My worry is that any dominant EMR (and at this point Epic is approaching that status) can ultimately force out the little guys because we cannot communicate with them.
I'm uncertain of what the future EHR landscape looks like. But I've still got some thoughts about it.
In the long-term, the inability for direct communication between market-dominating EHRs and other EHRs might become a serious problem for the little guys; but this problem could be mitigated by having robust Health Information Exchanges.