You can stay right where you are delivering MEDITECH (or whatever) solutions. You can remain successful there, perhaps your whole career. So fine, have a happy career. But don’t try to throw FUD at open source. Fear, uncertainty and doubt.

Specifics again: yes if your hospital wants large, deep customizations, and wants a fixed-bid estimate, whoever delivers the estimate will take on heavy risk. They could be wildly off in their estimate, either too high or too low. Again, and I’m getting tired of saying this, estimating is risky on both proprietary and open source systems.

Or, if you rely on an open source vendor for support, they can deny customizations. So long as you want to stick with the vendor, you must abide by their rules, and this is true whether the product is open source or proprietary.

Also, and this is side-stepping the question a little, but I want to put this out there: everyone should check out and understand what plugin architectures and composable systems are. This may change your whole outlook on what types of customizations are possible, and what types of customizations are ‘good ideas’ and what customizations are difficult to upgrade.

Examples of cheaper and easier to use OSS abound. histalk.com is hosted using Apache and WordPress, for example, two of the most ubiquitous examples. Care to point me to any better, let alone CHEAPER, examples of software to perform those functions?

“You’re soaking in it.”

Meanwhile, your position that OSS is dangerous because makes it impossible for you to describe to other folks the possible limits of your software solutions is…mind boggling. “Yes, sir, please sign me up for the self-limiting solution!”

Easier how?

From the CIO/IT Director perspective it doesn’t matter if I have to pay some contract programmer or pay as part of my contracy with EPIC, Cerner, GE or MEDITECH – I still have to pay.

How much cheaper and easier is it to go with an OSS?

And, I need to know how much cheaper it is once I factor in the fact the I no longer, as the CIO, have the abilty to tell the DON that MEDITECH/EPIC/Cerner/IDX doesn’t have the ability to do X.

From my perspective as a consultant, WorldVistA seems like a panacea. All the money that used to fund the lavish lifestyles of Judy Falkner and Neil Pappalardo will instead go to consultants that can show East Podunk Medical, Haircare & Tire Center how to implement VistA.

But, before I can sign on, I need some hard numbers and a disinterested, third party estimations as to the true cost/benefit of going with an OS Systems.

Open source won’t change the fact that if you heavily customize your system, you must commit to re-implementing those customizations with any future upgrades. This is true of proprietary software and this is true of open source software. This is true of good ideas and true of bad ideas. This is true of bugfixes (both discovering and fixing) and true of strategic direction (open source gives you the ability to fork a project). Open source just makes this all easier.

Open source isn’t pixie dust you sprinkle on your product to makes everything better, but it isn’t the boogie man either.