Using Open Source for Trust, not Growth, with Reshma Khilnani

This week on The Business of Open Source I spoke with Reshma Khilnani, CEO and founder of Medplum. Medplum is an open source electronic health record development platform, and one of the things I loved about this conversation is that Reshma is so focused on the healthcare industry — a level of focus that I find relatively rare in open source companies. And not only that, when I asked her if she thought the company’s focus was too narrow, she responded that actually she often worries that it’s too broad. 

Another thing I really liked about this episode is that open source, for Medplum, is about trust and transparency, not growth. Medplum’s customers, Reshma said, just don’t mess around with free software that doesn’t come with compliance certificates and some kind of support guarantees. It’s a great episode to come on the heels of the episode with Adam Jacob, who talked about the difference between code, software and a product — that is a distinction that Medplum has clearly nailed. 

Other takeaways if you’re running an open source company: 

• Reshma is clearly really passionate not just about developing software, but about building software for the healthcare industry. She can also clearly articulate why her customers are not well served by the standard, off the shelf development platforms that can be used by any industry. This industry-specific expertise is really powerful, and quite frankly something I don’t encounter very often. 
• Even though there are different legal regimes in different countries, the underlying needs are pretty similar, so even for something as specific as healthcare companies it’s not particularly challenging to provide a solution that meets the needs of customers around the world
• Medplum is Reshma’s third company, but her first open source company. She talked about how one of the key differences between building an open source company and a her previous companies that that the company has to pay incredible attention to the implementation details that at any other company no one would care about. 
• Yes, you’re building a product company… but that doesn’t mean you should never sell professional services. Reshma says that one mistake she made was being too rigid about not selling any professional services at all, and ultimately they ended up offering packages of services to help customers get their implementations running. 

One last bit of info: Reshma compared the conversation around open source startups now with “internet startups’ in 2013. Will all startups be open source startups in 10 years? I guess we’ll see.