For amusement value, here is my comment <http://www.theguardian.com/society/2013/sep/18/nhs-records-system-10bn#comment-27093075> on a Guardian article as to why the UK programme failed.
With respect to hardwired / hard coded access, I think you are talking about APIs or fixed messages. I potentially agree with that, and as over time we should be able to address more of that area, possibly with integrations to IHE and FHIR specifications. But I think that's a different technical job than what archetypes, templates and underlying RM were designed for - APIs are layers on top, with potentially complex logic in between.
- thomas
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