With $20 billion in stimulus funds earmarked to induce hospitals to adopt electronic records, one open-source start-up stands to benefit in a big way: Medsphere, the company that has commercialized VistA, the U.S. Department of Affairs' health care management system created with billions of dollars in taxpayer funds.

Medsphere is selling an upgraded version of VistA for comparative pennies on the dollar. Given that a comparable proprietary system routinely runs $20 million to $100 million, according to data assembled by The Wall Street Journal, Medsphere could completely upend the proprietary health care management market.

Proprietary vendors like McKesson and Cerner hold out the same tired arguments that used to be trotted out to combat Linux, MySQL, and other open-source technology: open source is really not cheaper, the software isn't as feature-rich as theirs, etc.

Given how much success such arguments did (not) have against other open-source projects, here's some advice for Cerner and the others determined to cling to their monopoly rents: it won't work. Open source, open standards, and open data is the new starting point for the software conversation.

Medsphere Chairman Kenneth Kizer says Medsphere's OpenVistA "can be installed in one third the time and for about one third the cost of the big-name proprietary systems." Particularly now, that's a story that is going to resonate.