I would argue that it is the crippling lack of appetite for change and innovation that stifles breakthrough technology that would create a data standard and a t

I would argue that it is the crippling lack of appetite for change and innovation that stifles breakthrough technology that would create a data standard and a thriving interoperable service ecosystem. The success of an innovative idea will attract the other members of a data ecosystem. ( Your example proves that!) So you need to have innovation first - not standardization. Standardization may follow. You were right to abandon IT as a VC --- this is an industry that is not about ROI. The only reason I do it is I can afford to subsidize it, fueled by the letters we get from patients thanking us for making their lives better, or saving them a tremendous amount of pain and suffering. The MDs at the hospitals I know don't do it for the money. Despite the outrageous prices in US healthcare, they get paid pennies on the dollar for 24X7X366 work (they take it home!) and little thanks (and lots of lawsuits). Often their own institutions don't support them. I would never recommend my child be an MD in the US, at least not for profit. (Advice a family friend and physician once told me when contemplating med school, which I took to heart.)