Hi Evan,
After using Meds for a few years now, I can say that they are pretty damned rock solid devices.
So yes, once set up correctly, they just work!
Format compatibility is excellent, and playback utterly flawless as long as you have your network set up properly.
I tried all sorts of players before settling for the Med - I tried Popcornhour, Netgear EVA, Media PCs - I even had the Kaleidescape rep demo their kit.
Nothing comes close and if you skin it nice and subtly, it's a great bit of kit for CI.
So yes, I'm perfectly happy with them, and they play nicely with Crestron.
The only caveat I'll put on it for CI is that <discreet off> is really a <standby> where the LAN card (and several other parts of the board!) stay active, so it can respond to TCP commands.
If you turn off with the remote or front buttons, the thing is then deaf to the LAN.
Two ways around this in an install would be either to have an IR backup <on> command in your program somewhere which is not ideal as it needs an eye or blaster sticking somewhere, or just make sure the customer can switch on at the front panel.
In reality, barring power cuts or finger trouble, it's never an issue.
I'm not sure if Apsolute's App has 3rd party control enabled or not and if so what the URL is - worth sending him a message to find out.
My sincere advice is to buy a Med immediately and start playing!
Attached is the Crestron IR driver in case you need it..
Mark