I don’t think most healthcare leaders understand the effort these Electronic Health Records systems require.  While the hardware and software expenses are significant, they are dwarfed by the level of implementation effort required.  I am working on a number of resource estimate models to implement a “fairly comprehensive” EHR for a 400 physician medical group.  While the hour estimates can vary be EHR product all of the estimates are breathtaking.  Currently, the high end of the range looks like 300,000 hours.  But, we still aren’t done scrubbing the numbers.