Ewan Davis, who knows of these things, doesn’t say in his good posting that one of the problems or reasons for deprecating the development of a single record is that it is too hard for us.
It would be A Very Big Program, and we are not good at that, and Have Many Complicated Bits and we are not good at that either.
Whereas the (Unix) approach of many small programs doing small things and doing them well, with simple rules to connect them like the Internet has prospered on seems to be within our capacity.
Naturally this is less attractive to potential buyers of One Big System or potential winners of the fight to sell One Big System, or to Knowers of the One True Way who want to regulate doctors and other healthcare workers by using the computer to program people, than it is to the minority of doctors and others who have a problem they can see a solution to, and know how to program it or know someone who does.
Bring on the bazaar.