What if, instead of having to reach out to the big players, the economics of having a software developer or 2 on staff make it such that you could build custom-tailored, bespoke software to work "with" your company and not against?

Because the hospitals those practices want to associate with say "we're on Epic and expect you to be as well"?

Wife in healthcare management...overhear this conversation once or twice a week.

Also the nurses in the floor learn the system and many are not great at adapting to different interfaces. Travel nurses who come in and only worked with GE or Cerner and now having to use Epic causes all kinds of issues.

Also from what I’ve seen is big city hospitals use a mix of all three. Which I believe actually creates an opening as it shows a willingness to use different walled gardens.

However I think there are a lot of opportunities to just build on top of these systems rather than wholesale replace. Because they’re one size fits all and the people who work on them haven’t a single designer bone in their body the interfaces are terribly clunky and slow. Macros exist but seemingly no one is aware of them. It’s rife to build better interfaces tied into macros behind the scenes.