It’s more than that actually. Where is actual interop? It’s been promised literally 10 years ago. It’s not that hard. People in Healthcare IT are just that bad.
The only time I’ve experience interop in healthcare is due to actual organizations merging. That’s it. This entire space is filled with incompetence. Maybe providers will actually use the tools if they work consistently. Food for thought.
It’s also strange to me that every time I go to the doctor I have to sit and fill out forms like I’m a new patient. All my insurance info, again. My entire medical history, again. Consent agreements, again. This experience hasn’t changed in decades, and I don’t understand why.
I’ve asked, why do you need all this again and the answer is usually “oh we have a new system” or “we need to know if anything changed” (but that’s not what the forms ask).
My observation has been that after filling out the form, the office skims it and enters nothing in the computer. I guess that's the "nothing changed" situation.
Patient time is worth 0 to the medical system.
Quick guess: 1. lawyers and 2. principal/agent problem (the providers don't give a crap about your wasted time and the bad data they're collecting).
FHIR was supposed to be the interopt but the end results look more like schemaless blobs of contained fields. But hey, at least I can find all the data related to a patient ID, I guess.
There's actually been significant progress towards interop in the last 10 years. HIEs (Health Information Exchanges) such as CommonWell are steadily improving and covering more patients.
Recently there's been a big push for TEFCA (Trusted Exchange Framework and Common Agreement) as the network-of-networks that federates all the different HIEs. It's been slow, but it's progressing.
As usual, the problem isn't really technological -- it's getting all these different stakeholders, with different business models, etc, to agree on how it should work.