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I think there are more options than malice or incompetence. My theory is difficulty.

There’s multiple countries with socialized medicine and no profit motive and it’s still not solved.

I think it’s just really complex with high negative consequences from a mistake. It takes lots of investment with good coordination to solve and there’s an “easy workaround” with pdfs that distributes liability to practitioners.



Healthcare suffers from strict regulatory requirements, underinvestment in organic IT capabilities, and huge integration challenges (system-to-system).

Layering any sort of data standard into that environment (and evolving it in a timely manner!) is nigh impossible without an external impetus forcing action (read: government payer mandate).




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