Added language to note that other considerations, such as administrative burden, workflow integration, privacy, etc. may be equally important to implementers.

Existing Wording:

As a rule, use of less re-useable and/or less adopted communication mechanisms will require more negotiation to achieve interoperability, and therefore the costs associated with the solution are likely to be greater. That does not mean that architectural circumstances will not make these approaches necessary (and justify the increased cost), merely that if there is a choice between equally viable architectural alternatives, preference should generally be given to the one with lowest overall long-term cost.

Proposed Wording:

Of course, additional considerations such as administrative burden, workflow integration, and patient privacy may be of equal importance to implementers.