We’ve handled EHR integrations—Epic, Cerner, you name it—more times than we can count. Every single time, we see teams plan to spend $30–40k, then end up shelling out twice as much. It’s not about bad developers. It’s the hidden costs: extra validation cycles, annual support hikes, and contract “gotchas.”
Where Most Startups Blow Their Budget (and How to Avoid It)
- Validation cycles drain cash. Epic and Cerner both charge $10k–$20k per round of validation—and there’s never just one. We always budget for at least two cycles.
- Support costs always go up. That $15k/year support contract? Expect it to climb by at least 10% each year. It adds up fast.
- Custom builds rarely pay off. Unless you have a massive budget and endless time, middleware like Redox wins. For a flat $45k/year, you get one API for multiple EHRs—no more vendor headaches.
Real Budget Snapshot for 2025
| Integration | Upfront | Yearly Support | Hidden Costs |
|---|---|---|---|
| Epic | $15–20k | $15–35k | Two+ validation cycles, support escalation |
| Cerner | $10–18k | $12–30k | Extra validation, sandbox fees |
| Redox (middleware) | $0–5k | $45k | All validation included |
Our typical client? Two EHR integrations through middleware: about $68k total, 14 weeks to MVP. Honest math—no surprises.
How to Save Time and Money
- Budget for two validation rounds. Don’t be caught off guard.
- Choose middleware for speed. The price tag looks high, but it saves money and headaches in the long run.
- Plan for annual support increases. They’re always in the contract—just expect it.
Why Count Every Dollar?
We’ve seen founders try to “save” on integration, only to lose much more fixing issues and paying HIPAA penalties. One client saved $250k the first year—just by syncing systems and avoiding duplicate work and billing errors.
Not a Fan of Guesswork?
Our 3-minute calculator gives you a real EHR integration estimate—support and risk included. No sign-up, no fluff.
👉 Full article, checklist, contract tips, and calculator here
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