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Certification isn't cheap though. It's a definite barrier to entry at the outset. CCHIT seems to be structured to favor monolithic companies with deep pockets, and startups with lots of funding. The certification process also dictates to a degree the functionality of the app, which to my way of thinking may inhibit innovation.

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Certification costs have been going down as the Federal government has become the accreditor of new certifying bodies. Previously there was only 1 certifying body. Now there are 6 that all have to conform to the same standards. As a result, certifying costs have come down and will likely trend down for sometime.

I believe it runs around 20k.. which is a pretty small number compared to cost of labor to build something that would pass the certification. That said, I'd certainly love it if it were cheaper :)

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