Cableops here has Mirth running as a Vmware appliance. See his website http://www.smartlinkemr.com/ I'm going to test out the appliance and see if I no longer need to keep developing Synapse's HL7 interface capabilities.
Hmmmm ... excellent idea to check it out. Synapse's HL7 has been working well but nothing wrong with outsourcing when it's beneficial.