[aaavl2821]

Unfortunately, from my experience the biggest barriers to sharing data are very deeply embedded incentives.

I was at a talk recently by an executive in charge of managing data for a massive health system. Think tens of millions of patients. He said they dont share data because if people learn their real quality metrics it would give payers, the public, anyone with an interest that isnt aligned w the hospital system ammunition against them. Have heard this sentiment echoed by many. Open data is their enemy because then patients could choose based on outcomes, not on market power or how nice the lobbies are

The EMRs designed a closed garden into their systems DNA. If data is shared freely then it's easy to switch systems, and they will have to compete based on cost and quality and couldn't charge hundreds of millions for installations and maintenance contracts

Call me cynical but this is all based on conversations with people well placed in the industry