If you havenât spent much time analyzing the costs of EHRs, this part of the process may be an eye opener. Why should one consider the hidden costs of EHRs? EHR costs are much more than just the initial purchase, implementation and maintenance fees. If a budget misses the hidden costs, an implementation could fail, degrade over time and worst-case scenario â bankrupt an organization. To help sort out these expenses, several broad cost categories should be considered: Initial, Repeat, Future and Special Project costs.