Additionally, the software dependencies (CentOS v6.7 & Java 7) that say breakage occurs with newer versions is very sketchy IMO, ignoring the HIPPA & PCI compliance work that needs to be done (the latter costs $40k a year to maintain).
I was part of the team which build it for about an year and can definitely say it did change the medical eco-system in such places
I'm familiar with another big medical software provider, and it's a cludgy mess, but it's all about the RFP and how the software can help in billing and meeting Meaning(ful|less) Use targets.
It might have a chance in developing countries with less regulation in place.
What if you have a computer, unconnected to the internet, simply sitting in a doctors office with billing information on it.... does this system need more 'protection' and regulation than the one it replaced of paper files, and sticky notes?
I am pretty sure even if your office is all paper charts you still fall under certain HIPAA guidelines such as notifying patients if there was a breach (e.g physically stealing records from the office). This happened in Rocklin, CA a few years ago.
http://www.cda.org/news-events/burglary-leads-to-lengthy-hip...
Plus add to what you mentioned that you need strong disk encryption and some physical security. Else an external key logger and its over.