[phren0logy]

Maybe we need a coalition of second-tier EMRs to band together and commit to supporting an API and a group to keep it open and updated? I agree that the current approach isn't really working, and doing more of the same is probably not going to help.

[wittyreference]

The problem, from my perspective, is that we're fighting the battle on two fronts: I need to get all my data from my old EMR into my new EMR, and I need my new EMR to slot in where my old EMR was with respect to feeding data to my data warehouse. Part of the difficulty there is the API, and part of it is that a bunch of shit is done as a black box in-EMR (e.g., my EMR will feed my warehouse some financial data, but my vendor is opaque as to how it's calculated).

It's gotten to the point where I don't want a legal requirement to be HLX compatible: I want a legal requirement separating back-end data from front-end UI, so that we can shop for each of those independently. Once all the front-end shops (which are more valuable than back-end - as a healthcare org, I care about documentation and billing and error prevention) can't lock you in via data, I imagine there will be a fucking quick race to be the universally compatible back-end. And the back-end is ultimately the stuff that affects patients (portability of records) and loosen the bindings on provider organizations (because... portability of records).

Which of course is why even things like HLX didn't really start working until major orgs like CMS and NYS Medicaid came along and said "you will find a way to be compatible with HLX voluntarily, or you will do it via regulation. One way or another it's going to happen within the next 12 months." (I was at a major conference where that was laid out pretty much that explicitly. It was wonderful.)