The benefits of the open source model in which the actual software parts to build the system are open to the customer to fix and extend holds the promise of overcoming the failures of the past and have been discussed in great detail on this site. They are: 1) Failures are not really failures since anyone can pick up ‘failed’ projects and continue engineering them until success is achieved 2) Intraoperability. 3) Ability to rapidly and cheaply change to meet evolving medical conditions. 4) Security.