Does anyone in high-income countries use something like that? It is worth nothing that the software product itself is only a tiny part of implementing most enterprise software projects.
Because people stand to lose profit if GNU Health is used.
EHRs in the USA, Germany and other countries with numerous health insurance providers are primarily there to ensure every service and tools used is billed fully (or overbilled).
GNU Health’s support for the whole set of pre-authorization, billing, payment, and related transactions seems to be...generating manual invoices.