because there's no clear signal (in the private sector there's some drive for sales, market share, profit), only made-up hyperpoliticized bullshit requirements and maybe some barely coherent vision.

as long as there's not a clear technocratic organization with sufficient independence and competence these projects are rudderless yellow duckies on the sea of tragisocial medicine mismanagement madness.

no party involved really has enough resources to deliver something nice. it's like high speed rail in the UK or the US. as a public project it's already stillborn, because it's too expensive to do it right (or if it would get the right amount of funding it immediately attracts unlimited scope creep, and the usual vultures show up, it becomes a typical everything bagel project, solve EMR but also education and childcare and whatnot), and to do it efficiently it would require draconian standardization and heroic amount of data migration work.

and on top it gets over promised and under staffed and so on