I think that would be a good idea and the only way it would work.
Unless this is way, way, way more polished you won't see a Mayo Clinic or Cedars-Sinai using something like this. They tried that 20 years ago and it was scrapped for Epic.
If it targeted smaller rural access hospitals or smaller practices and sold consulting and hosting services it might work if it way undercut the current bigger players... But this market is already way more crowded than the massive enterprise systems like Cerner-Oracle and Epic.
I work with a lot of smaller healthcare offices, and there are plenty of field-specific solutions like MedicFusion, ChiroTouch, et al.. Despite the relative small sizes and simpler needs for these offices, you'll still find unique complexities, business logic, and bespoke integrations.
The process of migrating from one solution to another is so involved and time-consuming that I wouldn't expect it to happen more than once in a decade, and only then if the current solution is somehow critically deficient, or their practice is changing in a way that demands expanded options.
The only potential advantage I can think of is the relatively higher frequency of new practices being opened, which creates a wider target audience of potential customers, and that's probably why there's more field-specific solutions, rather than general ePHI that supports multiple fields of practice.
One of the more interesting ones is ESO's ESOsuite, for pre-hospital providers.
It has to deal with rough and spotty connectivity even during record creation, it has to handle sync between different providers (FD arrives first, starts gathering information, EMS arrives after to transport. How do you reconcile field values? It's one thing to coalesce provider interventions, but what about demographic discrepancies? "Just give the provider a choice between options" you think - not the biggest priority when approaching the hospital and stabilizing your patient, and not when you need to contact the hospital and give them said demographics and CC/HX/VS before you arrive).
> They tried that 20 years ago and it was scrapped for Epic.
Did the Mayo Clinic use to use something open-source? They switched from Cerner to Epic 6 years ago [0], but that's just switching one closed-source vendor to another.
In the old days that would be classic VAR opportunity. Independents solving local problems. And, while license fees always affect the value proposition of a solution, there’s typically a lot of consulting and implementation labor dominates those contracts.
Today, though, the electronic medical record is a much more regulated with all the government standards. Part of the whole consolidation of smaller practices is just keeping up with the EMR requirements and other systemic parts of the modern health care system.
But where there are great opportunities for things like OpenEMR is internationally in developing countries. There’s a great need for fundamental EMR services and information exchange that open source solutions can be a really good fit.
One wonders if the business model for supporting efforts like this could be to provide the support/services, while keeping the code base open source?