Thanks to all for the input; I was hoping we could get a useful conversation like this started on this topic. The overall issue is inter-connectivity which we want for various reasons and in different ways. One of the drivers is certainly MU; as we have already seen, those MU dollars are a powerful force in the world of EMR development.
For now, though, I am thinking of something more basic to our practice, namely communication with other providers. State health information exchanges have a role here, as David points out. It will be great if we can easily access discharge summaries, medication lists, and maybe even consults, labs, and radiology reports from all of the surrounding hospitals on our patients. HIE's may enable us to do that.
On a day to day basis, what we all deal with to varying degrees is doctor-to-doctor communication, and I am speculating about how that can be facilitated. So if Jimmie wants to send me a patient, it would be helpful to both of us (and ultimately the patient) if he can efficiently send me everything from a consult request ("I am concerned about this guy's dropping hematocrit; can you see him quickly"); to demographics to pertinent notes, labs, and work-up. It would be equally helpful for me to be able to easily transmit my findings back to Jimmie.
Updox is great, if we both happen to have it. Unfortunately, just as with AC, Updox users are a tiny minority of the universe of providers, and will likely remain so.
A much more common scenario, and one that will probably only increase in frequency, is communication between an AC user (us) and a specialist or primary care provider who is employed by a hospital. In that case, the other party will be using one of the "big" EMR's. In addition, if you send your patient to the hospital for labs or imaging, or if the patient is hospitalized, then all of your information will be coming from that EMR. How does that information all go back and forth? In the past it was mailed; now some of it is faxed. To my mind, ideally, it would travel via an interface.
So facing a reality where 1% of the providers use AC and perhaps 75% use one of a handful of EMR's, wouldn't it make sense for us to take the initiative and try to get interfaces established between AC and Epic, AC and Allscripts, etc?
