[throwaway894345]

I work in the medical research space and we have to integrate with EMR systems to get our data. I don't think software is the root problem, but rather the root problem is "there aren't incentives for good CMSes"--namely, there's no incentive for systems that talk to each other because healthcare consumers don't think about this when choosing a hospital and hospitals don't have any incentive to make it easier for their customers to leave their system (and EMS vendors certainly don't have that incentive). Ultimately the question is "why do we believe EMSes are valuable, but no one can figure out how to make money from making them better?".

[cryptochamorro]

I used to work in Bioinformatics. Getting Epic and Cerner to flow into our i2b2 or REDCap was a mess. Epic was a real disappointment in terms of their willingness to implement simple features that would have truly helped researchers analyze more specific outcomes. But I guess you gotta make money some how.

[marcinzm]

Hospitals are liable for data breaches and leaks, they have a direct incentive in making data as hard to access as possible.

[FireBeyond]

Eh, as someone who deals with EPIC, ESO, and a few others... that's not the real motivation.

Epic will _happily_ interconnect with other systems for data sharing.

I mean Epic will happily _sell_ you interconnects with other systems, and will generally bill you on top a per patient, per export fee.