Based on discussion volume related to Snomed and RxNorm, it looks like these features are not much used. This is really sad since they are important for clinicians and would enhance quality of care and bring about better medical records. At the same time, based on the efforts involved and technical skils required to maintain this information upto date, for most of the practices it makes little practical sense to implement this functionality. On top of it, these add significant time and volume to daily backup.
Does oemr charter permit hosting of these services as a subscription? As non-profit, cost of this service should be inline with cost of hosting - may be AWS charges with allowance for some administration expenses. Obviously as part of the project, any clinic or vendor or those with unreliable internet connectivity can replicate the setup locally - no secret sauce. But small clinics will have something valuable for minimal expense. As a bonus for the project, demos can be setup to access this shared resource and will fully showcase project capabilities.