If you look at the healthcare space, you will realize interoperability only exists because it was mandated by government programs that the patient owns their data and must be provided timely access to all of that data; and also defines specifies the format of that data (open source definitions).
You might also define "exists" in some sort of way that makes sense. And you can also realize that payers are encroaching on every aspect of interoperability data exchange.
It was mandated because, in some cases, getting data from the patient is actually harmful. A CT scan is not benign. So to ensure that CT scans from manufacturer A could be read on a review station of manufacturer B, the DICOM standard was created.
But there is a real health element to it. Although I perfectly agree that standards are good for the consumer, the incentives here are not as strong.
There are also similarly a lot of controls mandated on who they cannot give the data to. It isn't like health records are an open free for all.
I know nothing about IT project management for healthcare, but just the other day over here in the local news there was a mention that the all-singing-all-dancing healthcare application that the region (with ~1M inhabitants) has been spending years and around 800 million euros to get into production has been so poorly received that they're considering starting over from scratch. I'm so happy seeing my tax money well spent...
This is an implementation of something called MUMPS, which is apparently some US system that is very arcane but widely used.
Again, I'm not an expert on this topic, but it indeed seems like standards, API's, file formats and whatnot would be keys to a system where decoupled components can be evolved step-by-step over time instead of the current system which seems to be a humongous monolith.
Which sounds crazy to me considering how much involvement the US has with FHIR.
http://hl7.org/fhir/
Even if you don't care about this stuff, FHIR is definitely worth investigating.