Having worked on various sides of EHR, HIPAA is the biggest barrier. Every organization I've worked in had a compliance officer both on the client and customer side for this reason alone.

Even if you succeed in making past this barrier, the next barrier is finding clients as many are not willing to chance it on a new platform given unless they're a new practice themselves but often they want an organization that's already established. Though, given the overall satisfaction I've seen, it's ripe for the taking.

HIPAA and government regulatory compliance is the ghost that will next stop haunting you. That's why the business logic layer of so many applications is so obfuscated and runs extremely deep. Government compliance comes in waves of quarters with the first of the year being the biggest where everything has to be in place with a huge risk if there's a failure.

Though, it also goes without saying that healthcare IT is one of the largest targets. So there's that.

If your exit strategy is to get bought out, you're in luck as many of the big players readily consume any upcomers to maintain their death grip on the industry. They have virtually limitless capital to make it happen.

Despite having said this, it would be something worth contributing towards.