That’s kind of what I was getting at. Medium to large organizations usually require a certain level of reliability that closed software companies usually guarantee with dedicated support staff and SLAs. An open source project developed by the community with no dedicated support is risky from that perspective.
If someone with the technical know-how and ability to maintain those systems offered support (red hat for example) for a lower price, many small and medium sized companies would get on board. That could also just look like a company hiring a small team to implement and maintain their own systems while contributing back to the community project.
It’s just a much harder sell to non-technical leaders. They just want uptime guarantees and fixed costs.
As a healthcare worker, the nurses are absolutely not washing their hands intentionally. You’d be surprised how many healthcare workers don’t believe in science based medicine.