There is no "ecosystem" that I can see since the data cannot be shared. Have you seen some examples where its providing value? I truly would like to know if I'm missing out on some great software.
I've helped a mid size doctor's office for over 10 years with their IT system. The only value it has for them is managing billing with insurers and scheduling patients. Everything else the system does (tracking lab reports, patient history) is either not practical for the doctors to use or they don't need it. The part about helping with insurers is a business they'd rather not be in but have no choice. The scheduling could be replaced with Google Calendar if not for the tie-in to the data already mandatory for the insurers. Overall the system is something they consider they have to use but a bit of a pain and provides no other value.
I can access my dental records online. But you're right, that's probably not a common scenario.
Since you have some experience in this field, could you imagine this situation changing in the next several years, so that there is a meaningful ecosystem?
I'm highly skeptical of the current program to subsidize purchasing EHR systems. I only see it leading to multiple vendors providing proprietary systems and frankly all the systems we've evaluated don't wow the doctors into finally believing they have a solution to the backlog of patient records they have to maintain. Sure, there's supposed to be an interoperable data format, but when I try to find how any of these vendors have made it accessible, I come up short. I don't think its in their best interest to do this. When I try to find out how to become an approved solution which qualifies for the subsidy (maybe to take an open source solution and run with it), I don't find out how you break into this magic government approved list of vendors.
If we do find a solution to the data sharing/privacy issues, its useless without a common core platform that all doctors/hospitals/insurers use. I think we need a core open source platform and have vendors provide value on top of this. I've heard good things about the VA program. Maybe this could be the start of the FOSS platform.
I've helped a mid size doctor's office for over 10 years with their IT system. The only value it has for them is managing billing with insurers and scheduling patients. Everything else the system does (tracking lab reports, patient history) is either not practical for the doctors to use or they don't need it. The part about helping with insurers is a business they'd rather not be in but have no choice. The scheduling could be replaced with Google Calendar if not for the tie-in to the data already mandatory for the insurers. Overall the system is something they consider they have to use but a bit of a pain and provides no other value.