A friend shared this interview with me. Worth the read.

Some thoughts…

• Keith (BTW, I have never met him) has a unique perspective having spent time on the vendor side, then the provider side, and is now also involved in policy. I think his points are spot on.
• I believe that some of the EMR monolith disruption will come from HIE vendors. They are slowly taking more parts of the EMR, and generally have newer architectures than most EMR systems. This will allow them to adapt to new standard APIs and protocols, such as those being defined in HL7 FHIR. They are also more open—they have to believe in openness, because without data sharing, they have no business.
• HIE vendors also typically have some form of clinical data repository, which can act as the data warehouse that Keith mentions. Adding moderns APIs to these can open the door to information freedom (without compromising security and privacy, BTW), without waiting for EMR vendors to do it.
• I like the analogy to the transformation that the travel industry went through. I make this comparison often. I also look at how banking and telecommunications have transformed themselves to provide new and improved services. The lessons for healthcare are all out there—we just need the leadership.