Clean data is hard, especially with such fragmentation, but there is progress! My company supports CCD/HL7 with as many other vendors as will work with us, but

Clean data is hard, especially with such fragmentation, but there is progress! My company supports CCD/HL7 with as many other vendors as will work with us, but you're right in that the loose specifications make it very hard. I just worked on a project to import 1M+ patient records and we spent a long time verifying that we weren't just getting junk. "This field says it's an ICD-9 code, but I just see a string description..." We also have a restful API that has a lot more traction with startups (honestly because it makes more sense). There is still so much legacy thinking around "documents" that we are more often trying to step back and think "is there a better paradigm we should be pushing here?".