It would be interesting to see a sensitivity analysis of how much this matters. Gut feeling, if you know where you are up to a few you should be able to initialize a PIM with a gravity vector that's essentially correct. For long-term missions, this can gradually
change over time.
If you have zero idea where you are at the beginning, so no GPS measurements. That's a different case.
As for supporting cartesian ECEF coordinates, I think only the PIM needs to be changed, if it cannot already do this.
Frank