There is absolutely an incentive for healthcare systems to do these transformations. But it requires leadership that is willing and able to see the long-term be

There is absolutely an incentive for healthcare systems to do these transformations. But it requires leadership that is willing and able to see the long-term benefits. Of course, that can be challenging, and is probably only feasible in larger nonprofits (for-profits need to please shareholders, and smaller organizations simply can't afford it), but the future payoff is there. I think we're in the turd-age (opposite of golden age) of EMRs right now. Everyone has adopted them—many unwillingly—but user interfaces are still terrible, and interoperability is spotty at best. There are signs of this changing (lots of vendors are touting/promising UX improvements, and FHIR is hot right now), but it will still take time.