While there has been much ado about interoperability, there are still no real solutions, same as last year and the year before that. The large EHR vendors who continue to dominate the market still maintain that interoperability is all but solved, still can’t connect EHRs across the continuum causing frustration by providers and a disservice to patients. The ONC pays lip service to the problem, but that is about it. It is time for the healthcare industry to consider alternatives like middleware which has been proven in other industries such as finance, retail and hospitality.