@gwynnion The one thing I can contribute is that large hospital systems will more or less take any chance they can to break the power of doctors. As an example, when I was in marketing, my firm was doing branding & communications for a large physician's org that was trying to develop their own medical information system. The main hospital system they worked with pretended to collaborate until they had their own version finished. Very questionable legally, but the physicians org was in a corner.