Yeah Roger you are right, acceptance has alot to do with it !
The reason for not developing in house is clear though. It is a specialist field, and Hospitals dont employ specialist in that field, and if they did it wouldn't be a permenant role, as that person would make more comercially, and the cost of that person would be considerable.
I mean Hospitals havent written their own operating system, havent written their own patient systems. These are all written externally then sold to the Hospital. It become too costly for an individual Hospital to do. They may have written something that sits on an SQL box, box thats about it. As soon as that person leaves, then theres no support.
I think the need is there, but you probably think I would say that. On the other hand, there are just some instances where there is no need, its just a want.
EBME is really one part of the puzzle that this technology fits into. Location based services in general fits across all the disaplines in one way or another. And having a solution that will fit most (as no solution fits all), is better than a solution that only fits one, from a cost perspective.