Assume that the costs associated with the purchase of EHR software are as follows:

• Purchase price: $25,000 per provider
• One time implementation fee: $10,000 per provider
• Annual maintenance fee: 18% of the purchase price applied after the first year

Estimate the ROI (%) at the end of five years for a group of 15 providers. Assume that the only monetary benefit considered is that each physician will earn $44,000 as an incentive (one time only).