I was a database admin for an EHR reseller/host for several years.
The expectations put forth in this article crack me up. In order for information to interchange, it needs a source, a destination, and a schema to interpret the information. However, this is privileged information intended to be treated as secure. So, that puts validation constraints on your source and destination. Then, each source and each destination has to agree to use the same transmission schema. In an industry where there are dozens of EHR software suites, each of which will sue the others for using the same database relationship diagram in their proprietary product.
When we set up secure tunnels, data was sent using HL7, which is an XML formatted data string with only a limited subset of the total information input by the provider in their EHR app.
The particular EHR app we supported initially allowed practices to highly customize their templates (the UI in front of them). But, as the database backend evolved, this became horrifically unsupportable in the long run and standardized templates were enforced to facilitate interchange like HL7.
All in all, I left the industry because I could see it spiraling into a technocratic greek tragedy. Doctors are better off dictating into a recorder and handing that off to a documentation specialist. As a patient, I find that it demeans a doctor to have him spend more time making eye contact with a computer screen than with me. I see him as a cause/effect ICD/CPT technician rather than an investigator into what might ail me.
The money spent on compliance enforcement, documentation, training, software licensing and hardware to run the application was not coming from thin air. It was coming from the up-spiraling fee schedules each insurance company agreed to pay for each procedure. This would ultimately come from increased premiums for the patient/employee/whatever.
Note that health insurance is far less pervasive in dental medicine and veterinary medicine. Look how much time your dentist (rather than the hygienist) spends on paperwork. Look at how much dental surgeries cost compared to general surgery. Look at how much pet surgery costs compared to human. Look at how much screen-typing your vet does, versus probing of your animal or other investigation and building of trust.