[jlamberts]

In my experience, it's a combination of a couple of things. First off, the field is heavily regulated (in the US anyway) and the penalties for violating regulations like HIPAA are incredibly high. Second, the field is currently dominated by major players such as Epic, so its pretty important to be compatible with them, but they don't really have an incentive to open up their ecosystem since they have such a stranglehold on the market. Finally, a lot of medical folks have been burned by technology in the past, and, in my experience, often view a lot of the tech they have to use as an insurance and government mandated evil, rather than a way to make their lives better.

Not to say things can't be improved, but there are a lot of factors that make it more difficult than a traditional B2B or B2C product.

[arkh]

> Finally, a lot of medical folks have been burned by technology in the past, and, in my experience, often view a lot of the tech they have to use as an insurance and government mandated evil, rather than a way to make their lives better.

Simply: those who choose the software are not those using it. So they go for recognizable names, certifications and how much money they'll get back for themselves.

[nradov]

The Epic ecosystem is actually pretty open now. They have multiple web service APIs with full documentation, and even provide a developer sandbox you can use to test client applications.

https://open.epic.com/

Epic also has an app store. You can write your own SMART on FHIR apps, then deploy them inside the EHR with full access to patient data.

https://apporchard.epic.com/

[arkh]

The full FHIR standard can be a lot at first sight https://www.hl7.org/fhir/ but I'd recommend anyone having to store names, addresses or contact information to check how they do it. The last example for names is always fun: https://www.hl7.org/fhir/datatypes-examples.html#HumanName

[MisterTea]

> First off, the field is heavily regulated (in the US anyway) and the penalties for violating regulations like HIPAA are incredibly high.

This is why heavy handed regulation is bad. The people on the end of the regulation have to deal with a ton of BS to the point where it becomes security theater. These systems need their own departments, experts, and even legal teams. The overhead is massive.You think a company is going to roll over and eat the costs without trying everything in their power to side step it? Loop holes to outright lies will be used. Anything to trim the fat.

Happened to a place I worked at. New regulations meant more overhead. During my tenure I watched the quality department grow from the side job of the head engineer to a department of three people (manager, assistant, engineer) and an outside contractor. I then watched the employee quality drop proportionately as they put more money into putting lipstick on a pig than actually fixing problems and improving quality. As long as you satisfy the auditor or customer you look like a well oiled machine. Just don't look under the rug.