Most of the big EMRs do not want to have interoperability as this would not make them the only game in town at a particular hospital.
Wendell is spot on - I have seen it for 30+ years - knowledge is [sea]Power, and fiefdoms are made around controlling data and limiting & controlling it's flow.
I am confident that the vendors will be aiming for minimally meeting gov requirements while blocking the intent of the enhanced flow of data to improve patient care and outcomes.
