No cost or a lower cost for licensing "open source" solutions
Flexibility to adapt the software for particular health care solutions
Continuing software enhancements available through the open source community
"Mission" rather than "market" objectives focused on patient-centered, population-based health improvement
Open architecture allows for greater opportunities for health information exchange
Ability to incorporate tools for personal health, such as personal health records
Many pre-existing tools for interface and reporting already developed
Tools make it easier to build generic rather than custom interfaces
Centralized hosting using the health center-controlled network model affords economies of scale


Often no single source to support all aspects of the application; multiple sources of technical and clinical support may be required
Must understand business logic to adjust configuration or make code adjustments to meet unique work flow and clinical needs
User assumes more "ownership" of the solution than under proprietary licenses, including initiation of upgrades, enhancements, configuration and support of software
Difficult to engage support of vendors with practical experience in supporting the application; often they have retired or left the agency
Difficult for smaller organizations to afford the resources individually
May require sophisticated professional guidance on licensing issues and the preparation of contracts
The open source solution may not be CCHIT certified by the originating agency and this may provide challenges, especially if the user is seeking grant funding that requires, as a condition of funding, that the software to be acquired is CCHIT certified.
Often have to adapt and develop training materials appropriate for the particular application of the open source solution
Must guard against information overload and alert fatigue

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