Heath centers pay unreal amounts of money for these kinds of commercial products, but in my experience the health centers themselves have very few technical resources. So the real "value" being delivered by the commercial software providers is often the setup, support, and hand-holding provided to customers who pay the crazy amounts. I imagine there will be a niche but high-paid market integrating these GNUHealth pro…
The problem open-source, and social media, and everything digital, has never overcome is accountability . Who do I sue, and who has insurance, if something goes wrong? Combine that with most small businesses having more money than time (just pay Gmail, don’t spend the required amount of time to self host), and open-source is stuck at being hobbyists if there is no corporate sponsorship.
There are lots of organizations that provide a throat-to-choke-as-a-service, e.g. Red Hat.