Nah, nobody wants the liability now, and maintainability is too much of an issue for custom solutions. Everyone wants a company that they can still trust to be there in 10 years’ time to do this stuff, and that’s honestly kind of fair.
You meet very few people that get their hands dirty with HL7 these days - not to be disrespectful, because I doubt our ages are that far apart, but most of the people still actively writing HL7 are older dudes from, well, the time you’re talking about - before everything got subsumed by bigger companies and consulting firms and so on.
Honestly, though, it’s weird that we have our own custom healthcare markup language. Why the fuck we don’t move to a standardized format like an XML is beyond me, and it would make it infinitely cheaper to maintain and much more extensible.
