With all the "givens" that I have to assume in my answer ("given" that going electronic was a wise decision, "given" that it has to be MU certified, etc.) then I'd say that AC does the basic job quite nicely and with decent cost effectiveness. However, I do sort of shudder when I read of a practice basing its decision solely on the apparent up front cost. It is the same feeling I get when a student pilot comes in for a flight physical and happily states he/she wants to learn to fly so he/she can get a plane and go hunting, and I know the skills required to use an aircraft for hunting are a couple of orders of magnitude above where this person will realistically be in a couple of years, and that I am looking at a statistic in the making. As you can see by the threads of backup power supplies, networks, backup systems, servers, etc. the cost of the software can become really only a modest percentage of the cost. IMHO, AC does a fairly good job of adhering to the KISS principle.