One of the most unpleasant things about working in the medical space is how tightly coupled and poorly modularized systems are.

Obviously, driven by the reasons and pressures you outlined in your parent comment. (Everything is sold and certified as a system, rather than a component)

It seems like there's an opportunity for OSS to eat shared functionality, that no vendor particularly liked implementing, and then allow for closed source UIs to be built on top.

E.g. EMR store/server being the open product, with {insert your preferred front end on top, for your specific use case}