Billing and marketing is likely the reason. There is no one responding to RFPs advocating for GNU Health, and it likely is not up to scratch for medical billing

Billing and marketing is likely the reason. There is no one responding to RFPs advocating for GNU Health, and it likely is not up to scratch for medical billing/automated overbilling of insurance providers. EHRs in the USA, Germany and other countries with numerous health insurance providers are primarily there to ensure every service and tools used is billed fully (or overbilled).