Healthcare has long been a technology paradox. There have been few places further out on the cutting edge of technology than biotech and medical devices. In contrast, healthIT has been in a time warp. Nearly 20 years after the advent of the web, the dominant healthIT vendors have thrived on a business model and technology architecture that harkens back to when Wang and Prodigy were cutting edge. That is, most healthIT still has the same company provide technology from the top to the bottom of the stack.