Thanks for your response! Most of my knowledge isn't personal experience, it's from speaking with other people and I will admit it isn't super comprehensive. I

Thanks for your response! Most of my knowledge isn't personal experience, it's from speaking with other people and I will admit it isn't super comprehensive. I know that there is a distinction to be made from EMRs and EHRs right? (I thought EMR was the electronic version of the old paper medical record, while EHR was designed to create a more longitudinal view of the patient's care). Yes I did know that though two hospitals with EPIC's system will still face interoperability issues due to varying data dictionaries, but I didn't consider the difficulty in updating features, etc. I agree and recognize that the incumbents are not pushing to make major changes (after all, they don't have strong incentive to, right?). But I did notice companies like RedoxEngine which provide a layer of abstraction to address interoperability issues for health tech startups. And also projects like this which are moving to slowly consolidate rather than silo data: http://hospital-zsfg.medicine.ucsf.edu/research/homerun.html http://hospital-zsfg.medicine.ucsf.edu/research/homerun.html Anyway I will dig more into it to inform myself -- appreciate your response.