If/since this is a freemium model, can you talk about the kinds of features you would end up charging for?
The 2019 state of open-source EHR is reported here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517630/
It would be interesting if published an assessment of your status and plans using their criteria.
I've seen practices successfully using two of the recommended EHR systems. Technically most seem in the ballpark, but the key seems to be whether there is a robust community validating the code and providing timely support. In that respect, another open-source alternative is not necessarily a good thing. Do you have any community-building hires in mind?
As for clients: the adopters are often medical people who picked up enough technology to wire things together, and do so for their practice employees. They're not super interested in sharing the secret sauce of their practice with consultants who will simply repurpose that knowledge for the competition. The most successful OS EHR's seem to be configurable by these adopters.
But it seems medplum targets developers (not the practice professional). If (since) those developers may have a tough time, do you have designs to pivot to new low-code approaches for end-user?
Conversely, if you stick with the EHR-AAS back end, the trend of the last few years has been for private equity to buy practice groups. I don't see yet the incremental value for the adopter or users of your offering over existing EHR's. But equity would be super eager to buy practices with EHR's ready to audit for due diligence before purchase and ready to integrate after. That could be a selling point for practice managers. Do you have any biz-dev plans to coordinate with the equity groups playing in the medical space, or investments from them, to tide you over the long process of gaining mindshare in a conservative market?