Wouldn't that require some kind of actual policing? Here (in Norway) at least, police does not use any of their time trying to access random data systems looking for personal info stored in violation with GDPR. This is not something anyone fears, so as long as you say you are OK, you are OK.
> Big companies have a real incentive to act.
The company I worked for was almost as big as they come here in Norway (handled extremely sensitive personal information also). We are full of clown tech companies here as well (just like your 'Epic Health Journals' etc.). These kind of companies cannot comply with these types of rules, they cannot even make their own systems work properly.