* Lack of standard, OPEN, free to implement formats; for everything.
* That are required as a native format for all vendors considered for selection.
* Ironically, HIPPA, which correctly makes collecting data a liability.
However this also makes releasing that data to patients difficult.
It makes patients authorizing the release to other entities even more difficult.
It contributes to making critical data during emergency situations difficult to locate.
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Some kind of standard civil contract singing PKI might be a technical solution, but
That's beyond the scope of healthcare solutions, it's a national ID / notary issue
* Lack of a central registry to at least annotate where patient records exist and can be located.
* A multitude of private healthcare cost management organizations (HMOs)**
* Artificially constrained supply in non-emergency contexts
* No shopping at all during emergency contexts (nor should there be)
(HMOs) which seem mostly to focus on for-profit results rather than actually improving quality of care, patient outcomes or actual medical costs; at least in most cases.
