I send almost all my labs to PAML and they did not bat an eye at paying for this interface, but I can see if I lived in the big city and my pt. chose different ones how that would be an issue. Unfortunately I cannot imagine an EMR not charging someone for the interface since they had to develop and support it - as things tend to change with time.
I do wish I could afford all the interfaces but $500 for a lab which only rarely sends me data. I don't think Meaningful Use can expect us to interface all labs.
