Open source changed the way Web Sites like this were done as Alain Veuve shows in his article:
How open source disrupted the CMS market
We believe that OpenEMR and other players in the healthcare market will do the same.
Medical Information Integration and William’s Medical Technology have banded together to provide, both support for the OpenEMR community project as well as a Pro version of OpenEMR that is tuned for specialized workflows, like women’s health, Federally Qualified Clinics (FQHC) and Behavioral Health.
We think, like WordPress and others, that the hybrid model of a strong community core project and subscription-based support and hosting from highly qualified vendors is a huge win and will change the market forever.