaapIncomeTaxExpenseBenefit" />
      <link:presentationArc order="150" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeStatementAbstract" xlink:to="loc_us-gaapIncomeTaxExpenseBenefit" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetIncomeLoss" xlink:label="loc_us-gaapNetIncomeLoss" />
      <link:presentationArc order="160" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeStatementAbstract" xlink:to="loc_us-gaapNetIncomeLoss" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:label="loc_us-gaapWeightedAverageNumberOfSharesOutstandingBasic" />
      <link:presentationArc order="170" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeStatementAbstract" xlink:to="loc_us-gaapWeightedAverageNumberOfSharesOutstandingBasic" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:label="loc_us-gaapWeightedAverageNumberOfDilutedSharesOutstanding" />
      <link:presentationArc order="180" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeStatementAbstract" xlink:to="loc_us-gaapWeightedAverageNumberOfDilutedSharesOutstanding" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeLossFromContinuingOperationsPerBasicShare" xlink:label="loc_us-gaapIncomeLossFromContinuingOperationsPerBasicShare" />
      <link:presentationArc order="190" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeStatementAbstract" xlink:to="loc_us-gaapIncomeLossFromContinuingOperationsPerBasicShare" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeLossFromContinuingOperationsPerDilutedShare" xlink:label="loc_us-gaapIncomeLossFromContinuingOperationsPerDilutedShare" />
      <link:presentationArc order="200" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeStatementAbstract" xlink:to="loc_us-gaapIncomeLossFromContinuingOperationsPerDilutedShare" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/StatementOfStockholdersEquity" xlink:title="00000005 - Statement - Consolidated Statement of Stockholders&apos; Equity">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementOfStockholdersEquityAbstract" xlink:label="loc_us-gaapStatementOfStockholdersEquityAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:label="loc_us-gaapStatementTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfStockholdersEquityAbstract" xlink:to="loc_us-gaapStatementTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:label="loc_us-gaapStatementLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapStatementLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementEquityComponentsAxis" xlink:label="loc_us-gaapStatementEquityComponentsAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapStatementEquityComponentsAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquityComponentDomain" xlink:label="loc_us-gaapEquityComponentDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementEquityComponentsAxis" xlink:to="loc_us-gaapEquityComponentDomain" order="50" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockMember" xlink:label="loc_us-gaapCommonStockMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementEquityComponentsAxis" xlink:to="loc_us-gaapCommonStockMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_WarrantMember" xlink:label="loc_us-gaapWarrantMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementEquityComponentsAxis" xlink:to="loc_us-gaapWarrantMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AdditionalPaidInCapitalMember" xlink:label="loc_us-gaapAdditionalPaidInCapitalMember" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementEquityComponentsAxis" xlink:to="loc_us-gaapAdditionalPaidInCapitalMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RetainedEarningsMember" xlink:label="loc_us-gaapRetainedEarningsMember" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementEquityComponentsAxis" xlink:to="loc_us-gaapRetainedEarningsMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockholdersEquity" xlink:label="loc_us-gaapStockholdersEquity" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockholdersEquity" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharesOutstanding" xlink:label="loc_us-gaapSharesOutstanding" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapSharesOutstanding" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_StockIssuedDuringPeriodCumulativeEffectOfChangeInAccountingPrincipleRelatedToRevenueRecognition" xlink:label="loc_oprxStockIssuedDuringPeriodCumulativeEffectOfChangeInAccountingPrincipleRelatedToRevenueRecognition" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxStockIssuedDuringPeriodCumulativeEffectOfChangeInAccountingPrincipleRelatedToRevenueRecognition" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_IncreaseInDeferredRevenue" xlink:label="loc_oprxIncreaseInDeferredRevenue" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxIncreaseInDeferredRevenue" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures" xlink:label="loc_us-gaapStockIssuedDuringPeriodValueRestrictedStockAwardForfeitures" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockIssuedDuringPeriodValueRestrictedStockAwardForfeitures" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited" xlink:label="loc_us-gaapStockIssuedDuringPeriodSharesRestrictedStockAwardForfeited" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockIssuedDuringPeriodSharesRestrictedStockAwardForfeited" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation" xlink:label="loc_us-gaapStockIssuedDuringPeriodValueShareBasedCompensation" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockIssuedDuringPeriodValueShareBasedCompensation" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_StockCompensationExpenseOptions" xlink:label="loc_oprxStockCompensationExpenseOptions" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxStockCompensationExpenseOptions" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardNetOfForfeitures" xlink:label="loc_us-gaapStockIssuedDuringPeriodValueRestrictedStockAwardNetOfForfeitures" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockIssuedDuringPeriodValueRestrictedStockAwardNetOfForfeitures" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueIssuedForServices" xlink:label="loc_us-gaapStockIssuedDuringPeriodValueIssuedForServices" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockIssuedDuringPeriodValueIssuedForServices" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesIssuedForServices" xlink:label="loc_us-gaapStockIssuedDuringPeriodSharesIssuedForServices" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockIssuedDuringPeriodSharesIssuedForServices" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueNewIssues" xlink:label="loc_us-gaapStockIssuedDuringPeriodValueNewIssues" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockIssuedDuringPeriodValueNewIssues" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesNewIssues" xlink:label="loc_us-gaapStockIssuedDuringPeriodSharesNewIssues" />
      <link:presentationArc order="130" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockIssuedDuringPeriodSharesNewIssues" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueStockOptionsExercised" xlink:label="loc_us-gaapStockIssuedDuringPeriodValueStockOptionsExercised" />
      <link:presentationArc order="140" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockIssuedDuringPeriodValueStockOptionsExercised" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" xlink:label="loc_us-gaapStockIssuedDuringPeriodSharesStockOptionsExercised" />
      <link:presentationArc order="150" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockIssuedDuringPeriodSharesStockOptionsExercised" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_IssuanceOfCommonStockForWarrantsExercisedValue" xlink:label="loc_oprxIssuanceOfCommonStockForWarrantsExercisedValue" />
      <link:presentationArc order="160" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxIssuanceOfCommonStockForWarrantsExercisedValue" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_IssuanceOfCommonStockForWarrantsExercisedShares" xlink:label="loc_oprxIssuanceOfCommonStockForWarrantsExercisedShares" />
      <link:presentationArc order="170" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxIssuanceOfCommonStockForWarrantsExercisedShares" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueAcquisitions" xlink:label="loc_us-gaapStockIssuedDuringPeriodValueAcquisitions" />
      <link:presentationArc order="180" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockIssuedDuringPeriodValueAcquisitions" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesAcquisitions" xlink:label="loc_us-gaapStockIssuedDuringPeriodSharesAcquisitions" />
      <link:presentationArc order="190" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockIssuedDuringPeriodSharesAcquisitions" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueOther" xlink:label="loc_us-gaapStockIssuedDuringPeriodValueOther" />
      <link:presentationArc order="200" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockIssuedDuringPeriodValueOther" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesOther" xlink:label="loc_us-gaapStockIssuedDuringPeriodSharesOther" />
      <link:presentationArc order="210" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockIssuedDuringPeriodSharesOther" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_StockDuringPeriodAdditionalSharesIssuedInConnectionWithReverseSplitDueToRounding" xlink:label="loc_oprxStockDuringPeriodAdditionalSharesIssuedInConnectionWithReverseSplitDueToRounding" />
      <link:presentationArc order="220" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxStockDuringPeriodAdditionalSharesIssuedInConnectionWithReverseSplitDueToRounding" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_StockDuringPeriodForAdditionalSharesIssuedInConnectionWithReverseSplitDueToRoundingShares" xlink:label="loc_oprxStockDuringPeriodForAdditionalSharesIssuedInConnectionWithReverseSplitDueToRoundingShares" />
      <link:presentationArc order="230" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxStockDuringPeriodForAdditionalSharesIssuedInConnectionWithReverseSplitDueToRoundingShares" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProfitLoss" xlink:label="loc_us-gaapProfitLoss" />
      <link:presentationArc order="240" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapProfitLoss" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockholdersEquity" xlink:label="loc_us-gaapStockholdersEquity_2" />
      <link:presentationArc order="250" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapStockholdersEquity_2" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharesOutstanding" xlink:label="loc_us-gaapSharesOutstanding_2" />
      <link:presentationArc order="260" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapSharesOutstanding_2" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/ConsolidatedStatementsOfCashFlow" xlink:title="00000006 - Statement - Consolidated Statements of Cash Flows">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementOfCashFlowsAbstract" xlink:label="loc_us-gaapStatementOfCashFlowsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:label="loc_us-gaapNetCashProvidedByUsedInOperatingActivitiesAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfCashFlowsAbstract" xlink:to="loc_us-gaapNetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetIncomeLoss" xlink:label="loc_us-gaapNetIncomeLoss" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="loc_us-gaapNetIncomeLoss" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:label="loc_us-gaapAdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="loc_us-gaapAdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DepreciationAndAmortization" xlink:label="loc_us-gaapDepreciationAndAmortization" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="loc_us-gaapDepreciationAndAmortization" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherNoncashExpense" xlink:label="loc_us-gaapOtherNoncashExpense" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="loc_us-gaapOtherNoncashExpense" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProvisionForDoubtfulAccounts" xlink:label="loc_us-gaapProvisionForDoubtfulAccounts" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="loc_us-gaapProvisionForDoubtfulAccounts" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GainLossOnDispositionOfAssets1" xlink:label="loc_us-gaapGainLossOnDispositionOfAssets1" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="loc_us-gaapGainLossOnDispositionOfAssets1" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensation" xlink:label="loc_us-gaapShareBasedCompensation" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="loc_us-gaapShareBasedCompensation" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="loc_us-gaapIncomeTaxExpenseBenefit" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="loc_us-gaapIncomeTaxExpenseBenefit" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ChangeInFairValueOfContingentConsideration" xlink:label="loc_oprxChangeInFairValueOfContingentConsideration" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="loc_oprxChangeInFairValueOfContingentConsideration" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:label="loc_us-gaapIncreaseDecreaseInOperatingCapitalAbstract" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="loc_us-gaapIncreaseDecreaseInOperatingCapitalAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncreaseDecreaseInAccountsReceivable" xlink:label="loc_us-gaapIncreaseDecreaseInAccountsReceivable" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncreaseDecreaseInOperatingCapitalAbstract" xlink:to="loc_us-gaapIncreaseDecreaseInAccountsReceivable" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncreaseDecreaseInPrepaidExpense" xlink:label="loc_us-gaapIncreaseDecreaseInPrepaidExpense" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncreaseDecreaseInOperatingCapitalAbstract" xlink:to="loc_us-gaapIncreaseDecreaseInPrepaidExpense" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncreaseDecreaseInAccountsPayable" xlink:label="loc_us-gaapIncreaseDecreaseInAccountsPayable" />
      <link:presentationArc order="130" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncreaseDecreaseInOperatingCapitalAbstract" xlink:to="loc_us-gaapIncreaseDecreaseInAccountsPayable" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_IncreaseDecreaseInRevenueSharePayable" xlink:label="loc_oprxIncreaseDecreaseInRevenueSharePayable" />
      <link:presentationArc order="140" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncreaseDecreaseInOperatingCapitalAbstract" xlink:to="loc_oprxIncreaseDecreaseInRevenueSharePayable" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncreaseDecreaseInAccruedLiabilities" xlink:label="loc_us-gaapIncreaseDecreaseInAccruedLiabilities" />
      <link:presentationArc order="150" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncreaseDecreaseInOperatingCapitalAbstract" xlink:to="loc_us-gaapIncreaseDecreaseInAccruedLiabilities" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncreaseDecreaseInOperatingLiabilities" xlink:label="loc_us-gaapIncreaseDecreaseInOperatingLiabilities" />
      <link:presentationArc order="160" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncreaseDecreaseInOperatingCapitalAbstract" xlink:to="loc_us-gaapIncreaseDecreaseInOperatingLiabilities" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncreaseDecreaseInDeferredRevenue" xlink:label="loc_us-gaapIncreaseDecreaseInDeferredRevenue" />
      <link:presentationArc order="170" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncreaseDecreaseInOperatingCapitalAbstract" xlink:to="loc_us-gaapIncreaseDecreaseInDeferredRevenue" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:label="loc_us-gaapNetCashProvidedByUsedInOperatingActivities" />
      <link:presentationArc order="180" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="loc_us-gaapNetCashProvidedByUsedInOperatingActivities" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:label="loc_us-gaapNetCashProvidedByUsedInInvestingActivitiesAbstract" />
      <link:presentationArc order="190" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfCashFlowsAbstract" xlink:to="loc_us-gaapNetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PaymentsToAcquirePropertyPlantAndEquipment" xlink:label="loc_us-gaapPaymentsToAcquirePropertyPlantAndEquipment" />
      <link:presentationArc order="200" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="loc_us-gaapPaymentsToAcquirePropertyPlantAndEquipment" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PaymentsToAcquireIntangibleAssets" xlink:label="loc_us-gaapPaymentsToAcquireIntangibleAssets" />
      <link:presentationArc order="210" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="loc_us-gaapPaymentsToAcquireIntangibleAssets" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired" xlink:label="loc_us-gaapPaymentsToAcquireBusinessesNetOfCashAcquired" />
      <link:presentationArc order="220" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="loc_us-gaapPaymentsToAcquireBusinessesNetOfCashAcquired" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetCashProvidedByUsedInInvestingActivities" xlink:label="loc_us-gaapNetCashProvidedByUsedInInvestingActivities" />
      <link:presentationArc order="230" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="loc_us-gaapNetCashProvidedByUsedInInvestingActivities" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:label="loc_us-gaapNetCashProvidedByUsedInFinancingActivitiesAbstract" />
      <link:presentationArc order="240" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfCashFlowsAbstract" xlink:to="loc_us-gaapNetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProceedsFromIssuanceOfCommonStock" xlink:label="loc_us-gaapProceedsFromIssuanceOfCommonStock" />
      <link:presentationArc order="250" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="loc_us-gaapProceedsFromIssuanceOfCommonStock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProceedsFromStockOptionsExercised" xlink:label="loc_us-gaapProceedsFromStockOptionsExercised" />
      <link:presentationArc order="260" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="loc_us-gaapProceedsFromStockOptionsExercised" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:label="loc_us-gaapNetCashProvidedByUsedInFinancingActivities" />
      <link:presentationArc order="270" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="loc_us-gaapNetCashProvidedByUsedInFinancingActivities" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease" xlink:label="loc_us-gaapCashAndCashEquivalentsPeriodIncreaseDecrease" />
      <link:presentationArc order="280" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfCashFlowsAbstract" xlink:to="loc_us-gaapCashAndCashEquivalentsPeriodIncreaseDecrease" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:label="loc_us-gaapCashAndCashEquivalentsAtCarryingValue" />
      <link:presentationArc order="290" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfCashFlowsAbstract" xlink:to="loc_us-gaapCashAndCashEquivalentsAtCarryingValue" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:label="loc_us-gaapCashAndCashEquivalentsAtCarryingValue_2" />
      <link:presentationArc order="300" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfCashFlowsAbstract" xlink:to="loc_us-gaapCashAndCashEquivalentsAtCarryingValue_2" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SupplementalCashFlowInformationAbstract" xlink:label="loc_us-gaapSupplementalCashFlowInformationAbstract" />
      <link:presentationArc order="310" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementOfCashFlowsAbstract" xlink:to="loc_us-gaapSupplementalCashFlowInformationAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_InterestPaidNet" xlink:label="loc_us-gaapInterestPaidNet" />
      <link:presentationArc order="320" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapSupplementalCashFlowInformationAbstract" xlink:to="loc_us-gaapInterestPaidNet" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeTaxesPaid" xlink:label="loc_us-gaapIncomeTaxesPaid" />
      <link:presentationArc order="330" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapSupplementalCashFlowInformationAbstract" xlink:to="loc_us-gaapIncomeTaxesPaid" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NoncashInvestingAndFinancingItemsAbstract" xlink:label="loc_us-gaapNoncashInvestingAndFinancingItemsAbstract" />
      <link:presentationArc order="340" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapSupplementalCashFlowInformationAbstract" xlink:to="loc_us-gaapNoncashInvestingAndFinancingItemsAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ExerciseOfStockWarrants" xlink:label="loc_oprxExerciseOfStockWarrants" />
      <link:presentationArc order="350" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNoncashInvestingAndFinancingItemsAbstract" xlink:to="loc_oprxExerciseOfStockWarrants" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_IssuanceOfSharesForRestrictedStockAwardsExpensed" xlink:label="loc_oprxIssuanceOfSharesForRestrictedStockAwardsExpensed" />
      <link:presentationArc order="360" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNoncashInvestingAndFinancingItemsAbstract" xlink:to="loc_oprxIssuanceOfSharesForRestrictedStockAwardsExpensed" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_LeaseLiabilitiesArisingFromRightOfUseAssets" xlink:label="loc_oprxLeaseLiabilitiesArisingFromRightOfUseAssets" />
      <link:presentationArc order="370" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNoncashInvestingAndFinancingItemsAbstract" xlink:to="loc_oprxLeaseLiabilitiesArisingFromRightOfUseAssets" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CommonStockIssuedForDebt" xlink:label="loc_oprxCommonStockIssuedForDebt" />
      <link:presentationArc order="380" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNoncashInvestingAndFinancingItemsAbstract" xlink:to="loc_oprxCommonStockIssuedForDebt" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_SharesIssuedInConnectionWithAcquisitions" xlink:label="loc_oprxSharesIssuedInConnectionWithAcquisitions" />
      <link:presentationArc order="390" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNoncashInvestingAndFinancingItemsAbstract" xlink:to="loc_oprxSharesIssuedInConnectionWithAcquisitions" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_NoncashEffectOfCumulativeAdjustmentsToAccumulatedDeficit" xlink:label="loc_oprxNoncashEffectOfCumulativeAdjustmentsToAccumulatedDeficit" />
      <link:presentationArc order="400" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNoncashInvestingAndFinancingItemsAbstract" xlink:to="loc_oprxNoncashEffectOfCumulativeAdjustmentsToAccumulatedDeficit" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/OrganizationAndNatureOfBusiness" xlink:title="00000007 - Disclosure - Organization and Nature of Business">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:label="loc_us-gaapOrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsDisclosureTextBlock" xlink:label="loc_us-gaapOrganizationConsolidationAndPresentationOfFinancialStatementsDisclosureTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapOrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="loc_us-gaapOrganizationConsolidationAndPresentationOfFinancialStatementsDisclosureTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/SummaryOfSignificantAccountingPolicies" xlink:title="00000008 - Disclosure - Summary of Significant Accounting Policies">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="loc_us-gaapAccountingPoliciesAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SignificantAccountingPoliciesTextBlock" xlink:label="loc_us-gaapSignificantAccountingPoliciesTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapSignificantAccountingPoliciesTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/Acquisition" xlink:title="00000009 - Disclosure - Acquisition">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:label="loc_us-gaapBusinessCombinationsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationDisclosureTextBlock" xlink:label="loc_us-gaapBusinessCombinationDisclosureTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapBusinessCombinationsAbstract" xlink:to="loc_us-gaapBusinessCombinationDisclosureTextBlock" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/PrepaidExpenses" xlink:title="00000010 - Disclosure - Prepaid Expenses">
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PrepaidExpensesAbstract" xlink:label="loc_oprxPrepaidExpensesAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PrepaidExpensesTextBlock" xlink:label="loc_oprxPrepaidExpensesTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxPrepaidExpensesAbstract" xlink:to="loc_oprxPrepaidExpensesTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/PropertyAndEquipment" xlink:title="00000011 - Disclosure - Property and Equipment">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentAbstract" xlink:label="loc_us-gaapPropertyPlantAndEquipmentAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock" xlink:label="loc_us-gaapPropertyPlantAndEquipmentDisclosureTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapPropertyPlantAndEquipmentAbstract" xlink:to="loc_us-gaapPropertyPlantAndEquipmentDisclosureTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/IntangibleAssets" xlink:title="00000012 - Disclosure - Intangible Assets">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:label="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IntangibleAssetsDisclosureTextBlock" xlink:label="loc_us-gaapIntangibleAssetsDisclosureTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="loc_us-gaapIntangibleAssetsDisclosureTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/DeferredRevenue" xlink:title="00000013 - Disclosure - Deferred Revenue">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RevenueRecognitionAbstract" xlink:label="loc_us-gaapRevenueRecognitionAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredRevenueDisclosureTextBlock" xlink:label="loc_us-gaapDeferredRevenueDisclosureTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRevenueRecognitionAbstract" xlink:to="loc_us-gaapDeferredRevenueDisclosureTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/RelatedPartyTransactions" xlink:title="00000014 - Disclosure - Related Party Transactions">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionsAbstract" xlink:label="loc_us-gaapRelatedPartyTransactionsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionsDisclosureTextBlock" xlink:label="loc_us-gaapRelatedPartyTransactionsDisclosureTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionsAbstract" xlink:to="loc_us-gaapRelatedPartyTransactionsDisclosureTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/ContingentPurchasePrice" xlink:title="00000015 - Disclosure - Contingent Purchase Price">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:label="loc_us-gaapCommitmentsAndContingenciesDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LossContingencyDisclosures" xlink:label="loc_us-gaapLossContingencyDisclosures" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapCommitmentsAndContingenciesDisclosureAbstract" xlink:to="loc_us-gaapLossContingencyDisclosures" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/StockholdersEquity" xlink:title="00000016 - Disclosure -  Stockholders&apos; Equity">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquityAbstract" xlink:label="loc_us-gaapEquityAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockholdersEquityNoteDisclosureTextBlock" xlink:label="loc_us-gaapStockholdersEquityNoteDisclosureTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapEquityAbstract" xlink:to="loc_us-gaapStockholdersEquityNoteDisclosureTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/StockCompensation" xlink:title="00000017 - Disclosure - Stock Compensation">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:label="loc_us-gaapDisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" xlink:label="loc_us-gaapDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapDisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="loc_us-gaapDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/Warrants" xlink:title="00000018 - Disclosure - Warrants">
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_WarrantsAbstract" xlink:label="loc_oprxWarrantsAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_WarrantsTextBlock" xlink:label="loc_oprxWarrantsTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxWarrantsAbstract" xlink:to="loc_oprxWarrantsTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/Leases" xlink:title="00000019 - Disclosure - Leases">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LeasesAbstract" xlink:label="loc_us-gaapLeasesAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LeasesOfLesseeDisclosureTextBlock" xlink:label="loc_us-gaapLeasesOfLesseeDisclosureTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapLeasesOfLesseeDisclosureTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/MajorCustomersAndVendors" xlink:title="00000020 - Disclosure - Major Customers and Vendors">
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_MajorCustomersAbstract" xlink:label="loc_oprxMajorCustomersAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_MajorCustomersTextBlock" xlink:label="loc_oprxMajorCustomersTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxMajorCustomersAbstract" xlink:to="loc_oprxMajorCustomersTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/IncomeTaxes" xlink:title="00000021 - Disclosure - Income Taxes">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:label="loc_us-gaapIncomeTaxDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeTaxDisclosureTextBlock" xlink:label="loc_us-gaapIncomeTaxDisclosureTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxDisclosureAbstract" xlink:to="loc_us-gaapIncomeTaxDisclosureTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/CommitmentsAndContingentLiabilities" xlink:title="00000022 - Disclosure - Commitments and Contingent Liabilities">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:label="loc_us-gaapCommitmentsAndContingenciesDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureTextBlock" xlink:label="loc_us-gaapCommitmentsAndContingenciesDisclosureTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapCommitmentsAndContingenciesDisclosureAbstract" xlink:to="loc_us-gaapCommitmentsAndContingenciesDisclosureTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/RetirementPlan" xlink:title="00000023 - Disclosure - Retirement Plan">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:label="loc_us-gaapCompensationAndRetirementDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock" xlink:label="loc_us-gaapPensionAndOtherPostretirementBenefitsDisclosureTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapCompensationAndRetirementDisclosureAbstract" xlink:to="loc_us-gaapPensionAndOtherPostretirementBenefitsDisclosureTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/SubsequentEvents" xlink:title="00000024 - Disclosure - Subsequent Events">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsequentEventsAbstract" xlink:label="loc_us-gaapSubsequentEventsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsequentEventsTextBlock" xlink:label="loc_us-gaapSubsequentEventsTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapSubsequentEventsAbstract" xlink:to="loc_us-gaapSubsequentEventsTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/SummaryOfSignificantAccountingPoliciesPolicies" xlink:title="00000025 - Disclosure - Summary of Significant Accounting Policies (Policies)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="loc_us-gaapAccountingPoliciesAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BasisOfAccountingPolicyPolicyTextBlock" xlink:label="loc_us-gaapBasisOfAccountingPolicyPolicyTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapBasisOfAccountingPolicyPolicyTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_UseOfEstimates" xlink:label="loc_us-gaapUseOfEstimates" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapUseOfEstimates" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConsolidationPolicyTextBlock" xlink:label="loc_us-gaapConsolidationPolicyTextBlock" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapConsolidationPolicyTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PriorPeriodReclassificationAdjustmentDescription" xlink:label="loc_us-gaapPriorPeriodReclassificationAdjustmentDescription" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapPriorPeriodReclassificationAdjustmentDescription" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CashAndCashEquivalentsPolicyTextBlock" xlink:label="loc_us-gaapCashAndCashEquivalentsPolicyTextBlock" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapCashAndCashEquivalentsPolicyTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueOfFinancialInstrumentsPolicy" xlink:label="loc_us-gaapFairValueOfFinancialInstrumentsPolicy" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapFairValueOfFinancialInstrumentsPolicy" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ReceivablesTradeAndOtherAccountsReceivableAllowanceForDoubtfulAccountsPolicy" xlink:label="loc_us-gaapReceivablesTradeAndOtherAccountsReceivableAllowanceForDoubtfulAccountsPolicy" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapReceivablesTradeAndOtherAccountsReceivableAllowanceForDoubtfulAccountsPolicy" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentPolicyTextBlock" xlink:label="loc_us-gaapPropertyPlantAndEquipmentPolicyTextBlock" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapPropertyPlantAndEquipmentPolicyTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock" xlink:label="loc_us-gaapGoodwillAndIntangibleAssetsPolicyTextBlock" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapGoodwillAndIntangibleAssetsPolicyTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsGoodwillPolicy" xlink:label="loc_us-gaapGoodwillAndIntangibleAssetsGoodwillPolicy" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapGoodwillAndIntangibleAssetsGoodwillPolicy" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_RevenueRecognitionsPolicyTextBlock" xlink:label="loc_oprxRevenueRecognitionsPolicyTextBlock" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_oprxRevenueRecognitionsPolicyTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_RevenueRecognitionAndRevenueShareExpensePolicyTextBlock" xlink:label="loc_oprxRevenueRecognitionAndRevenueShareExpensePolicyTextBlock" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_oprxRevenueRecognitionAndRevenueShareExpensePolicyTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeTaxPolicyTextBlock" xlink:label="loc_us-gaapIncomeTaxPolicyTextBlock" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapIncomeTaxPolicyTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskCreditRisk" xlink:label="loc_us-gaapConcentrationRiskCreditRisk" />
      <link:presentationArc order="130" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapConcentrationRiskCreditRisk" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ResearchAndDevelopmentExpensePolicy" xlink:label="loc_us-gaapResearchAndDevelopmentExpensePolicy" />
      <link:presentationArc order="140" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapResearchAndDevelopmentExpensePolicy" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy" xlink:label="loc_us-gaapShareBasedCompensationOptionAndIncentivePlansPolicy" />
      <link:presentationArc order="150" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapShareBasedCompensationOptionAndIncentivePlansPolicy" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EarningsPerSharePolicyTextBlock" xlink:label="loc_us-gaapEarningsPerSharePolicyTextBlock" />
      <link:presentationArc order="160" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapEarningsPerSharePolicyTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock" xlink:label="loc_us-gaapImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock" />
      <link:presentationArc order="170" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock" xlink:label="loc_us-gaapNewAccountingPronouncementsPolicyPolicyTextBlock" />
      <link:presentationArc order="180" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapNewAccountingPronouncementsPolicyPolicyTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/SummaryOfSignificantAccountingPoliciesTables" xlink:title="00000026 - Disclosure - Summary of Significant Accounting Policies (Tables)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="loc_us-gaapAccountingPoliciesAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisValuationTechniquesTableTextBlock" xlink:label="loc_us-gaapFairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisValuationTechniquesTableTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapFairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisValuationTechniquesTableTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueAssetsMeasuredOnRecurringBasisUnobservableInputReconciliationTextBlock" xlink:label="loc_us-gaapFairValueAssetsMeasuredOnRecurringBasisUnobservableInputReconciliationTextBlock" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapFairValueAssetsMeasuredOnRecurringBasisUnobservableInputReconciliationTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DisclosureOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTextBlock" xlink:label="loc_us-gaapDisclosureOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTextBlock" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapDisclosureOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock" xlink:label="loc_us-gaapScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/AcquisitionTables" xlink:title="00000027 - Disclosure - Acquisition (Tables)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:label="loc_us-gaapBusinessCombinationsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:label="loc_us-gaapStatementTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapBusinessCombinationsAbstract" xlink:to="loc_us-gaapStatementTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:label="loc_us-gaapStatementLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapStatementLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NonrecurringAdjustmentAxis" xlink:label="loc_us-gaapNonrecurringAdjustmentAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapNonrecurringAdjustmentAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NonrecurringAdjustmentDomain" xlink:label="loc_us-gaapNonrecurringAdjustmentDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNonrecurringAdjustmentAxis" xlink:to="loc_us-gaapNonrecurringAdjustmentDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CareSpeakAcquisitionMember" xlink:label="loc_oprxCareSpeakAcquisitionMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNonrecurringAdjustmentDomain" xlink:to="loc_oprxCareSpeakAcquisitionMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_RMDYAcquisitionMember" xlink:label="loc_oprxRMDYAcquisitionMember" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNonrecurringAdjustmentDomain" xlink:to="loc_oprxRMDYAcquisitionMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfRecognizedIdentifiedAssetsAcquiredAndLiabilitiesAssumedTableTextBlock" xlink:label="loc_us-gaapScheduleOfRecognizedIdentifiedAssetsAcquiredAndLiabilitiesAssumedTableTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapScheduleOfRecognizedIdentifiedAssetsAcquiredAndLiabilitiesAssumedTableTextBlock" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessAcquisitionProFormaInformationTextBlock" xlink:label="loc_us-gaapBusinessAcquisitionProFormaInformationTextBlock" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapBusinessAcquisitionProFormaInformationTextBlock" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/PrepaidExpensesTables" xlink:title="00000028 - Disclosure - Prepaid Expenses (Tables)">
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PrepaidExpensesAbstract" xlink:label="loc_oprxPrepaidExpensesAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PrepaidExpensesTableTextBlock" xlink:label="loc_oprxPrepaidExpensesTableTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxPrepaidExpensesAbstract" xlink:to="loc_oprxPrepaidExpensesTableTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/PropertyAndEquipmentTables" xlink:title="00000029 - Disclosure - Property and Equipment (Tables)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentAbstract" xlink:label="loc_us-gaapPropertyPlantAndEquipmentAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTextBlock" xlink:label="loc_us-gaapPropertyPlantAndEquipmentTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapPropertyPlantAndEquipmentAbstract" xlink:to="loc_us-gaapPropertyPlantAndEquipmentTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/IntangibleAssetsTables" xlink:title="00000030 - Disclosure - Intangible Assets (Tables)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:label="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" xlink:label="loc_us-gaapScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="loc_us-gaapScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ScheduleOfIntangiblesEstimatedUsefulLivesTableTextBlock" xlink:label="loc_oprxScheduleOfIntangiblesEstimatedUsefulLivesTableTextBlock" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="loc_oprxScheduleOfIntangiblesEstimatedUsefulLivesTableTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleofFiniteLivedIntangibleAssetsFutureAmortizationExpenseTableTextBlock" xlink:label="loc_us-gaapScheduleofFiniteLivedIntangibleAssetsFutureAmortizationExpenseTableTextBlock" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="loc_us-gaapScheduleofFiniteLivedIntangibleAssetsFutureAmortizationExpenseTableTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/RelatedPartyTransactionsTables" xlink:title="00000031 - Disclosure - Related Party Transactions (Tables)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionsAbstract" xlink:label="loc_us-gaapRelatedPartyTransactionsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfRelatedPartyTransactionsTableTextBlock" xlink:label="loc_us-gaapScheduleOfRelatedPartyTransactionsTableTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionsAbstract" xlink:to="loc_us-gaapScheduleOfRelatedPartyTransactionsTableTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/ContingentPurchasePriceTables" xlink:title="00000032 - Disclosure - Contingent Purchase Price (Tables)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:label="loc_us-gaapCommitmentsAndContingenciesDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_FairValueOfContingentPurchasePricePayablesTebleTextBlock" xlink:label="loc_oprxFairValueOfContingentPurchasePricePayablesTebleTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapCommitmentsAndContingenciesDisclosureAbstract" xlink:to="loc_oprxFairValueOfContingentPurchasePricePayablesTebleTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/StockCompensationTables" xlink:title="00000033 - Disclosure - Stock Compensation (Tables)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:label="loc_us-gaapDisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationActivityTableTextBlock" xlink:label="loc_us-gaapScheduleOfShareBasedCompensationActivityTableTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapDisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="loc_us-gaapScheduleOfShareBasedCompensationActivityTableTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ScheduleOfOptionsOutstandingTableTextBlock" xlink:label="loc_oprxScheduleOfOptionsOutstandingTableTextBlock" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapDisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="loc_oprxScheduleOfOptionsOutstandingTableTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/WarrantsTables" xlink:title="00000034 - Disclosure - Warrants (Tables)">
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_WarrantsAbstract" xlink:label="loc_oprxWarrantsAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ScheduleOfShareBasedCompensationWarrantActivityTableTextBlock" xlink:label="loc_oprxScheduleOfShareBasedCompensationWarrantActivityTableTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxWarrantsAbstract" xlink:to="loc_oprxScheduleOfShareBasedCompensationWarrantActivityTableTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/LeasesTables" xlink:title="00000035 - Disclosure - Leases (Tables)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LeasesAbstract" xlink:label="loc_us-gaapLeasesAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LeaseCostTableTextBlock" xlink:label="loc_us-gaapLeaseCostTableTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapLeaseCostTableTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock" xlink:label="loc_us-gaapScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/MajorCustomersAndVendorsTables" xlink:title="00000036 - Disclosure - Major Customers and Vendors (Tables)">
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_MajorCustomersAbstract" xlink:label="loc_oprxMajorCustomersAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:label="loc_us-gaapStatementTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxMajorCustomersAbstract" xlink:to="loc_us-gaapStatementTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:label="loc_us-gaapStatementLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapStatementLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionsByRelatedPartyAxis" xlink:label="loc_us-gaapRelatedPartyTransactionsByRelatedPartyAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapRelatedPartyTransactionsByRelatedPartyAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyDomain" xlink:label="loc_us-gaapRelatedPartyDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionsByRelatedPartyAxis" xlink:to="loc_us-gaapRelatedPartyDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CustomersMember" xlink:label="loc_oprxCustomersMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyDomain" xlink:to="loc_oprxCustomersMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_KeyPartnersMember" xlink:label="loc_oprxKeyPartnersMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyDomain" xlink:to="loc_oprxKeyPartnersMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock" xlink:label="loc_us-gaapSchedulesOfConcentrationOfRiskByRiskFactorTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapSchedulesOfConcentrationOfRiskByRiskFactorTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/IncomeTaxesTables" xlink:title="00000037 - Disclosure - Income Taxes (Tables)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:label="loc_us-gaapIncomeTaxDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" xlink:label="loc_us-gaapScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxDisclosureAbstract" xlink:to="loc_us-gaapScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" xlink:label="loc_us-gaapScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxDisclosureAbstract" xlink:to="loc_us-gaapScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/SummaryOfSignificantAccountingPoliciesDetails" xlink:title="00000038 - Disclosure - Summary of Significant Accounting Policies (Details)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="loc_us-gaapAccountingPoliciesAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_SummaryOfSignificantAccountingPoliciesTable" xlink:label="loc_oprxSummaryOfSignificantAccountingPoliciesTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_oprxSummaryOfSignificantAccountingPoliciesTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_SummaryOfSignificantAccountingPoliciesLineItems" xlink:label="loc_oprxSummaryOfSignificantAccountingPoliciesLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTable" xlink:to="loc_oprxSummaryOfSignificantAccountingPoliciesLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:label="loc_us-gaapFairValueByFairValueHierarchyLevelAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTable" xlink:to="loc_us-gaapFairValueByFairValueHierarchyLevelAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:label="loc_us-gaapFairValueMeasurementsFairValueHierarchyDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFairValueByFairValueHierarchyLevelAxis" xlink:to="loc_us-gaapFairValueMeasurementsFairValueHierarchyDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueInputsLevel1Member" xlink:label="loc_us-gaapFairValueInputsLevel1Member" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFairValueMeasurementsFairValueHierarchyDomain" xlink:to="loc_us-gaapFairValueInputsLevel1Member" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueInputsLevel2Member" xlink:label="loc_us-gaapFairValueInputsLevel2Member" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFairValueMeasurementsFairValueHierarchyDomain" xlink:to="loc_us-gaapFairValueInputsLevel2Member" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueInputsLevel3Member" xlink:label="loc_us-gaapFairValueInputsLevel3Member" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFairValueMeasurementsFairValueHierarchyDomain" xlink:to="loc_us-gaapFairValueInputsLevel3Member" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueByMeasurementFrequencyAxis" xlink:label="loc_us-gaapFairValueByMeasurementFrequencyAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTable" xlink:to="loc_us-gaapFairValueByMeasurementFrequencyAxis" order="20" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueMeasurementFrequencyDomain" xlink:label="loc_us-gaapFairValueMeasurementFrequencyDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFairValueByMeasurementFrequencyAxis" xlink:to="loc_us-gaapFairValueMeasurementFrequencyDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueMeasurementsRecurringMember" xlink:label="loc_us-gaapFairValueMeasurementsRecurringMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFairValueMeasurementFrequencyDomain" xlink:to="loc_us-gaapFairValueMeasurementsRecurringMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LiabilitiesFairValueDisclosureAbstract" xlink:label="loc_us-gaapLiabilitiesFairValueDisclosureAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesLineItems" xlink:to="loc_us-gaapLiabilitiesFairValueDisclosureAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationContingentConsiderationLiabilityCurrent" xlink:label="loc_us-gaapBusinessCombinationContingentConsiderationLiabilityCurrent" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLiabilitiesFairValueDisclosureAbstract" xlink:to="loc_us-gaapBusinessCombinationContingentConsiderationLiabilityCurrent" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/SummaryOfSignificantAccountingPoliciesDetails1" xlink:title="00000039 - Disclosure - Summary of Significant Accounting Policies (Details 1)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="loc_us-gaapAccountingPoliciesAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_SummaryOfSignificantAccountingPoliciesTable" xlink:label="loc_oprxSummaryOfSignificantAccountingPoliciesTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_oprxSummaryOfSignificantAccountingPoliciesTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_SummaryOfSignificantAccountingPoliciesLineItems" xlink:label="loc_oprxSummaryOfSignificantAccountingPoliciesLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTable" xlink:to="loc_oprxSummaryOfSignificantAccountingPoliciesLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:label="loc_us-gaapFairValueByFairValueHierarchyLevelAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTable" xlink:to="loc_us-gaapFairValueByFairValueHierarchyLevelAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:label="loc_us-gaapFairValueMeasurementsFairValueHierarchyDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFairValueByFairValueHierarchyLevelAxis" xlink:to="loc_us-gaapFairValueMeasurementsFairValueHierarchyDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueInputsLevel3Member" xlink:label="loc_us-gaapFairValueInputsLevel3Member" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFairValueMeasurementsFairValueHierarchyDomain" xlink:to="loc_us-gaapFairValueInputsLevel3Member" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueMeasurementWithUnobservableInputsReconciliationsRecurringBasisLiabilityValue" xlink:label="loc_us-gaapFairValueMeasurementWithUnobservableInputsReconciliationsRecurringBasisLiabilityValue" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesLineItems" xlink:to="loc_us-gaapFairValueMeasurementWithUnobservableInputsReconciliationsRecurringBasisLiabilityValue" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueMeasurementWithUnobservableInputsReconciliationRecurringBasisLiabilityPeriodIncreaseDecrease" xlink:label="loc_us-gaapFairValueMeasurementWithUnobservableInputsReconciliationRecurringBasisLiabilityPeriodIncreaseDecrease" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesLineItems" xlink:to="loc_us-gaapFairValueMeasurementWithUnobservableInputsReconciliationRecurringBasisLiabilityPeriodIncreaseDecrease" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueMeasurementWithUnobservableInputsReconciliationsRecurringBasisLiabilityValue" xlink:label="loc_us-gaapFairValueMeasurementWithUnobservableInputsReconciliationsRecurringBasisLiabilityValue_2" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesLineItems" xlink:to="loc_us-gaapFairValueMeasurementWithUnobservableInputsReconciliationsRecurringBasisLiabilityValue_2" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/SummaryOfSignificantAccountingPoliciesDetails2" xlink:title="00000040 - Disclosure - Summary of Significant Accounting Policies (Details 2)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="loc_us-gaapAccountingPoliciesAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_SummaryOfSignificantAccountingPoliciesTable" xlink:label="loc_oprxSummaryOfSignificantAccountingPoliciesTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_oprxSummaryOfSignificantAccountingPoliciesTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_SummaryOfSignificantAccountingPoliciesLineItems" xlink:label="loc_oprxSummaryOfSignificantAccountingPoliciesLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTable" xlink:to="loc_oprxSummaryOfSignificantAccountingPoliciesLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeAxis" xlink:label="loc_srtRangeAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTable" xlink:to="loc_srtRangeAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeMember" xlink:label="loc_srtRangeMember" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtRangeAxis" xlink:to="loc_srtRangeMember" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MaximumMember" xlink:label="loc_srtMaximumMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtRangeMember" xlink:to="loc_srtMaximumMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MinimumMember" xlink:label="loc_srtMinimumMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtRangeMember" xlink:to="loc_srtMinimumMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsAndMethodologyAbstract" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsAndMethodologyAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesLineItems" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsAndMethodologyAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedDividendRate" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedDividendRate" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsAndMethodologyAbstract" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedDividendRate" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRateMinimum" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRateMinimum" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsAndMethodologyAbstract" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRateMinimum" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRateMaximum" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRateMaximum" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsAndMethodologyAbstract" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRateMaximum" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardFairValueAssumptionsExpectedTerm1" xlink:label="loc_us-gaapSharebasedCompensationArrangementBySharebasedPaymentAwardFairValueAssumptionsExpectedTerm1" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsAndMethodologyAbstract" xlink:to="loc_us-gaapSharebasedCompensationArrangementBySharebasedPaymentAwardFairValueAssumptionsExpectedTerm1" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRate" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRate" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsAndMethodologyAbstract" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRate" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRateMinimum" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRateMinimum" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsAndMethodologyAbstract" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRateMinimum" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRateMaximum" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRateMaximum" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsAndMethodologyAbstract" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRateMaximum" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/SummaryOfSignificantAccountingPoliciesDetails3" xlink:title="00000041 - Disclosure - Summary of Significant Accounting Policies (Details 3)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="loc_us-gaapAccountingPoliciesAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetIncomeLossAvailableToCommonStockholdersBasic" xlink:label="loc_us-gaapNetIncomeLossAvailableToCommonStockholdersBasic" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapNetIncomeLossAvailableToCommonStockholdersBasic" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetIncomeLossAvailableToCommonStockholdersDiluted" xlink:label="loc_us-gaapNetIncomeLossAvailableToCommonStockholdersDiluted" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapNetIncomeLossAvailableToCommonStockholdersDiluted" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:label="loc_us-gaapWeightedAverageNumberOfSharesOutstandingBasic" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapWeightedAverageNumberOfSharesOutstandingBasic" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncrementalCommonSharesAttributableToCallOptionsAndWarrants" xlink:label="loc_us-gaapIncrementalCommonSharesAttributableToCallOptionsAndWarrants" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapIncrementalCommonSharesAttributableToCallOptionsAndWarrants" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:label="loc_us-gaapWeightedAverageNumberOfDilutedSharesOutstanding" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapWeightedAverageNumberOfDilutedSharesOutstanding" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EarningsPerShareBasic" xlink:label="loc_us-gaapEarningsPerShareBasic" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapEarningsPerShareBasic" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EarningsPerShareDiluted" xlink:label="loc_us-gaapEarningsPerShareDiluted" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_us-gaapEarningsPerShareDiluted" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/SummaryOfSignificantAccountingPoliciesDetailsTextual" xlink:title="00000042 - Disclosure - Summary of Significant Accounting Policies (Details Textual)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="loc_us-gaapAccountingPoliciesAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_SummaryOfSignificantAccountingPoliciesTable" xlink:label="loc_oprxSummaryOfSignificantAccountingPoliciesTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAccountingPoliciesAbstract" xlink:to="loc_oprxSummaryOfSignificantAccountingPoliciesTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_SummaryOfSignificantAccountingPoliciesLineItems" xlink:label="loc_oprxSummaryOfSignificantAccountingPoliciesLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTable" xlink:to="loc_oprxSummaryOfSignificantAccountingPoliciesLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AwardTypeAxis" xlink:label="loc_us-gaapAwardTypeAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTable" xlink:to="loc_us-gaapAwardTypeAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:label="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAwardTypeAxis" xlink:to="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RestrictedStockMember" xlink:label="loc_us-gaapRestrictedStockMember" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_us-gaapRestrictedStockMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_SummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:label="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesLineItems" xlink:to="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentUsefulLife" xlink:label="loc_us-gaapPropertyPlantAndEquipmentUsefulLife" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:to="loc_us-gaapPropertyPlantAndEquipmentUsefulLife" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProvisionForDoubtfulAccounts" xlink:label="loc_us-gaapProvisionForDoubtfulAccounts" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:to="loc_us-gaapProvisionForDoubtfulAccounts" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent" xlink:label="loc_us-gaapAllowanceForDoubtfulAccountsReceivableCurrent" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:to="loc_us-gaapAllowanceForDoubtfulAccountsReceivableCurrent" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ResearchAndDevelopmentExpense" xlink:label="loc_us-gaapResearchAndDevelopmentExpense" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:to="loc_us-gaapResearchAndDevelopmentExpense" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RevenueRecognitionNewAccountingPronouncementMaterialEffectDescription" xlink:label="loc_us-gaapRevenueRecognitionNewAccountingPronouncementMaterialEffectDescription" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:to="loc_us-gaapRevenueRecognitionNewAccountingPronouncementMaterialEffectDescription" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount" xlink:label="loc_us-gaapAntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:to="loc_us-gaapAntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" xlink:label="loc_us-gaapAcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:to="loc_us-gaapAcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CashFDICInsuredAmount" xlink:label="loc_us-gaapCashFDICInsuredAmount" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:to="loc_us-gaapCashFDICInsuredAmount" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_IncreaseInDeferredRevenue" xlink:label="loc_oprxIncreaseInDeferredRevenue" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:to="loc_oprxIncreaseInDeferredRevenue" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_DecreaseRevenues" xlink:label="loc_oprxDecreaseRevenues" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:to="loc_oprxDecreaseRevenues" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationContingentConsiderationArrangementsDescription" xlink:label="loc_us-gaapBusinessCombinationContingentConsiderationArrangementsDescription" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:to="loc_us-gaapBusinessCombinationContingentConsiderationArrangementsDescription" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationTaxSettlements" xlink:label="loc_us-gaapEffectiveIncomeTaxRateReconciliationTaxSettlements" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:to="loc_us-gaapEffectiveIncomeTaxRateReconciliationTaxSettlements" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_WeightedAverageNumberOfSharesRestrictedStock" xlink:label="loc_us-gaapWeightedAverageNumberOfSharesRestrictedStock" />
      <link:presentationArc order="130" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSummaryOfSignificantAccountingPoliciesTextualAbstract" xlink:to="loc_us-gaapWeightedAverageNumberOfSharesRestrictedStock" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/AcquisitionDetails" xlink:title="00000043 - Disclosure - Acquisition (Details)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:label="loc_us-gaapBusinessCombinationsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:label="loc_us-gaapStatementTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapBusinessCombinationsAbstract" xlink:to="loc_us-gaapStatementTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:label="loc_us-gaapStatementLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapStatementLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NonrecurringAdjustmentAxis" xlink:label="loc_us-gaapNonrecurringAdjustmentAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapNonrecurringAdjustmentAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NonrecurringAdjustmentDomain" xlink:label="loc_us-gaapNonrecurringAdjustmentDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNonrecurringAdjustmentAxis" xlink:to="loc_us-gaapNonrecurringAdjustmentDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CareSpeakAcquisitionMember" xlink:label="loc_oprxCareSpeakAcquisitionMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNonrecurringAdjustmentDomain" xlink:to="loc_oprxCareSpeakAcquisitionMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_RMDYAcquisitionMember" xlink:label="loc_oprxRMDYAcquisitionMember" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNonrecurringAdjustmentDomain" xlink:to="loc_oprxRMDYAcquisitionMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsByMajorClassAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsByMajorClassAxis" order="20" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GoodwillMember" xlink:label="loc_us-gaapGoodwillMember" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_us-gaapGoodwillMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PatentsMember" xlink:label="loc_us-gaapPatentsMember" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_us-gaapPatentsMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_TradeNamesMember" xlink:label="loc_us-gaapTradeNamesMember" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_us-gaapTradeNamesMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NoncompeteAgreementsMember" xlink:label="loc_us-gaapNoncompeteAgreementsMember" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_us-gaapNoncompeteAgreementsMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CustomerRelationshipsMember" xlink:label="loc_us-gaapCustomerRelationshipsMember" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_us-gaapCustomerRelationshipsMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DevelopedTechnologyRightsMember" xlink:label="loc_us-gaapDevelopedTechnologyRightsMember" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_us-gaapDevelopedTechnologyRightsMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_TradenameMember" xlink:label="loc_oprxTradenameMember" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_oprxTradenameMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CashPaidPurchasePriceAllocation" xlink:label="loc_oprxCashPaidPurchasePriceAllocation" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxCashPaidPurchasePriceAllocation" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CommonStockIssuedPurchasePriceAllocation" xlink:label="loc_oprxCommonStockIssuedPurchasePriceAllocation" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxCommonStockIssuedPurchasePriceAllocation" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ContingentPaymentPurchasePriceAllocation" xlink:label="loc_oprxContingentPaymentPurchasePriceAllocation" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxContingentPaymentPurchasePriceAllocation" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PurchasePriceAllocationNet" xlink:label="loc_oprxPurchasePriceAllocationNet" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxPurchasePriceAllocationNet" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssetsOther" xlink:label="loc_us-gaapBusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssetsOther" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapBusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssetsOther" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountsReceivableNet" xlink:label="loc_us-gaapAccountsReceivableNet" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapAccountsReceivableNet" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssetsPrepaidExpenseAndOtherAssets" xlink:label="loc_us-gaapBusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssetsPrepaidExpenseAndOtherAssets" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapBusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssetsPrepaidExpenseAndOtherAssets" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedPropertyPlantAndEquipment" xlink:label="loc_us-gaapBusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedPropertyPlantAndEquipment" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapBusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedPropertyPlantAndEquipment" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles" xlink:label="loc_us-gaapBusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapBusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedLiabilities" xlink:label="loc_us-gaapBusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedLiabilities" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapBusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedLiabilities" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountsPayableCurrent" xlink:label="loc_us-gaapAccountsPayableCurrent" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapAccountsPayableCurrent" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccruedLiabilitiesCurrent" xlink:label="loc_us-gaapAccruedLiabilitiesCurrent" />
      <link:presentationArc order="130" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapAccruedLiabilitiesCurrent" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredTaxAssetsLiabilitiesNet" xlink:label="loc_us-gaapDeferredTaxAssetsLiabilitiesNet" />
      <link:presentationArc order="140" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapDeferredTaxAssetsLiabilitiesNet" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNet" xlink:label="loc_us-gaapBusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNet" />
      <link:presentationArc order="150" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapBusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNet" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/AcquisitionDetails1" xlink:title="00000044 - Disclosure - Acquisition (Details 1)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:label="loc_us-gaapBusinessCombinationsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:label="loc_us-gaapStatementTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapBusinessCombinationsAbstract" xlink:to="loc_us-gaapStatementTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:label="loc_us-gaapStatementLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapStatementLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ScenarioAxis" xlink:label="loc_oprxScenarioAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_oprxScenarioAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ScenarioDomain" xlink:label="loc_oprxScenarioDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxScenarioAxis" xlink:to="loc_oprxScenarioDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ProFormaMember" xlink:label="loc_srtProFormaMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxScenarioDomain" xlink:to="loc_srtProFormaMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_Revenues" xlink:label="loc_us-gaapRevenues" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapRevenues" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:label="loc_us-gaapIncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapIncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EarningsPerShareAbstract" xlink:label="loc_us-gaapEarningsPerShareAbstract" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapEarningsPerShareAbstract" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EarningsPerShareBasic" xlink:label="loc_us-gaapEarningsPerShareBasic" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapEarningsPerShareAbstract" xlink:to="loc_us-gaapEarningsPerShareBasic" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EarningsPerShareDiluted" xlink:label="loc_us-gaapEarningsPerShareDiluted" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapEarningsPerShareAbstract" xlink:to="loc_us-gaapEarningsPerShareDiluted" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/definitionGuidance" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/AcquisitionDetailsTextual" xlink:title="00000045 - Disclosure - Acquisition (Details Textual)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:label="loc_us-gaapBusinessCombinationsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:label="loc_us-gaapStatementTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapBusinessCombinationsAbstract" xlink:to="loc_us-gaapStatementTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:label="loc_us-gaapStatementLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapStatementLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NonrecurringAdjustmentAxis" xlink:label="loc_us-gaapNonrecurringAdjustmentAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapNonrecurringAdjustmentAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NonrecurringAdjustmentDomain" xlink:label="loc_us-gaapNonrecurringAdjustmentDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNonrecurringAdjustmentAxis" xlink:to="loc_us-gaapNonrecurringAdjustmentDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CareSpeakAcquisitionMember" xlink:label="loc_oprxCareSpeakAcquisitionMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNonrecurringAdjustmentDomain" xlink:to="loc_oprxCareSpeakAcquisitionMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_RMDYAcquisitionMember" xlink:label="loc_oprxRMDYAcquisitionMember" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapNonrecurringAdjustmentDomain" xlink:to="loc_oprxRMDYAcquisitionMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeAxis" xlink:label="loc_srtRangeAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_srtRangeAxis" order="20" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeMember" xlink:label="loc_srtRangeMember" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtRangeAxis" xlink:to="loc_srtRangeMember" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MinimumMember" xlink:label="loc_srtMinimumMember" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtRangeMember" xlink:to="loc_srtMinimumMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_AcquisitionTextualAbstract" xlink:label="loc_oprxAcquisitionTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxAcquisitionTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PurchasePriceAllocationNet" xlink:label="loc_oprxPurchasePriceAllocationNet" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxAcquisitionTextualAbstract" xlink:to="loc_oprxPurchasePriceAllocationNet" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessAcquisitionCostOfAcquiredEntityTransactionCosts" xlink:label="loc_us-gaapBusinessAcquisitionCostOfAcquiredEntityTransactionCosts" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxAcquisitionTextualAbstract" xlink:to="loc_us-gaapBusinessAcquisitionCostOfAcquiredEntityTransactionCosts" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationContingentConsiderationLiability" xlink:label="loc_us-gaapBusinessCombinationContingentConsiderationLiability" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxAcquisitionTextualAbstract" xlink:to="loc_us-gaapBusinessCombinationContingentConsiderationLiability" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_FairValueOfContingentPayment" xlink:label="loc_oprxFairValueOfContingentPayment" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxAcquisitionTextualAbstract" xlink:to="loc_oprxFairValueOfContingentPayment" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentEstimatedUsefulLives" xlink:label="loc_us-gaapPropertyPlantAndEquipmentEstimatedUsefulLives" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxAcquisitionTextualAbstract" xlink:to="loc_us-gaapPropertyPlantAndEquipmentEstimatedUsefulLives" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccruedLiabilitiesCurrentAndNoncurrent" xlink:label="loc_us-gaapAccruedLiabilitiesCurrentAndNoncurrent" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxAcquisitionTextualAbstract" xlink:to="loc_us-gaapAccruedLiabilitiesCurrentAndNoncurrent" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/PrepaidExpensesDetails" xlink:title="00000046 - Disclosure - Prepaid Expenses (Details)">
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PrepaidExpensesAbstract" xlink:label="loc_oprxPrepaidExpensesAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PrepaidInsurance" xlink:label="loc_us-gaapPrepaidInsurance" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxPrepaidExpensesAbstract" xlink:to="loc_us-gaapPrepaidInsurance" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PrepaidRevenueSharesPayment" xlink:label="loc_oprxPrepaidRevenueSharesPayment" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxPrepaidExpensesAbstract" xlink:to="loc_oprxPrepaidRevenueSharesPayment" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PrepaidExpensesFees" xlink:label="loc_oprxPrepaidExpensesFees" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxPrepaidExpensesAbstract" xlink:to="loc_oprxPrepaidExpensesFees" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherPrepaidExpenseCurrent" xlink:label="loc_us-gaapOtherPrepaidExpenseCurrent" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxPrepaidExpensesAbstract" xlink:to="loc_us-gaapOtherPrepaidExpenseCurrent" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PrepaidExpenseCurrent" xlink:label="loc_us-gaapPrepaidExpenseCurrent" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxPrepaidExpensesAbstract" xlink:to="loc_us-gaapPrepaidExpenseCurrent" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/PropertyandEquipmentDetails" xlink:title="00000047 - Disclosure - Property and Equipment (Details)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentAbstract" xlink:label="loc_us-gaapPropertyPlantAndEquipmentAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" xlink:label="loc_us-gaapScheduleOfPropertyPlantAndEquipmentTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapPropertyPlantAndEquipmentAbstract" xlink:to="loc_us-gaapScheduleOfPropertyPlantAndEquipmentTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentLineItems" xlink:label="loc_us-gaapPropertyPlantAndEquipmentLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfPropertyPlantAndEquipmentTable" xlink:to="loc_us-gaapPropertyPlantAndEquipmentLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:label="loc_us-gaapPropertyPlantAndEquipmentByTypeAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfPropertyPlantAndEquipmentTable" xlink:to="loc_us-gaapPropertyPlantAndEquipmentByTypeAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:label="loc_us-gaapPropertyPlantAndEquipmentTypeDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapPropertyPlantAndEquipmentByTypeAxis" xlink:to="loc_us-gaapPropertyPlantAndEquipmentTypeDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ComputerEquipmentMember" xlink:label="loc_us-gaapComputerEquipmentMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapPropertyPlantAndEquipmentTypeDomain" xlink:to="loc_us-gaapComputerEquipmentMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FurnitureAndFixturesMember" xlink:label="loc_us-gaapFurnitureAndFixturesMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapPropertyPlantAndEquipmentTypeDomain" xlink:to="loc_us-gaapFurnitureAndFixturesMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentGross" xlink:label="loc_us-gaapPropertyPlantAndEquipmentGross" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapPropertyPlantAndEquipmentLineItems" xlink:to="loc_us-gaapPropertyPlantAndEquipmentGross" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" xlink:label="loc_us-gaapAccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapPropertyPlantAndEquipmentLineItems" xlink:to="loc_us-gaapAccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentNet" xlink:label="loc_us-gaapPropertyPlantAndEquipmentNet" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapPropertyPlantAndEquipmentLineItems" xlink:to="loc_us-gaapPropertyPlantAndEquipmentNet" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/PropertyAndEquipmentDetailsTextual" xlink:title="00000048 - Disclosure - Property and Equipment (Details Textual)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentAbstract" xlink:label="loc_us-gaapPropertyPlantAndEquipmentAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PropertyAndEquipmentTextualAbstract" xlink:label="loc_oprxPropertyAndEquipmentTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapPropertyPlantAndEquipmentAbstract" xlink:to="loc_oprxPropertyAndEquipmentTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_Depreciation" xlink:label="loc_us-gaapDepreciation" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxPropertyAndEquipmentTextualAbstract" xlink:to="loc_us-gaapDepreciation" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/IntangibleAssetsDetails" xlink:title="00000049 - Disclosure - Intangible Assets (Details)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:label="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:label="loc_us-gaapScheduleOfFiniteLivedIntangibleAssetsTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="loc_us-gaapScheduleOfFiniteLivedIntangibleAssetsTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfFiniteLivedIntangibleAssetsTable" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsByMajorClassAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfFiniteLivedIntangibleAssetsTable" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsByMajorClassAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PatentsMember" xlink:label="loc_us-gaapPatentsMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_us-gaapPatentsMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_TradenameMember" xlink:label="loc_oprxTradenameMember" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_oprxTradenameMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NoncompeteAgreementsMember" xlink:label="loc_us-gaapNoncompeteAgreementsMember" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_us-gaapNoncompeteAgreementsMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CustomerRelationshipsMember" xlink:label="loc_us-gaapCustomerRelationshipsMember" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_us-gaapCustomerRelationshipsMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherIntangibleAssetsMember" xlink:label="loc_us-gaapOtherIntangibleAssetsMember" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_us-gaapOtherIntangibleAssetsMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_WebbasedTechnologyMember" xlink:label="loc_oprxWebbasedTechnologyMember" />
      <link:presentationArc order="230" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_oprxWebbasedTechnologyMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquitySecuritiesByIndustryAxis" xlink:label="loc_us-gaapEquitySecuritiesByIndustryAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfFiniteLivedIntangibleAssetsTable" xlink:to="loc_us-gaapEquitySecuritiesByIndustryAxis" order="20" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquitySecuritiesIndustryMember" xlink:label="loc_us-gaapEquitySecuritiesIndustryMember" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapEquitySecuritiesByIndustryAxis" xlink:to="loc_us-gaapEquitySecuritiesIndustryMember" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_TechnologySectorMember" xlink:label="loc_us-gaapTechnologySectorMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapEquitySecuritiesIndustryMember" xlink:to="loc_us-gaapTechnologySectorMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsGross" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsGross" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsLineItems" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsGross" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsAccumulatedAmortization" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsLineItems" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsAccumulatedAmortization" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsNet" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsNet" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsLineItems" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsNet" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" xlink:label="loc_us-gaapAcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsLineItems" xlink:to="loc_us-gaapAcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_IndefiniteLivedIntangibleAssetWeightedAverageUsefulLife" xlink:label="loc_oprxIndefiniteLivedIntangibleAssetWeightedAverageUsefulLife" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsLineItems" xlink:to="loc_oprxIndefiniteLivedIntangibleAssetWeightedAverageUsefulLife" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/IntangibleAssetsDetails1" xlink:title="00000050 - Disclosure - Intangible Assets (Details 1)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:label="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:label="loc_us-gaapStatementTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="loc_us-gaapStatementTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:label="loc_us-gaapStatementLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapStatementLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsByMajorClassAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsByMajorClassAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PatentsMember" xlink:label="loc_us-gaapPatentsMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_us-gaapPatentsMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_TradenameMember" xlink:label="loc_oprxTradenameMember" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_oprxTradenameMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NoncompeteAgreementsMember" xlink:label="loc_us-gaapNoncompeteAgreementsMember" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_us-gaapNoncompeteAgreementsMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CustomerRelationshipsMember" xlink:label="loc_us-gaapCustomerRelationshipsMember" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapFiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="loc_us-gaapCustomerRelationshipsMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeAxis" xlink:label="loc_srtRangeAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_srtRangeAxis" order="20" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeMember" xlink:label="loc_srtRangeMember" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtRangeAxis" xlink:to="loc_srtRangeMember" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MaximumMember" xlink:label="loc_srtMaximumMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtRangeMember" xlink:to="loc_srtMaximumMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MinimumMember" xlink:label="loc_srtMinimumMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtRangeMember" xlink:to="loc_srtMinimumMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquitySecuritiesByIndustryAxis" xlink:label="loc_us-gaapEquitySecuritiesByIndustryAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapEquitySecuritiesByIndustryAxis" order="30" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquitySecuritiesIndustryMember" xlink:label="loc_us-gaapEquitySecuritiesIndustryMember" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapEquitySecuritiesByIndustryAxis" xlink:to="loc_us-gaapEquitySecuritiesIndustryMember" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_TechnologySectorMember" xlink:label="loc_us-gaapTechnologySectorMember" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapEquitySecuritiesIndustryMember" xlink:to="loc_us-gaapTechnologySectorMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetUsefulLife" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetUsefulLife" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetUsefulLife" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/IntangibleAssetsDetails2" xlink:title="00000051 - Disclosure - Intangible Assets (Details 2)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:label="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_IntangibleAssetsAbstract" xlink:label="loc_oprxIntangibleAssetsAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="loc_oprxIntangibleAssetsAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxIntangibleAssetsAbstract" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsAmortizationExpenseYearTwo" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxIntangibleAssetsAbstract" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsAmortizationExpenseYearTwo" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsAmortizationExpenseYearThree" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxIntangibleAssetsAbstract" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsAmortizationExpenseYearThree" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsAmortizationExpenseYearFour" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxIntangibleAssetsAbstract" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsAmortizationExpenseYearFour" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsAmortizationExpenseYearFive" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxIntangibleAssetsAbstract" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsAmortizationExpenseYearFive" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseAfterYearFive" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsAmortizationExpenseAfterYearFive" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxIntangibleAssetsAbstract" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsAmortizationExpenseAfterYearFive" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsNet" xlink:label="loc_us-gaapFiniteLivedIntangibleAssetsNet" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="loc_us-gaapFiniteLivedIntangibleAssetsNet" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/IntangibleAssetsDetailsTextual" xlink:title="00000052 - Disclosure - Intangible Assets (Details Textual)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:label="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_IntangibleAssetsTextualAbstract" xlink:label="loc_oprxIntangibleAssetsTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapGoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="loc_oprxIntangibleAssetsTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AdjustmentForAmortization" xlink:label="loc_us-gaapAdjustmentForAmortization" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxIntangibleAssetsTextualAbstract" xlink:to="loc_us-gaapAdjustmentForAmortization" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FinitelivedIntangibleAssetsAcquired1" xlink:label="loc_us-gaapFinitelivedIntangibleAssetsAcquired1" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxIntangibleAssetsTextualAbstract" xlink:to="loc_us-gaapFinitelivedIntangibleAssetsAcquired1" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/DeferredRevenueDetails" xlink:title="00000053 - Disclosure - Deferred Revenue (Details)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RevenueRecognitionAbstract" xlink:label="loc_us-gaapRevenueRecognitionAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_DeferredRevenueTextualAbstract" xlink:label="loc_oprxDeferredRevenueTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRevenueRecognitionAbstract" xlink:to="loc_oprxDeferredRevenueTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredRevenueCurrent" xlink:label="loc_us-gaapDeferredRevenueCurrent" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxDeferredRevenueTextualAbstract" xlink:to="loc_us-gaapDeferredRevenueCurrent" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/RelatedPartyTransactionsDetails" xlink:title="00000054 - Disclosure - Related Party Transactions (Details)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionsAbstract" xlink:label="loc_us-gaapRelatedPartyTransactionsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfRelatedPartyTransactionsByRelatedPartyTable" xlink:label="loc_us-gaapScheduleOfRelatedPartyTransactionsByRelatedPartyTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionsAbstract" xlink:to="loc_us-gaapScheduleOfRelatedPartyTransactionsByRelatedPartyTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionLineItems" xlink:label="loc_us-gaapRelatedPartyTransactionLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfRelatedPartyTransactionsByRelatedPartyTable" xlink:to="loc_us-gaapRelatedPartyTransactionLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionAxis" xlink:label="loc_us-gaapRelatedPartyTransactionAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfRelatedPartyTransactionsByRelatedPartyTable" xlink:to="loc_us-gaapRelatedPartyTransactionAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionDomain" xlink:label="loc_us-gaapRelatedPartyTransactionDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionAxis" xlink:to="loc_us-gaapRelatedPartyTransactionDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_TotalBillingsToRelatedPartiesMember" xlink:label="loc_oprxTotalBillingsToRelatedPartiesMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionDomain" xlink:to="loc_oprxTotalBillingsToRelatedPartiesMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_RevenueRecognizedFromRelatedPartyMember" xlink:label="loc_oprxRevenueRecognizedFromRelatedPartyMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionDomain" xlink:to="loc_oprxRevenueRecognizedFromRelatedPartyMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountsReceivableMember" xlink:label="loc_us-gaapAccountsReceivableMember" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionDomain" xlink:to="loc_us-gaapAccountsReceivableMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionAmountsOfTransaction" xlink:label="loc_us-gaapRelatedPartyTransactionAmountsOfTransaction" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionLineItems" xlink:to="loc_us-gaapRelatedPartyTransactionAmountsOfTransaction" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/RelatedPartyTransactionsDetailsTextual" xlink:title="00000055 - Disclosure - Related Party Transactions (Details Textual)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionsAbstract" xlink:label="loc_us-gaapRelatedPartyTransactionsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfRelatedPartyTransactionsByRelatedPartyTable" xlink:label="loc_us-gaapScheduleOfRelatedPartyTransactionsByRelatedPartyTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionsAbstract" xlink:to="loc_us-gaapScheduleOfRelatedPartyTransactionsByRelatedPartyTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionLineItems" xlink:label="loc_us-gaapRelatedPartyTransactionLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfRelatedPartyTransactionsByRelatedPartyTable" xlink:to="loc_us-gaapRelatedPartyTransactionLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionsByRelatedPartyAxis" xlink:label="loc_us-gaapRelatedPartyTransactionsByRelatedPartyAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfRelatedPartyTransactionsByRelatedPartyTable" xlink:to="loc_us-gaapRelatedPartyTransactionsByRelatedPartyAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyDomain" xlink:label="loc_us-gaapRelatedPartyDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionsByRelatedPartyAxis" xlink:to="loc_us-gaapRelatedPartyDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ChiefExecutiveOfficerMember" xlink:label="loc_srtChiefExecutiveOfficerMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyDomain" xlink:to="loc_srtChiefExecutiveOfficerMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_RelatedPartyTransactionsTextualAbstract" xlink:label="loc_oprxRelatedPartyTransactionsTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionLineItems" xlink:to="loc_oprxRelatedPartyTransactionsTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesPurchaseOfAssets" xlink:label="loc_us-gaapStockIssuedDuringPeriodSharesPurchaseOfAssets" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxRelatedPartyTransactionsTextualAbstract" xlink:to="loc_us-gaapStockIssuedDuringPeriodSharesPurchaseOfAssets" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsGrantedToAcquireExclusivePatentRights" xlink:label="loc_oprxOptionsGrantedToAcquireExclusivePatentRights" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxRelatedPartyTransactionsTextualAbstract" xlink:to="loc_oprxOptionsGrantedToAcquireExclusivePatentRights" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountsPayableRelatedPartiesCurrent" xlink:label="loc_us-gaapAccountsPayableRelatedPartiesCurrent" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxRelatedPartyTransactionsTextualAbstract" xlink:to="loc_us-gaapAccountsPayableRelatedPartiesCurrent" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquityMethodInvestmentOwnershipPercentage" xlink:label="loc_us-gaapEquityMethodInvestmentOwnershipPercentage" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxRelatedPartyTransactionsTextualAbstract" xlink:to="loc_us-gaapEquityMethodInvestmentOwnershipPercentage" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/ContingentPurchasePriceDetails" xlink:title="00000056 - Disclosure - Contingent Purchase Price (Details)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:label="loc_us-gaapCommitmentsAndContingenciesDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:label="loc_us-gaapStatementTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapCommitmentsAndContingenciesDisclosureAbstract" xlink:to="loc_us-gaapStatementTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:label="loc_us-gaapStatementLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapStatementLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionAxis" xlink:label="loc_us-gaapRelatedPartyTransactionAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapRelatedPartyTransactionAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionDomain" xlink:label="loc_us-gaapRelatedPartyTransactionDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionAxis" xlink:to="loc_us-gaapRelatedPartyTransactionDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CareSpeakCommunicationsIncMember" xlink:label="loc_oprxCareSpeakCommunicationsIncMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionDomain" xlink:to="loc_oprxCareSpeakCommunicationsIncMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_RMDYHealthIncMember" xlink:label="loc_oprxRMDYHealthIncMember" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionDomain" xlink:to="loc_oprxRMDYHealthIncMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ExtinguishmentOfDebtAxis" xlink:label="loc_us-gaapExtinguishmentOfDebtAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapExtinguishmentOfDebtAxis" order="20" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ExtinguishmentOfDebtTypeDomain" xlink:label="loc_us-gaapExtinguishmentOfDebtTypeDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapExtinguishmentOfDebtAxis" xlink:to="loc_us-gaapExtinguishmentOfDebtTypeDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CurrentMember" xlink:label="loc_oprxCurrentMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapExtinguishmentOfDebtTypeDomain" xlink:to="loc_oprxCurrentMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_LongTermMember" xlink:label="loc_oprxLongTermMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapExtinguishmentOfDebtTypeDomain" xlink:to="loc_oprxLongTermMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_FairValueOfContingentPurchasePricePayable" xlink:label="loc_oprxFairValueOfContingentPurchasePricePayable" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxFairValueOfContingentPurchasePricePayable" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/ContingentPurchasePriceDetailsTextual" xlink:title="00000057 - Disclosure - Contingent Purchase Price (Details Textual)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:label="loc_us-gaapCommitmentsAndContingenciesDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ContingentPurchasePriceTextualAbstract" xlink:label="loc_oprxContingentPurchasePriceTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapCommitmentsAndContingenciesDisclosureAbstract" xlink:to="loc_oprxContingentPurchasePriceTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ContingentConsiderationClassifiedAsEquityFairValueDisclosure" xlink:label="loc_us-gaapContingentConsiderationClassifiedAsEquityFairValueDisclosure" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxContingentPurchasePriceTextualAbstract" xlink:to="loc_us-gaapContingentConsiderationClassifiedAsEquityFairValueDisclosure" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_FairValueOfRiskFreeRateOfReturn" xlink:label="loc_oprxFairValueOfRiskFreeRateOfReturn" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxContingentPurchasePriceTextualAbstract" xlink:to="loc_oprxFairValueOfRiskFreeRateOfReturn" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_FairValueOfTerm" xlink:label="loc_oprxFairValueOfTerm" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxContingentPurchasePriceTextualAbstract" xlink:to="loc_oprxFairValueOfTerm" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_FairValueOfVolatility" xlink:label="loc_oprxFairValueOfVolatility" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxContingentPurchasePriceTextualAbstract" xlink:to="loc_oprxFairValueOfVolatility" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquityFairValueDisclosure" xlink:label="loc_us-gaapEquityFairValueDisclosure" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxContingentPurchasePriceTextualAbstract" xlink:to="loc_us-gaapEquityFairValueDisclosure" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_MinimumPaymentForContingent" xlink:label="loc_oprxMinimumPaymentForContingent" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxContingentPurchasePriceTextualAbstract" xlink:to="loc_oprxMinimumPaymentForContingent" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ContingentEquityFairValueDisclosure" xlink:label="loc_oprxContingentEquityFairValueDisclosure" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxContingentPurchasePriceTextualAbstract" xlink:to="loc_oprxContingentEquityFairValueDisclosure" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/StockholdersEquityDetails" xlink:title="00000058 - Disclosure -  Stockholders&apos; Equity (Details)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquityAbstract" xlink:label="loc_us-gaapEquityAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:label="loc_us-gaapStatementTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapEquityAbstract" xlink:to="loc_us-gaapStatementTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:label="loc_us-gaapStatementLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapStatementLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionsByRelatedPartyAxis" xlink:label="loc_us-gaapRelatedPartyTransactionsByRelatedPartyAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapRelatedPartyTransactionsByRelatedPartyAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyDomain" xlink:label="loc_us-gaapRelatedPartyDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionsByRelatedPartyAxis" xlink:to="loc_us-gaapRelatedPartyDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsidiaryOfCommonParentMember" xlink:label="loc_us-gaapSubsidiaryOfCommonParentMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyDomain" xlink:to="loc_us-gaapSubsidiaryOfCommonParentMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_RMDYHealthIncMember" xlink:label="loc_oprxRMDYHealthIncMember" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyDomain" xlink:to="loc_oprxRMDYHealthIncMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_DirectorMember" xlink:label="loc_srtDirectorMember" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyDomain" xlink:to="loc_srtDirectorMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_InvestorMember" xlink:label="loc_us-gaapInvestorMember" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyDomain" xlink:to="loc_us-gaapInvestorMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsidiarySaleOfStockAxis" xlink:label="loc_us-gaapSubsidiarySaleOfStockAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapSubsidiarySaleOfStockAxis" order="20" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SaleOfStockNameOfTransactionDomain" xlink:label="loc_us-gaapSaleOfStockNameOfTransactionDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapSubsidiarySaleOfStockAxis" xlink:to="loc_us-gaapSaleOfStockNameOfTransactionDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PrivatePlacementMember" xlink:label="loc_us-gaapPrivatePlacementMember" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapSaleOfStockNameOfTransactionDomain" xlink:to="loc_us-gaapPrivatePlacementMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeAxis" xlink:label="loc_srtRangeAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_srtRangeAxis" order="30" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeMember" xlink:label="loc_srtRangeMember" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtRangeAxis" xlink:to="loc_srtRangeMember" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MaximumMember" xlink:label="loc_srtMaximumMember" />
      <link:presentationArc order="150" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtRangeMember" xlink:to="loc_srtMaximumMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MinimumMember" xlink:label="loc_srtMinimumMember" />
      <link:presentationArc order="160" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtRangeMember" xlink:to="loc_srtMinimumMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_EquityTextualAbstract" xlink:label="loc_oprxEquityTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxEquityTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PreferredStockSharesAuthorized" xlink:label="loc_us-gaapPreferredStockSharesAuthorized" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapPreferredStockSharesAuthorized" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PreferredStockParOrStatedValuePerShare" xlink:label="loc_us-gaapPreferredStockParOrStatedValuePerShare" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapPreferredStockParOrStatedValuePerShare" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PreferredStockSharesIssued" xlink:label="loc_us-gaapPreferredStockSharesIssued" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapPreferredStockSharesIssued" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PreferredStockSharesOutstanding" xlink:label="loc_us-gaapPreferredStockSharesOutstanding" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapPreferredStockSharesOutstanding" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesNewIssues" xlink:label="loc_us-gaapStockIssuedDuringPeriodSharesNewIssues" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapStockIssuedDuringPeriodSharesNewIssues" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueNewIssues" xlink:label="loc_us-gaapStockIssuedDuringPeriodValueNewIssues" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapStockIssuedDuringPeriodValueNewIssues" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_GrossProceedsFromIssuanceOfCommonStock" xlink:label="loc_oprxGrossProceedsFromIssuanceOfCommonStock" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_oprxGrossProceedsFromIssuanceOfCommonStock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PaymentsToAdvisorsAndLegalFees" xlink:label="loc_oprxPaymentsToAdvisorsAndLegalFees" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_oprxPaymentsToAdvisorsAndLegalFees" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProceedsFromIssuanceOrSaleOfEquity" xlink:label="loc_us-gaapProceedsFromIssuanceOrSaleOfEquity" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapProceedsFromIssuanceOrSaleOfEquity" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueIssuedForServices" xlink:label="loc_us-gaapStockIssuedDuringPeriodValueIssuedForServices" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapStockIssuedDuringPeriodValueIssuedForServices" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesIssuedForServices" xlink:label="loc_us-gaapStockIssuedDuringPeriodSharesIssuedForServices" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapStockIssuedDuringPeriodSharesIssuedForServices" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueAcquisitions" xlink:label="loc_us-gaapStockIssuedDuringPeriodValueAcquisitions" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapStockIssuedDuringPeriodValueAcquisitions" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesAcquisitions" xlink:label="loc_us-gaapStockIssuedDuringPeriodSharesAcquisitions" />
      <link:presentationArc order="130" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapStockIssuedDuringPeriodSharesAcquisitions" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_IssuedSharesOfCommonStockInConnectionWithCashlessExercise" xlink:label="loc_oprxIssuedSharesOfCommonStockInConnectionWithCashlessExercise" />
      <link:presentationArc order="140" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_oprxIssuedSharesOfCommonStockInConnectionWithCashlessExercise" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_WarrantToPurchaseSharesOfCommonStock" xlink:label="loc_oprxWarrantToPurchaseSharesOfCommonStock" />
      <link:presentationArc order="150" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_oprxWarrantToPurchaseSharesOfCommonStock" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_EffectOfAscSixHundredSixRevenueRecognition" xlink:label="loc_oprxEffectOfAscSixHundredSixRevenueRecognition" />
      <link:presentationArc order="160" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_oprxEffectOfAscSixHundredSixRevenueRecognition" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesOther" xlink:label="loc_us-gaapStockIssuedDuringPeriodSharesOther" />
      <link:presentationArc order="170" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapStockIssuedDuringPeriodSharesOther" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensation" xlink:label="loc_us-gaapShareBasedCompensation" />
      <link:presentationArc order="180" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapShareBasedCompensation" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardCompensationCost1" xlink:label="loc_us-gaapSharebasedCompensationArrangementBySharebasedPaymentAwardCompensationCost1" />
      <link:presentationArc order="190" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapSharebasedCompensationArrangementBySharebasedPaymentAwardCompensationCost1" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_StockIssuedDuringPeriodSharesExerciseOfOptions" xlink:label="loc_oprxStockIssuedDuringPeriodSharesExerciseOfOptions" />
      <link:presentationArc order="200" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_oprxStockIssuedDuringPeriodSharesExerciseOfOptions" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_StockIssuedDuringPeriodValueExerciseOfOptions" xlink:label="loc_oprxStockIssuedDuringPeriodValueExerciseOfOptions" />
      <link:presentationArc order="210" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_oprxStockIssuedDuringPeriodValueExerciseOfOptions" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationForfeited" xlink:label="loc_us-gaapStockIssuedDuringPeriodValueShareBasedCompensationForfeited" />
      <link:presentationArc order="220" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapStockIssuedDuringPeriodValueShareBasedCompensationForfeited" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharePrice" xlink:label="loc_us-gaapSharePrice" />
      <link:presentationArc order="230" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapSharePrice" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsForfeituresInPeriod" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsForfeituresInPeriod" />
      <link:presentationArc order="240" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsForfeituresInPeriod" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockholdersEquityReverseStockSplit" xlink:label="loc_us-gaapStockholdersEquityReverseStockSplit" />
      <link:presentationArc order="250" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapStockholdersEquityReverseStockSplit" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_RetainedEarningsAmount" xlink:label="loc_oprxRetainedEarningsAmount" />
      <link:presentationArc order="260" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_oprxRetainedEarningsAmount" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharesIssued" xlink:label="loc_us-gaapSharesIssued" />
      <link:presentationArc order="270" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapSharesIssued" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardGross" xlink:label="loc_us-gaapStockIssuedDuringPeriodValueRestrictedStockAwardGross" />
      <link:presentationArc order="280" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapStockIssuedDuringPeriodValueRestrictedStockAwardGross" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardGross" xlink:label="loc_us-gaapStockIssuedDuringPeriodSharesRestrictedStockAwardGross" />
      <link:presentationArc order="290" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxEquityTextualAbstract" xlink:to="loc_us-gaapStockIssuedDuringPeriodSharesRestrictedStockAwardGross" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockParOrStatedValuePerShare" xlink:label="loc_us-gaapCommonStockParOrStatedValuePerShare" />
      <link:presentationArc order="300" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapCommonStockParOrStatedValuePerShare" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockSharesAuthorized" xlink:label="loc_us-gaapCommonStockSharesAuthorized" />
      <link:presentationArc order="310" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapCommonStockSharesAuthorized" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockSharesIssued" xlink:label="loc_us-gaapCommonStockSharesIssued" />
      <link:presentationArc order="320" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapCommonStockSharesIssued" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockSharesOutstanding" xlink:label="loc_us-gaapCommonStockSharesOutstanding" />
      <link:presentationArc order="330" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapCommonStockSharesOutstanding" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/StockOptionsDetails" xlink:title="00000059 - Disclosure - Stock Compensation (Details)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:label="loc_us-gaapDisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:label="loc_us-gaapScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapDisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="loc_us-gaapScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AwardTypeAxis" xlink:label="loc_us-gaapAwardTypeAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="loc_us-gaapAwardTypeAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:label="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAwardTypeAxis" xlink:to="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_StockOptionsMember" xlink:label="loc_oprxStockOptionsMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxStockOptionsMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGross" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGross" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGross" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" xlink:label="loc_us-gaapStockIssuedDuringPeriodSharesStockOptionsExercised" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="loc_us-gaapStockIssuedDuringPeriodSharesStockOptionsExercised" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExpirationsInPeriod" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExpirationsInPeriod" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExpirationsInPeriod" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber_2" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber_2" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisable" xlink:label="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisable" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisable" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsGrantsInPeriodWeightedAverageExercisePrice" xlink:label="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsGrantsInPeriodWeightedAverageExercisePrice" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsGrantsInPeriodWeightedAverageExercisePrice" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice" xlink:label="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExpirationsInPeriodWeightedAverageExercisePrice" xlink:label="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExpirationsInPeriodWeightedAverageExercisePrice" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExpirationsInPeriodWeightedAverageExercisePrice" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice_2" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice_2" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisableInPeriodWeightedAverageExercisePrice" xlink:label="loc_oprxShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisableInPeriodWeightedAverageExercisePrice" />
      <link:presentationArc order="130" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="loc_oprxShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisableInPeriodWeightedAverageExercisePrice" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeOutstandingOptionsWeightedAverageRemainingContractualTerm2" xlink:label="loc_us-gaapSharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeOutstandingOptionsWeightedAverageRemainingContractualTerm2" />
      <link:presentationArc order="140" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="loc_us-gaapSharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeOutstandingOptionsWeightedAverageRemainingContractualTerm2" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1" xlink:label="loc_us-gaapSharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1" />
      <link:presentationArc order="150" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="loc_us-gaapSharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue" />
      <link:presentationArc order="160" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1" xlink:label="loc_us-gaapSharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1" />
      <link:presentationArc order="170" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="loc_us-gaapSharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/StockOptionsDetails1" xlink:title="00000060 - Disclosure - Stock Compensation (Details 1)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:label="loc_us-gaapDisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:label="loc_us-gaapScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapDisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="loc_us-gaapScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AwardTypeAxis" xlink:label="loc_us-gaapAwardTypeAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="loc_us-gaapAwardTypeAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:label="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAwardTypeAxis" xlink:to="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsOneMember" xlink:label="loc_oprxOptionsOneMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsOneMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsTwoMember" xlink:label="loc_oprxOptionsTwoMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsTwoMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsThreeMember" xlink:label="loc_oprxOptionsThreeMember" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsThreeMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsFourMember" xlink:label="loc_oprxOptionsFourMember" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsFourMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsFiveMember" xlink:label="loc_oprxOptionsFiveMember" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsFiveMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsSixMember" xlink:label="loc_oprxOptionsSixMember" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsSixMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsSevenMember" xlink:label="loc_oprxOptionsSevenMember" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsSevenMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsEightMember" xlink:label="loc_oprxOptionsEightMember" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsEightMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsNineMember" xlink:label="loc_oprxOptionsNineMember" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsNineMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsTenMember" xlink:label="loc_oprxOptionsTenMember" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsTenMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsElevenMember" xlink:label="loc_oprxOptionsElevenMember" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsElevenMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsTwelveMember" xlink:label="loc_oprxOptionsTwelveMember" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsTwelveMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsThirteenMember" xlink:label="loc_oprxOptionsThirteenMember" />
      <link:presentationArc order="130" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsThirteenMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsFourteenMember" xlink:label="loc_oprxOptionsFourteenMember" />
      <link:presentationArc order="140" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsFourteenMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsFiveteenMember" xlink:label="loc_oprxOptionsFiveteenMember" />
      <link:presentationArc order="150" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsFiveteenMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsSixteenMember" xlink:label="loc_oprxOptionsSixteenMember" />
      <link:presentationArc order="160" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsSixteenMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsSeventeenMember" xlink:label="loc_oprxOptionsSeventeenMember" />
      <link:presentationArc order="170" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsSeventeenMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsEighteenMember" xlink:label="loc_oprxOptionsEighteenMember" />
      <link:presentationArc order="180" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsEighteenMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsNineteenMember" xlink:label="loc_oprxOptionsNineteenMember" />
      <link:presentationArc order="190" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsNineteenMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsTwentyMember" xlink:label="loc_oprxOptionsTwentyMember" />
      <link:presentationArc order="200" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsTwentyMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsTwentyOneMember" xlink:label="loc_oprxOptionsTwentyOneMember" />
      <link:presentationArc order="210" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsTwentyOneMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsTwentyTwoMember" xlink:label="loc_oprxOptionsTwentyTwoMember" />
      <link:presentationArc order="220" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsTwentyTwoMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsTwentyThreeMember" xlink:label="loc_oprxOptionsTwentyThreeMember" />
      <link:presentationArc order="230" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsTwentyThreeMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsTwentyFourMember" xlink:label="loc_oprxOptionsTwentyFourMember" />
      <link:presentationArc order="240" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsTwentyFourMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsTwentyFiveMember" xlink:label="loc_oprxOptionsTwentyFiveMember" />
      <link:presentationArc order="250" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxOptionsTwentyFiveMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsOutstanding" xlink:label="loc_oprxOptionsOutstanding" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="loc_oprxOptionsOutstanding" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_InvestmentOptionsExercisesPrice" xlink:label="loc_oprxInvestmentOptionsExercisesPrice" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="loc_oprxInvestmentOptionsExercisesPrice" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_InvestmentOptionsExpirationsDate" xlink:label="loc_oprxInvestmentOptionsExpirationsDate" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="loc_oprxInvestmentOptionsExpirationsDate" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/StockCompensationDetailsTextual" xlink:title="00000061 - Disclosure - Stock Compensation (Details Textual)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:label="loc_us-gaapDisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:label="loc_us-gaapScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapDisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="loc_us-gaapScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AwardTypeAxis" xlink:label="loc_us-gaapAwardTypeAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="loc_us-gaapAwardTypeAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:label="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapAwardTypeAxis" xlink:to="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockCompensationPlanMember" xlink:label="loc_us-gaapStockCompensationPlanMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_us-gaapStockCompensationPlanMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_StockOptionsMember" xlink:label="loc_oprxStockOptionsMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_oprxStockOptionsMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RestrictedStockMember" xlink:label="loc_us-gaapRestrictedStockMember" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="loc_us-gaapRestrictedStockMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_StockOptionsTextualAbstract" xlink:label="loc_oprxStockOptionsTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="loc_oprxStockOptionsTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredCompensationArrangementWithIndividualCommonStockReservedForFutureIssuance" xlink:label="loc_us-gaapDeferredCompensationArrangementWithIndividualCommonStockReservedForFutureIssuance" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_us-gaapDeferredCompensationArrangementWithIndividualCommonStockReservedForFutureIssuance" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardPlanModificationDescriptionAndTerms" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardPlanModificationDescriptionAndTerms" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardPlanModificationDescriptionAndTerms" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGrossOne" xlink:label="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGrossOne" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGrossOne" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockRedeemedOrCalledDuringPeriodShares" xlink:label="loc_us-gaapStockRedeemedOrCalledDuringPeriodShares" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_us-gaapStockRedeemedOrCalledDuringPeriodShares" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardGross" xlink:label="loc_us-gaapStockIssuedDuringPeriodSharesRestrictedStockAwardGross" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_us-gaapStockIssuedDuringPeriodSharesRestrictedStockAwardGross" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardGross" xlink:label="loc_us-gaapStockIssuedDuringPeriodValueRestrictedStockAwardGross" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_us-gaapStockIssuedDuringPeriodValueRestrictedStockAwardGross" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_StockDuringPeriodRestrictedStockVestingPeriod" xlink:label="loc_oprxStockDuringPeriodRestrictedStockVestingPeriod" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_oprxStockDuringPeriodRestrictedStockVestingPeriod" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsCapitalizedAmount" xlink:label="loc_us-gaapEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsCapitalizedAmount" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_us-gaapEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsCapitalizedAmount" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardCompensationCost1" xlink:label="loc_us-gaapSharebasedCompensationArrangementBySharebasedPaymentAwardCompensationCost1" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_us-gaapSharebasedCompensationArrangementBySharebasedPaymentAwardCompensationCost1" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsNonvestedNumberOfShares" xlink:label="loc_us-gaapSharebasedCompensationArrangementBySharebasedPaymentAwardOptionsNonvestedNumberOfShares" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_us-gaapSharebasedCompensationArrangementBySharebasedPaymentAwardOptionsNonvestedNumberOfShares" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1" xlink:label="loc_us-gaapSharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_us-gaapSharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisable" xlink:label="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisable" />
      <link:presentationArc order="130" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisable" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockOptionPlanExpense" xlink:label="loc_us-gaapStockOptionPlanExpense" />
      <link:presentationArc order="140" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_us-gaapStockOptionPlanExpense" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeExercisableOptionsWeightedAverageRemainingContractualTerm2" xlink:label="loc_us-gaapSharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeExercisableOptionsWeightedAverageRemainingContractualTerm2" />
      <link:presentationArc order="150" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxStockOptionsTextualAbstract" xlink:to="loc_us-gaapSharebasedCompensationSharesAuthorizedUnderStockOptionPlansExercisePriceRangeExercisableOptionsWeightedAverageRemainingContractualTerm2" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/WarrantsDetails" xlink:title="00000062 - Disclosure - Warrants (Details)">
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_WarrantsAbstract" xlink:label="loc_oprxWarrantsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:label="loc_us-gaapStatementTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxWarrantsAbstract" xlink:to="loc_us-gaapStatementTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:label="loc_us-gaapStatementLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapStatementLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementEquityComponentsAxis" xlink:label="loc_us-gaapStatementEquityComponentsAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapStatementEquityComponentsAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquityComponentDomain" xlink:label="loc_us-gaapEquityComponentDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementEquityComponentsAxis" xlink:to="loc_us-gaapEquityComponentDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_WarrantMember" xlink:label="loc_us-gaapWarrantMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapEquityComponentDomain" xlink:to="loc_us-gaapWarrantMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsOutstandingRollForward" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsOutstandingRollForward" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsOutstandingRollForward" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsOutstandingNumber" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsOutstandingNumber" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsOutstandingRollForward" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsOutstandingNumber" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsGranted" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsGranted" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsOutstandingRollForward" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsGranted" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsExercised" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsExercised" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsOutstandingRollForward" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsExercised" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsOutstandingNumber" xlink:label="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsOutstandingNumber_2" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsOutstandingRollForward" xlink:to="loc_us-gaapShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsOutstandingNumber_2" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentWeightedAverageOutstandingAbstract" xlink:label="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentWeightedAverageOutstandingAbstract" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentWeightedAverageOutstandingAbstract" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentOutstandingWeightedAverage" xlink:label="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentOutstandingWeightedAverage" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentWeightedAverageOutstandingAbstract" xlink:to="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentOutstandingWeightedAverage" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentWeightedAverageGranted" xlink:label="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentWeightedAverageGranted" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentWeightedAverageOutstandingAbstract" xlink:to="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentWeightedAverageGranted" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsWeightedAverageExercisePriceExercised" xlink:label="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsWeightedAverageExercisePriceExercised" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentWeightedAverageOutstandingAbstract" xlink:to="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentsWeightedAverageExercisePriceExercised" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentOutstandingWeightedAverage" xlink:label="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentOutstandingWeightedAverage_2" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentWeightedAverageOutstandingAbstract" xlink:to="loc_oprxShareBasedCompensationArrangementByShareBasedPaymentAwardNonOptionEquityInstrumentOutstandingWeightedAverage_2" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/LeasesDetails" xlink:title="00000063 - Disclosure - Leases (Details)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LeasesAbstract" xlink:label="loc_us-gaapLeasesAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeaseCost" xlink:label="loc_us-gaapOperatingLeaseCost" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapOperatingLeaseCost" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShortTermLeaseCost" xlink:label="loc_us-gaapShortTermLeaseCost" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapShortTermLeaseCost" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LeaseCost" xlink:label="loc_us-gaapLeaseCost" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapLeaseCost" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/LeasesDetails1" xlink:title="00000064 - Disclosure - Leases (Details 1)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LeasesAbstract" xlink:label="loc_us-gaapLeasesAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent" xlink:label="loc_us-gaapOperatingLeasesFutureMinimumPaymentsDueCurrent" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapOperatingLeasesFutureMinimumPaymentsDueCurrent" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears" xlink:label="loc_us-gaapOperatingLeasesFutureMinimumPaymentsDueInTwoYears" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapOperatingLeasesFutureMinimumPaymentsDueInTwoYears" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears" xlink:label="loc_us-gaapOperatingLeasesFutureMinimumPaymentsDueInThreeYears" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapOperatingLeasesFutureMinimumPaymentsDueInThreeYears" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears" xlink:label="loc_us-gaapOperatingLeasesFutureMinimumPaymentsDueInFourYears" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapOperatingLeasesFutureMinimumPaymentsDueInFourYears" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears" xlink:label="loc_us-gaapOperatingLeasesFutureMinimumPaymentsDueInFiveYears" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapOperatingLeasesFutureMinimumPaymentsDueInFiveYears" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter" xlink:label="loc_us-gaapOperatingLeasesFutureMinimumPaymentsDueThereafter" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapOperatingLeasesFutureMinimumPaymentsDueThereafter" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDue" xlink:label="loc_us-gaapOperatingLeasesFutureMinimumPaymentsDue" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapOperatingLeasesFutureMinimumPaymentsDue" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LesseeOperatingLeaseLiabilityUndiscountedExcessAmount" xlink:label="loc_us-gaapLesseeOperatingLeaseLiabilityUndiscountedExcessAmount" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapLesseeOperatingLeaseLiabilityUndiscountedExcessAmount" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LesseeOperatingLeaseLiabilityPaymentsDue" xlink:label="loc_us-gaapLesseeOperatingLeaseLiabilityPaymentsDue" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapLesseeOperatingLeaseLiabilityPaymentsDue" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/LeasesDetailsTextual" xlink:title="00000065 - Disclosure - Leases (Details Textual)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LeasesAbstract" xlink:label="loc_us-gaapLeasesAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:label="loc_us-gaapStatementTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapLeasesAbstract" xlink:to="loc_us-gaapStatementTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:label="loc_us-gaapStatementLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_us-gaapStatementLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeAxis" xlink:label="loc_srtRangeAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementTable" xlink:to="loc_srtRangeAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeMember" xlink:label="loc_srtRangeMember" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtRangeAxis" xlink:to="loc_srtRangeMember" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MinimumMember" xlink:label="loc_srtMinimumMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtRangeMember" xlink:to="loc_srtMinimumMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MaximumMember" xlink:label="loc_srtMaximumMember" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtRangeMember" xlink:to="loc_srtMaximumMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_LeasesTextualAbstract" xlink:label="loc_oprxLeasesTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxLeasesTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OperatingLeasesExpiresPeriod" xlink:label="loc_oprxOperatingLeasesExpiresPeriod" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxOperatingLeasesExpiresPeriod" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeasesRentExpenseNet" xlink:label="loc_us-gaapOperatingLeasesRentExpenseNet" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapOperatingLeasesRentExpenseNet" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LesseeOperatingLeaseDescription" xlink:label="loc_us-gaapLesseeOperatingLeaseDescription" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapLesseeOperatingLeaseDescription" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeaseRightOfUseAsset" xlink:label="loc_us-gaapOperatingLeaseRightOfUseAsset" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapOperatingLeaseRightOfUseAsset" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeaseLiability" xlink:label="loc_us-gaapOperatingLeaseLiability" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapOperatingLeaseLiability" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeaseWeightedAverageRemainingLeaseTerm1" xlink:label="loc_us-gaapOperatingLeaseWeightedAverageRemainingLeaseTerm1" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapOperatingLeaseWeightedAverageRemainingLeaseTerm1" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeaseWeightedAverageDiscountRatePercent" xlink:label="loc_us-gaapOperatingLeaseWeightedAverageDiscountRatePercent" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapOperatingLeaseWeightedAverageDiscountRatePercent" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_MeasurementOfLeaseLiabilities" xlink:label="loc_oprxMeasurementOfLeaseLiabilities" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxMeasurementOfLeaseLiabilities" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeaseLeaseIncomeLeasePayments" xlink:label="loc_us-gaapOperatingLeaseLeaseIncomeLeasePayments" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_us-gaapOperatingLeaseLeaseIncomeLeasePayments" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OperatingLeaseRightOfUseAssetAmortization" xlink:label="loc_oprxOperatingLeaseRightOfUseAssetAmortization" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapStatementLineItems" xlink:to="loc_oprxOperatingLeaseRightOfUseAssetAmortization" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/MajorCustomersAndVendorsDetails" xlink:title="00000066 - Disclosure - Major Customers and Vendors (Details)">
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_MajorCustomerAbstract" xlink:label="loc_oprxMajorCustomerAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfEntityWideRevenueByMajorCustomersByReportingSegmentsTable" xlink:label="loc_us-gaapScheduleOfEntityWideRevenueByMajorCustomersByReportingSegmentsTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxMajorCustomerAbstract" xlink:to="loc_us-gaapScheduleOfEntityWideRevenueByMajorCustomersByReportingSegmentsTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EntityWideRevenueMajorCustomerLineItems" xlink:label="loc_us-gaapEntityWideRevenueMajorCustomerLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfEntityWideRevenueByMajorCustomersByReportingSegmentsTable" xlink:to="loc_us-gaapEntityWideRevenueMajorCustomerLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MajorCustomersAxis" xlink:label="loc_srtMajorCustomersAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfEntityWideRevenueByMajorCustomersByReportingSegmentsTable" xlink:to="loc_srtMajorCustomersAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_NameOfMajorCustomerDomain" xlink:label="loc_srtNameOfMajorCustomerDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtMajorCustomersAxis" xlink:to="loc_srtNameOfMajorCustomerDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CustomerThreeMember" xlink:label="loc_oprxCustomerThreeMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtNameOfMajorCustomerDomain" xlink:to="loc_oprxCustomerThreeMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CustomerFourMember" xlink:label="loc_oprxCustomerFourMember" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtNameOfMajorCustomerDomain" xlink:to="loc_oprxCustomerFourMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CustomerFiveMember" xlink:label="loc_oprxCustomerFiveMember" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtNameOfMajorCustomerDomain" xlink:to="loc_oprxCustomerFiveMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CustomerSixMember" xlink:label="loc_oprxCustomerSixMember" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtNameOfMajorCustomerDomain" xlink:to="loc_oprxCustomerSixMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CustomerSevenMember" xlink:label="loc_oprxCustomerSevenMember" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtNameOfMajorCustomerDomain" xlink:to="loc_oprxCustomerSevenMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PartnerOneMember" xlink:label="loc_oprxPartnerOneMember" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtNameOfMajorCustomerDomain" xlink:to="loc_oprxPartnerOneMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PartnerTwoMember" xlink:label="loc_oprxPartnerTwoMember" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtNameOfMajorCustomerDomain" xlink:to="loc_oprxPartnerTwoMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PartnerThreeMember" xlink:label="loc_oprxPartnerThreeMember" />
      <link:presentationArc order="130" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtNameOfMajorCustomerDomain" xlink:to="loc_oprxPartnerThreeMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_PartnerFourMember" xlink:label="loc_oprxPartnerFourMember" />
      <link:presentationArc order="140" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtNameOfMajorCustomerDomain" xlink:to="loc_oprxPartnerFourMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_Revenues" xlink:label="loc_us-gaapRevenues" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapEntityWideRevenueMajorCustomerLineItems" xlink:to="loc_us-gaapRevenues" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskPercentage1" xlink:label="loc_us-gaapConcentrationRiskPercentage1" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapEntityWideRevenueMajorCustomerLineItems" xlink:to="loc_us-gaapConcentrationRiskPercentage1" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/MajorCustomersAndVendorsDetailsTextual" xlink:title="00000067 - Disclosure - Major Customers and Vendors (Details Textual)">
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_MajorCustomerAbstract" xlink:label="loc_oprxMajorCustomerAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfEntityWideRevenueByMajorCustomersByReportingSegmentsTable" xlink:label="loc_us-gaapScheduleOfEntityWideRevenueByMajorCustomersByReportingSegmentsTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxMajorCustomerAbstract" xlink:to="loc_us-gaapScheduleOfEntityWideRevenueByMajorCustomersByReportingSegmentsTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EntityWideRevenueMajorCustomerLineItems" xlink:label="loc_us-gaapEntityWideRevenueMajorCustomerLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfEntityWideRevenueByMajorCustomersByReportingSegmentsTable" xlink:to="loc_us-gaapEntityWideRevenueMajorCustomerLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MajorCustomersAxis" xlink:label="loc_srtMajorCustomersAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfEntityWideRevenueByMajorCustomersByReportingSegmentsTable" xlink:to="loc_srtMajorCustomersAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_NameOfMajorCustomerDomain" xlink:label="loc_srtNameOfMajorCustomerDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtMajorCustomersAxis" xlink:to="loc_srtNameOfMajorCustomerDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CustomerOneMember" xlink:label="loc_oprxCustomerOneMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtNameOfMajorCustomerDomain" xlink:to="loc_oprxCustomerOneMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OtherCustomersMember" xlink:label="loc_oprxOtherCustomersMember" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtNameOfMajorCustomerDomain" xlink:to="loc_oprxOtherCustomersMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CustomerTwoMember" xlink:label="loc_oprxCustomerTwoMember" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtNameOfMajorCustomerDomain" xlink:to="loc_oprxCustomerTwoMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CustomerThreeMember" xlink:label="loc_oprxCustomerThreeMember" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtNameOfMajorCustomerDomain" xlink:to="loc_oprxCustomerThreeMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:label="loc_us-gaapConcentrationRiskByBenchmarkAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfEntityWideRevenueByMajorCustomersByReportingSegmentsTable" xlink:to="loc_us-gaapConcentrationRiskByBenchmarkAxis" order="20" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskBenchmarkDomain" xlink:label="loc_us-gaapConcentrationRiskBenchmarkDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapConcentrationRiskByBenchmarkAxis" xlink:to="loc_us-gaapConcentrationRiskBenchmarkDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SalesRevenueNetMember" xlink:label="loc_us-gaapSalesRevenueNetMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapConcentrationRiskBenchmarkDomain" xlink:to="loc_us-gaapSalesRevenueNetMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountsReceivableMember" xlink:label="loc_us-gaapAccountsReceivableMember" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapConcentrationRiskBenchmarkDomain" xlink:to="loc_us-gaapAccountsReceivableMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyTransactionsByRelatedPartyAxis" xlink:label="loc_us-gaapRelatedPartyTransactionsByRelatedPartyAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapScheduleOfEntityWideRevenueByMajorCustomersByReportingSegmentsTable" xlink:to="loc_us-gaapRelatedPartyTransactionsByRelatedPartyAxis" order="30" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RelatedPartyDomain" xlink:label="loc_us-gaapRelatedPartyDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyTransactionsByRelatedPartyAxis" xlink:to="loc_us-gaapRelatedPartyDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_FourKeyPartnersMember" xlink:label="loc_oprxFourKeyPartnersMember" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapRelatedPartyDomain" xlink:to="loc_oprxFourKeyPartnersMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_MajorCustomersAndVendorsTextualAbstract" xlink:label="loc_oprxMajorCustomersAndVendorsTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapEntityWideRevenueMajorCustomerLineItems" xlink:to="loc_oprxMajorCustomersAndVendorsTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskPercentage1" xlink:label="loc_us-gaapConcentrationRiskPercentage1" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxMajorCustomersAndVendorsTextualAbstract" xlink:to="loc_us-gaapConcentrationRiskPercentage1" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_NumberOfCustomers" xlink:label="loc_oprxNumberOfCustomers" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxMajorCustomersAndVendorsTextualAbstract" xlink:to="loc_oprxNumberOfCustomers" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/IncomeTaxesDetails" xlink:title="00000068 - Disclosure - Income Taxes (Details)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:label="loc_us-gaapIncomeTaxDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeTaxExpenseBenefitContinuingOperationsByJurisdictionAbstract" xlink:label="loc_us-gaapIncomeTaxExpenseBenefitContinuingOperationsByJurisdictionAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxDisclosureAbstract" xlink:to="loc_us-gaapIncomeTaxExpenseBenefitContinuingOperationsByJurisdictionAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CurrentFederalTaxExpenseBenefit" xlink:label="loc_us-gaapCurrentFederalTaxExpenseBenefit" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxExpenseBenefitContinuingOperationsByJurisdictionAbstract" xlink:to="loc_us-gaapCurrentFederalTaxExpenseBenefit" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_FederalIncomeTaxAcquisitionCosts" xlink:label="loc_oprxFederalIncomeTaxAcquisitionCosts" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxExpenseBenefitContinuingOperationsByJurisdictionAbstract" xlink:to="loc_oprxFederalIncomeTaxAcquisitionCosts" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_FederalIncomeTaxChangeInFairValueOfContingentConsideration" xlink:label="loc_oprxFederalIncomeTaxChangeInFairValueOfContingentConsideration" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxExpenseBenefitContinuingOperationsByJurisdictionAbstract" xlink:to="loc_oprxFederalIncomeTaxChangeInFairValueOfContingentConsideration" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_FederalIncomeTaxOtherPermanentItems" xlink:label="loc_oprxFederalIncomeTaxOtherPermanentItems" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxExpenseBenefitContinuingOperationsByJurisdictionAbstract" xlink:to="loc_oprxFederalIncomeTaxOtherPermanentItems" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_FederalIncomeTaxDeferredAdjustment" xlink:label="loc_oprxFederalIncomeTaxDeferredAdjustment" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxExpenseBenefitContinuingOperationsByJurisdictionAbstract" xlink:to="loc_oprxFederalIncomeTaxDeferredAdjustment" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_FederalIncomeTaxExpensesBenefitValueAllowance" xlink:label="loc_oprxFederalIncomeTaxExpensesBenefitValueAllowance" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxExpenseBenefitContinuingOperationsByJurisdictionAbstract" xlink:to="loc_oprxFederalIncomeTaxExpensesBenefitValueAllowance" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations" xlink:label="loc_us-gaapFederalIncomeTaxExpenseBenefitContinuingOperations" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxExpenseBenefitContinuingOperationsByJurisdictionAbstract" xlink:to="loc_us-gaapFederalIncomeTaxExpenseBenefitContinuingOperations" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CurrentForeignTaxExpenseBenefit" xlink:label="loc_us-gaapCurrentForeignTaxExpenseBenefit" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxExpenseBenefitContinuingOperationsByJurisdictionAbstract" xlink:to="loc_us-gaapCurrentForeignTaxExpenseBenefit" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredFederalIncomeTaxExpenseBenefit" xlink:label="loc_us-gaapDeferredFederalIncomeTaxExpenseBenefit" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxExpenseBenefitContinuingOperationsByJurisdictionAbstract" xlink:to="loc_us-gaapDeferredFederalIncomeTaxExpenseBenefit" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_TaxAdjustmentsSettlementsAndUnusualProvisions" xlink:label="loc_us-gaapTaxAdjustmentsSettlementsAndUnusualProvisions" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxExpenseBenefitContinuingOperationsByJurisdictionAbstract" xlink:to="loc_us-gaapTaxAdjustmentsSettlementsAndUnusualProvisions" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeTaxesPaidNet" xlink:label="loc_us-gaapIncomeTaxesPaidNet" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxExpenseBenefitContinuingOperationsByJurisdictionAbstract" xlink:to="loc_us-gaapIncomeTaxesPaidNet" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/IncomeTaxesDetails1" xlink:title="00000069 - Disclosure - Income Taxes (Details 1)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:label="loc_us-gaapIncomeTaxDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ComponentsOfDeferredTaxAssetsAbstract" xlink:label="loc_us-gaapComponentsOfDeferredTaxAssetsAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxDisclosureAbstract" xlink:to="loc_us-gaapComponentsOfDeferredTaxAssetsAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredTaxAssetsOperatingLossCarryforwards" xlink:label="loc_us-gaapDeferredTaxAssetsOperatingLossCarryforwards" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapComponentsOfDeferredTaxAssetsAbstract" xlink:to="loc_us-gaapDeferredTaxAssetsOperatingLossCarryforwards" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost" xlink:label="loc_us-gaapDeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapComponentsOfDeferredTaxAssetsAbstract" xlink:to="loc_us-gaapDeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredTaxAssetsGoodwillAndIntangibleAssets" xlink:label="loc_us-gaapDeferredTaxAssetsGoodwillAndIntangibleAssets" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapComponentsOfDeferredTaxAssetsAbstract" xlink:to="loc_us-gaapDeferredTaxAssetsGoodwillAndIntangibleAssets" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredTaxAssetsOther" xlink:label="loc_us-gaapDeferredTaxAssetsOther" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapComponentsOfDeferredTaxAssetsAbstract" xlink:to="loc_us-gaapDeferredTaxAssetsOther" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredTaxAssetsGross" xlink:label="loc_us-gaapDeferredTaxAssetsGross" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapComponentsOfDeferredTaxAssetsAbstract" xlink:to="loc_us-gaapDeferredTaxAssetsGross" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredTaxLiabilitiesNetAbstract" xlink:label="loc_us-gaapDeferredTaxLiabilitiesNetAbstract" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapComponentsOfDeferredTaxAssetsAbstract" xlink:to="loc_us-gaapDeferredTaxLiabilitiesNetAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" xlink:label="loc_us-gaapDeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapDeferredTaxLiabilitiesNetAbstract" xlink:to="loc_us-gaapDeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssets" xlink:label="loc_us-gaapDeferredTaxLiabilitiesGoodwillAndIntangibleAssets" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapDeferredTaxLiabilitiesNetAbstract" xlink:to="loc_us-gaapDeferredTaxLiabilitiesGoodwillAndIntangibleAssets" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredTaxLiabilitiesOther" xlink:label="loc_us-gaapDeferredTaxLiabilitiesOther" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapDeferredTaxLiabilitiesNetAbstract" xlink:to="loc_us-gaapDeferredTaxLiabilitiesOther" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredTaxAssetsValuationAllowance" xlink:label="loc_us-gaapDeferredTaxAssetsValuationAllowance" />
      <link:presentationArc order="100" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapComponentsOfDeferredTaxAssetsAbstract" xlink:to="loc_us-gaapDeferredTaxAssetsValuationAllowance" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredTaxLiabilities" xlink:label="loc_us-gaapDeferredTaxLiabilities" />
      <link:presentationArc order="110" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapComponentsOfDeferredTaxAssetsAbstract" xlink:to="loc_us-gaapDeferredTaxLiabilities" xlink:type="arc" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredTaxAssetsNet" xlink:label="loc_us-gaapDeferredTaxAssetsNet" />
      <link:presentationArc order="120" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapComponentsOfDeferredTaxAssetsAbstract" xlink:to="loc_us-gaapDeferredTaxAssetsNet" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/IncomeTaxesDetailsTextual" xlink:title="00000070 - Disclosure - Income Taxes (Details Textual)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:label="loc_us-gaapIncomeTaxDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_IncomeTaxesTextualAbstract" xlink:label="loc_oprxIncomeTaxesTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapIncomeTaxDisclosureAbstract" xlink:to="loc_oprxIncomeTaxesTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLossCarryforwards" xlink:label="loc_us-gaapOperatingLossCarryforwards" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxIncomeTaxesTextualAbstract" xlink:to="loc_us-gaapOperatingLossCarryforwards" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLossCarryforwardsLimitationsOnUse" xlink:label="loc_us-gaapOperatingLossCarryforwardsLimitationsOnUse" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxIncomeTaxesTextualAbstract" xlink:to="loc_us-gaapOperatingLossCarryforwardsLimitationsOnUse" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:label="loc_us-gaapEffectiveIncomeTaxRateContinuingOperations" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxIncomeTaxesTextualAbstract" xlink:to="loc_us-gaapEffectiveIncomeTaxRateContinuingOperations" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/CommitmentsAndContingentLiabilitiesDetails" xlink:title="00000071 - Disclosure - Commitments and Contingent Liabilities (Details)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:label="loc_us-gaapCommitmentsAndContingenciesDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_CommitmentsAndContingentsLiabilitiesTextualAbstract" xlink:label="loc_oprxCommitmentsAndContingentsLiabilitiesTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapCommitmentsAndContingenciesDisclosureAbstract" xlink:to="loc_oprxCommitmentsAndContingentsLiabilitiesTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_RevenueShareContractsPercentage" xlink:label="loc_oprxRevenueShareContractsPercentage" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxCommitmentsAndContingentsLiabilitiesTextualAbstract" xlink:to="loc_oprxRevenueShareContractsPercentage" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherCommitment" xlink:label="loc_us-gaapOtherCommitment" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxCommitmentsAndContingentsLiabilitiesTextualAbstract" xlink:to="loc_us-gaapOtherCommitment" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherCommitmentsDescription" xlink:label="loc_us-gaapOtherCommitmentsDescription" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxCommitmentsAndContingentsLiabilitiesTextualAbstract" xlink:to="loc_us-gaapOtherCommitmentsDescription" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/RetirementPlanDetails" xlink:title="00000072 - Disclosure - Retirement Plan (Details)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:label="loc_us-gaapCompensationAndRetirementDisclosureAbstract" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_RetirementPlanTextualAbstract" xlink:label="loc_oprxRetirementPlanTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapCompensationAndRetirementDisclosureAbstract" xlink:to="loc_oprxRetirementPlanTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DefinedBenefitPlansGeneralInformation" xlink:label="loc_us-gaapDefinedBenefitPlansGeneralInformation" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapCompensationAndRetirementDisclosureAbstract" xlink:to="loc_us-gaapDefinedBenefitPlansGeneralInformation" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DefinedContributionPlanAdministrativeExpenses" xlink:label="loc_us-gaapDefinedContributionPlanAdministrativeExpenses" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapCompensationAndRetirementDisclosureAbstract" xlink:to="loc_us-gaapDefinedContributionPlanAdministrativeExpenses" xlink:type="arc" />
    </link:presentationLink>
    <link:presentationLink xlink:type="extended" xlink:role="http://OPRX/role/SubsequentEventsDetails" xlink:title="00000073 - Disclosure - Subsequent Events (Details)">
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsequentEventsAbstract" xlink:label="loc_us-gaapSubsequentEventsAbstract" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsequentEventTable" xlink:label="loc_us-gaapSubsequentEventTable" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapSubsequentEventsAbstract" xlink:to="loc_us-gaapSubsequentEventTable" order="100" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsequentEventLineItems" xlink:label="loc_us-gaapSubsequentEventLineItems" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapSubsequentEventTable" xlink:to="loc_us-gaapSubsequentEventLineItems" order="200" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsequentEventTypeAxis" xlink:label="loc_us-gaapSubsequentEventTypeAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapSubsequentEventTable" xlink:to="loc_us-gaapSubsequentEventTypeAxis" order="10" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsequentEventTypeDomain" xlink:label="loc_us-gaapSubsequentEventTypeDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapSubsequentEventTypeAxis" xlink:to="loc_us-gaapSubsequentEventTypeDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsequentEventMember" xlink:label="loc_us-gaapSubsequentEventMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapSubsequentEventTypeDomain" xlink:to="loc_us-gaapSubsequentEventMember" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_TitleOfIndividualAxis" xlink:label="loc_srtTitleOfIndividualAxis" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapSubsequentEventTable" xlink:to="loc_srtTitleOfIndividualAxis" order="20" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_TitleOfIndividualWithRelationshipToEntityDomain" xlink:label="loc_srtTitleOfIndividualWithRelationshipToEntityDomain" />
      <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtTitleOfIndividualAxis" xlink:to="loc_srtTitleOfIndividualWithRelationshipToEntityDomain" order="0" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_DirectorMember" xlink:label="loc_srtDirectorMember" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_srtTitleOfIndividualWithRelationshipToEntityDomain" xlink:to="loc_srtDirectorMember" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_SubsequentEventsTextualAbstract" xlink:label="loc_oprxSubsequentEventsTextualAbstract" />
      <link:presentationArc order="0" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_us-gaapSubsequentEventLineItems" xlink:to="loc_oprxSubsequentEventsTextualAbstract" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockRepurchaseProgramNumberOfSharesAuthorizedToBeRepurchased" xlink:label="loc_us-gaapStockRepurchaseProgramNumberOfSharesAuthorizedToBeRepurchased" />
      <link:presentationArc order="10" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSubsequentEventsTextualAbstract" xlink:to="loc_us-gaapStockRepurchaseProgramNumberOfSharesAuthorizedToBeRepurchased" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_RestrictedCommonStockGranted" xlink:label="loc_oprxRestrictedCommonStockGranted" />
      <link:presentationArc order="20" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSubsequentEventsTextualAbstract" xlink:to="loc_oprxRestrictedCommonStockGranted" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsToPurchase" xlink:label="loc_oprxOptionsToPurchase" />
      <link:presentationArc order="30" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSubsequentEventsTextualAbstract" xlink:to="loc_oprxOptionsToPurchase" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsToNewEmployees" xlink:label="loc_oprxOptionsToNewEmployees" />
      <link:presentationArc order="40" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSubsequentEventsTextualAbstract" xlink:to="loc_oprxOptionsToNewEmployees" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_OptionsToPurchaseExercisePrice" xlink:label="loc_oprxOptionsToPurchaseExercisePrice" />
      <link:presentationArc order="50" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSubsequentEventsTextualAbstract" xlink:to="loc_oprxOptionsToPurchaseExercisePrice" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_ExistingOptionsThatPreviouslyVested" xlink:label="loc_oprxExistingOptionsThatPreviouslyVested" />
      <link:presentationArc order="60" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSubsequentEventsTextualAbstract" xlink:to="loc_oprxExistingOptionsThatPreviouslyVested" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="oprx-20191231.xsd#oprx_LeaseTerm" xlink:label="loc_oprxLeaseTerm" />
      <link:presentationArc order="70" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSubsequentEventsTextualAbstract" xlink:to="loc_oprxLeaseTerm" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OperatingLeasePayments" xlink:label="loc_us-gaapOperatingLeasePayments" />
      <link:presentationArc order="80" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSubsequentEventsTextualAbstract" xlink:to="loc_us-gaapOperatingLeasePayments" xlink:type="arc" />
      <link:loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockSharesIssued" xlink:label="loc_us-gaapCommonStockSharesIssued" />
      <link:presentationArc order="90" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="loc_oprxSubsequentEventsTextualAbstract" xlink:to="loc_us-gaapCommonStockSharesIssued" xlink:type="arc" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    </link:presentationLink>
</link:linkbase>
