Netherlands Embraces Open Source to Break Healthcare Technology Monopolies
The Hague, Tuesday, 10 February 2026.
The Dutch Health Ministry is making open source software central to digital healthcare, aiming to end vendor lock-in and reduce costs. Officials compare this shift to bicycle maintenance - choosing any mechanic over being tied to one manufacturer. The ministry’s health information system will be fully open source, challenging traditional bundled software models that have dominated healthcare technology for years.
Strategic Vision for Healthcare Independence
The Dutch Ministry of Health, Welfare and Sport’s commitment to open source development represents a fundamental shift in how the nation approaches healthcare technology [1]. Maurice Hendriks, an open source expert at VWS, emphasizes that this is not an experimental approach but rather aligning healthcare with established digital norms [1]. According to Hendriks, open source has become the standard in digital technology, much like the infrastructure powering the internet and smartphones [1]. The ministry’s strategy explicitly aims to reduce dependence on major suppliers, increase system interoperability, and make healthcare ICT more affordable and transparent [2].
The Bicycle Mechanic Analogy
Hendriks illustrates the ministry’s vision using a compelling analogy that resonates with Dutch culture: bicycle maintenance [1]. “When you buy a bike, you don’t have it serviced by the manufacturer. You just go to the bike shop around the corner. They can supply and install parts from different brands, prices and quality. Everything is interchangeable. And you’re not tied to one producer,” Hendriks explains [1]. This comparison highlights the fundamental problem with current healthcare ICT systems, where vendor lock-in creates expensive dependencies that limit flexibility and innovation [1]. The bicycle analogy demonstrates how open standards and interchangeable components can create a more competitive and efficient marketplace [1].
Implementation Through the Health Information System
VWS is putting this philosophy into practice through the development of the gezondheidsinformatiestelsel (GIS), which will be built as a fully open source system [1]. This represents a concrete application of the ministry’s strategic vision, moving beyond theoretical discussions to actual implementation [1]. Laurens Rijpstra, who oversees data for citizens and personal health environments (PGOs) at VWS, emphasizes a fundamental shift in business models within healthcare technology [1]. “The starting point should be that you earn money by delivering value: a good product with the associated services. Not by locking away data or making users dependent on you,” Rijpstra states [1]. This approach challenges the traditional healthcare ICT market structure that has historically bundled software, maintenance, and licenses in ways that complicate switching providers and increase costs [1].
Addressing Industry Concerns and Market Dynamics
The transition to open source healthcare systems faces resistance from suppliers and healthcare institutions concerned about revenue models, continuity, and control [1]. These concerns reflect the significant economic interests at stake in the current healthcare technology market [1]. The Autoriteit Consument & Markt (ACM) has previously identified the substantial market power held by major software suppliers in healthcare, validating VWS’s concerns about vendor concentration [1]. VWS suggests that collaborative organizations like MedMij should play a crucial role in overseeing the open source development of personal health environments, providing governance structures for this transition [1][2]. Rijpstra notes that digitalization is a gradual process, with patients only noticing improvements when systems fail or suddenly become easier to use, such as when MRI scans become immediately available digitally instead of requiring physical transport on CDs [1].