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EHR is not difficult. There's a lot to the required data model, but building a working system doesn't require mental gymnastics, just time and effort.

Selling isn't particularly challenging either. There is a tried and true model for selling to medical practices and hospitals that works. Customer acquisition is expensive and resource intensive, but it's doable with the right team and right investment for any product.

There is risk, but HIPAA is a lot more of a risk than a logical failure. With every HIPAA violation, there are fingers pointing in every direction, and that means that resources are required to respond to everything - even when it's painfully obvious the software isn't at fault.

I would say that the biggest challenge to creating a market for a new EHR product is that there are generations of people resistant to any real user interface changes. I'm not even talking about adding tabs or checkboxes. If an EHR product logically maps to one of the legacy powerhouses like EPIC, it makes sense to people. If it logically maps to health care instead - No dice. People are entrenched in a system that was designed by engineers for health care because that's all that was available for a generation. They've gone to classes to learn how to work in that environment, they've worked in it for years, and it works for them. A major shift of any sort means retraining doctors, nurses, call center operators... anyone and everyone up and down the food chain. Even in a small practice that's a lot of time and energy to invest. There is resistance every step of the way.



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