> before deciding that I can build something better
It's very likely that something better already exists. The reason you use something terrible is because "better" does not result in adoption. Personal relationships, salespeople, and marketers drive adoption, not the quality of the actual product.
Right, but if I have control over my practice, I also control what EHR I use. No idea if I'll end up in private practice, but there's always that possibility.
That's not how meaningful use works. You can use paper for all you care, you're just going to take a hit financially from the government (and many do). You can use whatever electronic system you want as long as it all adds up to meaningful use. The insurance companies have nothing to do with this.
I would still implore you not to write your own EHR unless you are a tried-and-true data-security expert.
If you aren't positive that you are one or you haven't had this tested in the real world, then you aren't one.
It's not fair to patients to play fast and loose with their data, nor is it at all easy to develop and design usable software. It's not something you could do in your spare time while also working as a doctor. You'd most likely need to start a company and put together a team.
It's very likely that something better already exists. The reason you use something terrible is because "better" does not result in adoption. Personal relationships, salespeople, and marketers drive adoption, not the quality of the actual product.