Commercial Solutions for OMOP/OHDSI Research Acceleration

Dear Community,

I would like to understand why commercial solutions (ie. software that is developed by for-profit companies, eg IQVIA, et. al.) have utterly failed to gain any traction in this community of researchers.

I have spent 3.5 years developing in this space, and have contributed to Broadsea as part and parcel of my engagement with the International Rett Syndrome Foundation.

We were able to convert their 15 year NIH funded Natural History data into the CDM 5.4, which enabled them to co-operate with 3 Pharma developers to bring to market novel therapies through the FDA/NDA process.

We launched the Parthenon platform back in March, and received support and interest in how we have engineered a common, singular, comprehensive “protocol-to-evidence-to-publication” pipeline. Since then we have proven that this AI-native platform can serve researchers from Korea, to Chile, to 20+ institutions in the US, to the OHDSI community in India.

I have reached out to @Chris_Knoll, @Paul_Nagy, @Christian_Reich, @Ajit_Londhe @clairblacketer and others who have contributed massively to this community, and I have received little or no response.

Here is the deal: www.acumenus.io

Please let me know whether our Parthenon platform is worth investing in, as beta testers, as code evaluators, as institutions that you work for, across the gamut of AMCs, Pharma, etc. I genuinely need your informed opinions.

To others who are long time users/contributors to the fragmented set of solutions from ATLAS to HADES and all other sub-solutions that you need to tie together… Please let me know of your level of satisfaction of where we are as an FOSS dependent community. My intention is to ALWAYS provide a FOSS solution, but also for those who can AFFORD it, a vibrant and evolving platform paid for by those who can support accelerated advancement to the rest of the world of outcomes researchers.

As an example of what our fine-tuned LLM based on the free and open source MedGemma:27b model which we call Abby, also a harness for the larger frontier models, is capable of… I am attaching our latest test study on Hypertension and our earlier work on Rett Syndrome.

I genuinely hope for a sincere response and guidance.

Yours,
-Sanjay M. Udoshi MD.

Under-Diagnosis_of_Hypertension_JAMA-style.pdf (718.7 KB)
IRSF_Vocabulary_Mapping_Appendix.pdf (258.3 KB)
IRSF_Genotype_Severity_Paper.pdf (2.4 MB)

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Hi Sanjay, thanks for your post. From my perspective, the engagement problem you’re experiencing is not because you have a commercial solution. It may be in part because for many teams (like mine), a monolithic, all-in-one platform is not the right solution. As a global analytics team at a large pharma company we have a complex set of workflow and IT requirements, so modularity and flexibility are important to us. I think this also applies to the OHDSI community as a whole. OHDSI caters to such a wide user base that keeping things modular and low-level is important in driving adoption.

Relatedly, as an open-source maintainer in OHDSI, I prefer to spend the little spare time I have contributing to core OHDSI software. While our open-source community may progress much slower than vendor-led projects, I believe strongly that the value of OHDSI lies in its community-led, distributed nature.

That said, there is absolutely space for vendor solutions in OHDSI. Some institutions likely are seeking an all in one platform solution, and many definitely want/need to offload their OMOP/OHDSI implementation to a vendor. It’s commendable that you’ve made your solution open-source, but if you’re seeking contributors I think you’ll need to hire them, or source them from within your user base.

If you want contributions from OHDSI maintainers and contributors you’ll need to get buy in that your solution is a priority for the community, and that it’s worth it for those individuals to volunteer their time on. Doing so can be incredibly challenging and isn’t guaranteed to pan out. So it’s definitely understandable (and expected, and a good thing!) that vendors develop independent solutions. You’ll just need to resource those differently than a project developed by & for the community.

These are just my opinions, and I hope I understood your questions correctly. OHDSI does currently lack a structured pathway for new open-source solution investment/prioritization. One aim of the Technical Advisory Board has been to create such a pathway, but our progress has been limited. I will admit that my contributions in this area have slipped recently, but this thread has gotten me thinking about it again - so thank you for that :slight_smile:

Thank you @katy-sadowski. Commercial vendors continue to have success in OHDSI, but most are boutique services like OMOP transformation, phenotyping or study design and execution. There are proprietary platform/product companies in OHDSI. The other problem is, with vibe coding, there is a lot of platforms that looks very similar and there is a lot of me too replicas. There is a lot of AI experimentation and that may be a factor too.

@katy-sadowski @Gowtham_Rao — thank you both. This is exactly the informed perspective I was asking for, and rather than just say it landed, I’d like to show you what it changed.

First, though: to the people I tagged in my original post — that was poor form on my part. Calling individuals out by name in a public thread and pressing them for responses put people in an unfair position, and I apologize.

Now the substance. Your two replies, together with candid feedback I’ve received since posting, led to decisions I want to make publicly, here:

Parthenon will be free and open source — all of it, permanently, under Apache 2.0. The code is public at GitHub - Acumenus-Data-Sciences/Parthenon: Parthenon unifies the OHDSI ecosystem (Atlas, Achilles, Usagi, WhiteRabbit, and more) into a single AI-powered app — replacing two decades of language sprawl with one Docker Compose stack. · GitHub, and two concrete commitments both land by the end of this month. First, we are retiring the separate commercial Enterprise Edition and re-integrating it into the Community Edition — SSO/SAML, multi-tenancy, audit retention, and the Kubernetes operator will all live in the open repository, and the private EE repo will be archived. Second, we are relicensing the platform from AGPL-3.0 to Apache 2.0 — the same license Atlas, WebAPI, and the rest of the OHDSI stack carry — so no copyleft clause stands between Parthenon and any institution’s IT policy.

No paid tiers, and no “for those who can AFFORD it” edition — I wrote that line in my original post, and I retract it. Acumenus’s only commercial activity going forward will be optional services: implementation, deployment, and long-term support for institutions that want a partner rather than a product. Gowtham, that is the pattern you described as the one that actually succeeds in this community: services rather than proprietary platforms. The honest conclusion from your comment was to stop swimming against it.

Katy, your three points stand and will shape how we operate.

Modularity: Parthenon runs as roughly eighteen composable Docker services rather than one binary, and it maintains strict compatibility with the ecosystem: Atlas cohort definitions and concept sets import and export without modification, and a WebAPI-compatible layer supports legacy R package integration. We replaced runtimes, not semantics. But we’ll demonstrate modularity rather than assert it — we will carve out and publish individual components, starting with Darkstar, our rebuilt OHDSI R runtime (already a discrete service in the stack), as independently deployable pieces a team like yours could adopt à la carte without ever touching the rest.

Resourcing: We will not expect maintainers to donate scarce volunteer hours to our roadmap, and if contributors emerge from the user base, we’ll support them properly — there’s a CONTRIBUTING.md with our quality gates waiting for them, and with the move to Apache 2.0, contribution carries no copyleft strings.

The TAB pathway: the offer stands, and matters even more now. A structured intake and evaluation pathway would give projects like ours a legitimate front door and protect the community from the noise Gowtham describes. Acumenus will commit real engineering time to that effort, and Parthenon volunteers as a test case for whatever process the TAB designs.

What we’re asking for, and how to engage: serious beta testers across the world and across industries: AMCs, pharma, registries, public health networks, willing to run Parthenon against their own OMOP instance and tell us bluntly where it breaks, what’s redundant with your existing stack, and what’s missing. Structured, time-bounded evaluation, not volunteer development. A live demo, the full user manual, and the API reference are at parthenon.acumenus.net; a one-line bootstrap installs the latest tagged release. Issues and pull requests are open on the repo, and I’d welcome the hardest code review this community can offer.

For real-time help such as installs, troubleshooting, study questions; we run an open Discord at OHDSI (Acumenus.io), where we’ve been supporting users around the world; anything of community-wide interest, I’ll keep here on the forums. If any workgroup or community call would find a walkthrough useful, I’ll gladly present and take questions. Otherwise, reply here or message me directly.

On differentiation, I’ll keep offering artifacts rather than adjectives: twelve public releases with full CI, the IRSF natural-history conversion now supporting three pharma partners’ FDA-facing programs, the attached studies produced end-to-end on the platform, and code anyone here can read. We have successfully tested a complex Hypertension research protocol, and will be testing an Obesity protocol in the coming weeks. One design note relevant to the IT constraints Katy raised: Abby, our assistant, defaults to the openly available MedGemma running on a local Ollama stack, so the platform can run fully on-prem with no patient-level data leaving the institution.

Thank you both again. This thread changed our direction — and I believe for the better. I’ll report back here when the re-integration and relicensing are complete.

Sanjay M. Udoshi MD
Founder - https://www.acumenus.io

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