Move interops up to a platform - new HIE
If doctors like their EHR then the answer is to take interops up a level to a platform that sits on any EMr system and then all the vendor has to do is write an API to connect. I have been reading about the C-CDA interops issues with import/export and the cross walk issues with importing as it seems most can create a document but importing it due to the XHTML templates is the issue with all fields mathing properly. That's a standards issuee and most outside the industry don't understand the complexities of mapping beyond discreet data.
So here's a platform that is a new HIE design, with no data warehousing required as link is live as long as you need it, and cuts off when done collaborating with medical records and can save billions versus having a bit new huge HIE warehouse of synchronizing patient medical records. Legacy EHRs, EMRs, ok, just write the API and and you can write all kinds of other apps on it as well, such as adding population health if desired.
So again if this level of interoperability is correctly entertained, it solves a lot of problems and can save money and granted there are some real old EMRs that doctors may want to replace just due to the advances in technology too but this certainly with using a platform on top is a big breath of relief for many of the smaller and medium size EMRs as it could have those communiting with the big ones with use of APIs as that's a real big threat right now with the big EMR vendors of course wanting more market share and having doctors/hospitals spend more money they may not have.
So far the design here has a 3-6 year proposed ONC timeline as well.