A great example of the problems that you have with using a proprietary license for your EHR has been posted on GPLMedicine.org
From the main article: (McGoverns) tech support contract with Boca Raton-based Dr. Notes was originally for $1,200 a year but the company wanted her to pay $5,000 a year. When McGovern refused, the company didn’t give her an updated monthly password needed to access the program and view records, she said. You cant make this stuff up.’