phone-home-to-the-mother-ship-to-do-anything status quo," he said. 

In addition, open source health IT applications are hitting their late teens, with more growth coming. What will be available in the next year, he said, will likely challenge anything in the proprietary world. 

A physician now has many options with respect to picking and choosing among open source health IT software packages, though the choices have narrowed. Valdes said when he started watching the open source health IT market seven years ago, dozens of projects were active, though many have fallen by the wayside. 

This can cause confusion, but some front-runners in the open source health IT market have emerged in the last few years, he said, though the confusion level is nothing compared to the proprietary software world. 

"In the proprietary world, whole companies and software suites disappear forever in business failures, buyouts, forced 'upgrades' and changes in corporate agendas," he said. "Somehow, this is considered normal. 

"Free and open source software EMR/EHRs are relatively immortal and are much more resistant to service decline, price increases, buyouts and corporate failure than the proprietary world. It's odd that many people in medicine see proprietary software as 'normal' and free and open source software as abnormal -- when myself and a fair number of people see the opposite, especially in medicine."
Shane Peterson  |  Associate Editor