The GPL says that you must provide source code to the recepients of any application you distribute under that license. This is really meeting the legal requirements of that license. However, is that “all” that is needed? If you say that you have an open source application (especially in healthcare) but you do not attempt to engage the wider community to get feedback on your application or allow other developers to review the data structures and application code. Is it really an open source application? As I stated above. It is clear that all you “have” to do (legally) is give the source code to the recipients of the application.
But, when you restrict the distribution of your application to a specific audience that is not really knowledgable about FOSS issues and you do not accept review and comments from the wider healthcare FOSS; is it really “right” for you to say that you are an open source healthcare application provider? What happens when you apply for and take funding from international organizations under these circumstances?