AOL had 26.5M paying subscribers. Encarta had licensed content and a real editorial staff. Enterprise blockchain had billions in institutional backing. Open beat all of them anyway. Here is why that pattern matters for healthcare AI right now.
TCP/IP produced zero dollars for CERN. Wikipedia runs on a budget smaller than a mid-sized software company’s marketing line. Ethereum processed more activity in one month of 2024 than all enterprise consortium chains combined ever did.
Healthcare keeps replaying the same version: HL7 v2 became a consulting racket. Mirth got relicensed in 2024 and forked immediately. Epic cut Particle Health off from Carequality over a data use dispute. Network access is always one policy decision away from gone.
Open weights plus open context infrastructure is the only configuration where health systems and regulators keep any leverage - because if the AI reasoning layer and the patient context layer are both closed, the vendor owning both owns the patient.
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