Robert Connely in the HIE blog makes some bery sound points about how the enite EHR intergration could and should work.  Note, could and should are not closely aligned at this point.

http://infosite.medicity.com/thehieblog/post/The-Practical-Reality-of-Hospital-and-EHR-Integration-Challenges-in-the-Trenches.aspx#comment

He writes, :This is not to say that the “standards and stimulus” approach isn’t a good thing – it’s just that the day-to-day problems we really deal with may not be adequately addressed by the current approach.”

I think he’s being generous to the extent of the words, “may not be adequaltely addressed.”  I can’t prove my statement, however I think that the mere fact that more than one group are working on standards is not standard.

How much more difficult will interoperability be, my guess is at least one more order of magnitude that what’s planned.

And as for interfaces?  I think Jimmy Weeks recently wrote having 400 he needed to meet.

My best – Paul