I think the Personally controlled Health Record (PCHR) is the key that collapses the ownership/legal/liability complexities created by the RHIO and company approach. The hub is not an RHIO but an individual's PCHR. You own your data (self evident). Host your PCHR with whomever you trust. Your doctor doesn't pass your info to others; your doctor tells you who needs to see it, and you give them access. No ownership questions; no legal/liability issues.

We must establish an efficient EDI solution so we can all confidently get on with creating applications. If HL7/CCR is acceptable to all, let's go with it. If not, consider a generic datamodel on top of which custom views can be built, and any data structure can be imported to or exported from. I suggest looking at ISO standard Topic Maps for both the generic data model concept and its EDI format, xtm. It seems so much simpler, yet more flexible than HL7/CCR.