[nradov]

Epic, Cerner, and their major competitors are actually a lot more open now and no longer putting up major roadblocks. The real roadblocks appear to be in the hospital and clinic IT departments. They have to upgrade to a current version of the EHR which supports SMART on FHIR (many organizations are several versions behind) and then enable the app store feature. Some organizations have concerns about using third-party apps due to training requirements, security, and malpractice liability.

I do think that SMART on FHIR makes it easier to turn clinicians into software developers, so hopefully that will spur some innovative apps.