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Comment by x0x0 | Hacker News Reader

I worked for one and it works very well. They build one of the most common electronic medical record systems plus a bunch of associated software. Any large client, in this case a hospital, hospital chain, or large ambulatory clinic, pays a $mm annual fee for the right to call and notify of a breaking bug and get engineers to issue a fix asap.

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This basically highlights why there's no comfortable middle ground in pricing software.

At a high price, you can get strong service guarantees.

At a zero price, you can use open source and manage the critical service yourself.

At a low but nonzero price, you get neither.

Some of it is client-side.

By that I mean, clients with budgets will opt for enterprise services. That's not necessarily fair, but humans like expensive stuff, especially when it's not their money.

The thing is, engineers who move into SaaS and try to tackle that middle ground tend to be shafted. This is why people like 'patio11 so often recommend aiming for the enterprisey folks - that's where you make a living.

>> one of the most common electronic medical record systems

Can you point to the company name? I am checking what is out there (EMRS).

Has it ever led to a pseudo-ransom situation if only a single client is affected by a showstopper bug? If not, how is this mitigated?

Well, I believe two ways. First, I'm sure the contracts have penalties, plus hospitals have lawyers. Second, when companies spend tens of millions of dollars per year or more, they certainly talk to a bunch of current clients. If word gets around that your company screws customers it will throw a wrench in sales. There aren't that many hospitals, particularly if you view chains like kaiser as a single customer, in the US.

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