>> On Wednesday 20 September 2006 07:38, Andrew N. Shrosbree wrote:
>>   
>>> 4. Your altruistic motives will be derided by your competition, with
>>> doubt being cast on your true agenda
>>>
>>> 5. You will be vilified by the opensource community if you dare to
>>> deviate from their puritanical, idealistic view of software.    
Honestly I think it's a shame Andrew has come to feel this way,
certainly it's a tough slog in the commercial world.

In terms of software development, you do have to choose
either the "low road" or the "high road"
If we start doing this with professional programmers from the
get-go, then, yes, it all starts getting very hard very quickly,
and serious, presumably taxpayer, cash up-front is required.
We all know that simply isn't going to happen.

The "low road" is using local volunteers and cheap overseas contractors,
with essentially no cashflow: if you have donor money, you spend it on
Russian coders, no money,
you proceed more slowly. Sure, this means no real marketing or
proper support, so you first generation of users is completely limited
to the initiates of medical
IT on this list. If that's where it stops, frankly I'm happy. If it makes
one commercial vendor port their software to Qt and postgres, to head us
off as competition,
I consider my job done.

However, if the product is good, other people want to use it too. They
want hold-your-hand support: they flip out the chequebooks, and a
'real' business organisation forms. We all know support costs, and
no-one has ever
had a problem with being expected to pay for it.

The other factor is the importance of network effects in medical comms,
which don't apply so much in
EMRs, which I suspect adds some extra vitriol in the market as some
players feel it's 'kill-or-be-killed'
in the race to become the Microsoft of messaging.


Ian
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