"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?"

Isn't this what the AAFP looked at about 10 yrs ago and gave up???

Me thinks the only option will be that somewhere in the future Unc Sam says "...here is the source code/data base/exchange format that will need to be used for all electronic medical records here in the U.S.of A, you can make your EMR look as pretty as you want as long as it fits the database/exchange format.

Leaving it up to private enterprise doesn't seem like it will happen without a large price tag applied to the end user to pay for multiple interfaces.