It's hard to argue marketing to giant health care systems is difficult when you go up against corporations like Epic, Cerner, or Athena Health. We simply lack the funding to do so (just thinking about Cerner's marketing budget is mind-spinning). But outside the U.S. I find that marketing is substantially easier. Many developing nations and low-resource clinics seek out ways to be financially stable with next to no funding (compared to U.S. providers). While hard to track, we estimate most of the installs are outside the U.S. helping build healthcare in areas that could never dream of a 9 figure IT install. Being a free and open-source platform is our greatest "sales pitch."

I wrote a reference implementation of OpenEMR, the "OpenEMR Full Stack", that's taking aim at facility-grade loads. It's deployed from Amazon CloudFormation, and the highlights include multi-AZ redundancy, an Elastic Beanstalk deployment fronted with a load balancer running parallel OpenEMR instances in multiple AZs, an internal Route53 domain protected with SSL between nodes, redundant document stores for patient records, and enterprise-grade backup and recovery structures all wrapped up CloudTrail and Amazon's Key Management System.

https://github.com/openemr/openemr-devops/tree/master/packag...

Yep, marketing is a real issue, since that can take up extensive resources (I am just guessing that the proprietary EMRs sink 20% or more of their resources into marketing).

Especially since US based physicians are trained that more money means better things. As you can imagine the skepticism that then results when discussing a free EMR.

Prior to a year or so ago, OpenEMR really relied on the professional support (this is basically an organic ecosystem of companies, vendors, and professionals that offer paid services to support OpenEMR) for marketing. However, the project is now taking on a more active role in marketing and is why it is listed as an item to fund in the OpenEMR Collective blog. The goal would be to get professional marketing advice and guidance.

The developing nations market is really another matter. The marketing is still important and requires resources, but is mainly focused on making OpenEMR known and accessible to these nations (for example, OpenEMR currently supports 33 languages).

And we are always looking for volunteers with (or without since we are all learning) expertise to help us in these endeavors, and anybody is free to participate in the community (hint hint).