First off, great post, James. Very thorough and well-versed. As long as it remains an option and not a requirement. Some other pointers. When you start using CloudServices, you need a decent ISP. A basic T1 line is ~300-400 dollars.
Some internet plans have data caps like Comcast which means you have a limit to how much you can access AC. Also, this would essentially kill Imported Items as you'd have to upload everything into the cloud, we would have to focus on compression and optimization so a web interface doesn't slow us down. I.e. if you took a picture of a patient and wanted to put it in their chart, you'd have to upload it. I'm fine with this as long as it's not required. You're also right about people not wanting to spend money on the hardware when that's their entire practice sitting on it. I'd never use an off-the-shelf desktop for my server.

Last edited by Sandeep; 02/03/2012 3:43 AM.