The licence ledger
IllustrativeThe commercial shape of a healthcare stack, as a buyer reads it
- Basis of charge
- Per encounter, per bed, per provider, per result. Capacity and activity are the measures, and both are the ones you exist to grow.
- Growth condition
- Expansion adds line items across five vendors on five renewal cycles. Contraction rarely removes them before the term ends.
- Model opacity
- Clinical decision support is licensed as an artefact. Tuning it to your specialty and showing a safety reviewer why it fired are both outside the contract.
- On exit
- Patient records, order sets and clinical pathways sit inside the vendor's schema — not in an asset you hold.
Shape only — the direction of travel, not a quantity. Your own curve comes from your own renewal schedule.