[owenmarshall]

I think it really depends on your scale. If I'm a small healthtech startup and I can interchange with people hooked up to the candidate QHINs like eHealth and CommonWell I just saved thousands of independent VPN setups and HL7 mappings.

But I already have thousands of independent VPN setups and API integrations, so the cost is harder to justify at scale.

[ThaDood]

That is exactly how my previous employer (HIE) operated. Mirth was fairly low-cost and if we wanted. We could bootstrap our own Mirth Servers. But managing that many VPNs was a giant pain.