[webjprgm]

It may not be deliberate attempt to lock customers in, but just the first part of what you said: there is no incentive to make this any easier. It basically works, so hospitals/clinics that need to make a few simple customizations can do so with REST API calls but it isn't easy enough for third-parties to quickly and easily build large applications. There's so much going on in healthcare that it is hard for big vendors to justify cleaning up their web services over doing other things. Especially when the "interoperability" buzz fits in better with supporting FHIR, CommonWell, Healtheway, HL7, etc.