I have been a strong supporter of free software (GPL) and open source since Linux was created and remain so. The company I started and system we created, ClearH

I have been a strong supporter of free software (GPL) and open source since Linux was created and remain so. The company I started and system we created, ClearHealth, was the only open source EMR to receive the necessary federal certifications and other partner certifications (SureScripts, Payers, DEA, etc) to be used in real large scale institutions. Unfortunately the fact that is was open source, the cons dramatically outweighed the pros in terms of contracts (it is difficult/complicated to get sole source contracts typical for software when you are open source) and investment (health tech investors at the time all wanted lock in). We were fortunate to have a strong business model around our healthcare management operations that had nothing to do with the EMR but if I had to do it again speaking from a business standpoint only, I don't think I would do it as open source that way. As recently as 5 years ago open source was viewed with extreme suspicioun if not outright disdain in the largest health institutions, I think that is changing but still has 10-15 years to go.