Brick and mortar stores can compete if they offer good customer service, which companies like Best Buy clearly have not been doing. That’s why it has basically turned into a showroom for Amazon. Look at Apple, the stores have definitely helped their bottom line.
I, for one, support Amazon’s business model. Who loses from what basically amounts to a non-profit retailer? Wall Street? Clearly not, because investors don’t seem to mind paying a sky-high price (dat P/E ratio) for AMZN stock.
The HITECH act includes many initiatives to incentivize doctors to get into EMR documentation. In a year or two, that incentive will become a penalty. One way or another, hospitals are going to be forced into this. If NY state wants HIE mass adoption, they’ll have to adopt a similar policy to basically force people into it.
I wouldn’t worry about EMR vendors refusing to develop ways to integrate. If their customers demand it, they will have no choice if they want to say competitive.