Welcome NPR

Apparently, npr mentioned my blog. They contacted me for a comment on Medsphere’s ROI calculator.

So if you are from NPR I thought I should actually give you the entire email I sent to Mr. Weaver:

My impression of Medsphere’s prices is that they are a “premium” VistA vendor. If you look you can find cheaper VistA support. However, there are only a handful of VistA support companies with real experience and all of them charge like Medsphere does. On the other hand, even “premium” support for VistA is cheaper than proprietary solutions by 30% to 80%. This is simple evidence of the economic pressures of Open Source. Medsphere can and does charge as much as it can. But it is competing against other groups using the same software that it developed, and against hospitals doing the work internally. There is objective value in going with a vendor who has succeeded with an Open Source project in the past. The balance between open competition (which lowers the price) and proven track record (with raises it) means that Medsphere’s price is objectively fair, and subject to market forces both before and after the installation of the software.

This is the real story about Medsphere and other Open Source Health IT vendors. It’s not that they are inexpensive, although they are much cheaper. Its that their prices actually reflect the markets response to their ongoing performance. That not only makes things cheaper now, but ensures long term cost savings and improvements in performance.

Proprietary lock-in is a form of monopoly where the vendor has an economic incentive to provide poor support. Therefore at least the support services from proprietary vendors are not subject to market forces. That is why they are so poor and Senator Grassely seems to think they warrant investigation.