The hospitals in San Diego all still share on paper. Technology is not the problem here, it has to do more with incentives, for one why would 2 competing hospitals want to share, and I say this from a business standpoint only, as reflected in the article. The next question is who funds the middleware software to make this possible.
Hospitals with budget constraints can’t afford to help finance for the physicians on staff as well. It comes back to who’s going to pay the bill once more. Personal health 
records maintained by patients can help, but it should not be the ultimate answer by any means, and there are still a number of practices that are not even aware of what a PHR is, so that further complicates matters. So as it stands now, the interoperability question still has one major issue and that is money. BD
“It's been about three years since San Diego's five major hospitals first convened to discuss sharing electronic medical record data in an effort to improve diagnoses, reduce errors and improve the quality of patient care. The group held several meetings and entered discussions with a vendor as a possible corporate sponsor -- and that was that. "It really didn't go anywhere," says Dr. Joshua Lee, medical director of information services at the University of California, San Diego, Medical Center, one of the participants in the EMR discussion”
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