This is also why it annoys me when the standards organization calls these 'products' and charges $$ to use them. I want my work to be used, more than I want to be paid to create the work.This is why I am more creative working for DICOM or IHE; and more satisfied when those works are used. I think HL7 should think about this, how much more creative could the HL7 standards be?
As Dan says in the presentation, in order to get to this state one must be paid enough money to get money off-the-table. This is why I unabashedly working for GE Healthcare, and I have no problem with the fact that an organization brings together people that create using one motivation, with people who do mechanical (manufacturing) work with a different motivation, to produce value. This is what a vendor does, put together the whole-package.
Yet I have the best of both worlds, as I get to see GE Healthcare create value and deploy it; but as a standards developer I also get the pleasure out of others using these same standards.
The open-source community is missing this whole-package, yes the creative part is free (somehow the participants have achieved the money off-the-table state); but there is no-one there to finish the job. Hence why open-source doesn't dominate as it should, if one looks only at the technology (the creative part). This is niche is being filled to some degree by enterprising organizations that take the free creative-part and do the rest. But they will never 'own' their own destiny.