Having seen this world up close, the absolute last place you ever want your medical data to be is on the Windows Server in the closet of your local doctors office. The public cloud account of a Silicon Valley type company that hires reasonably competent people is Fort Knox by comparison.
Yeah but the a local private practice is a fairly small target. No one is going to break into my house just to steal my medical records, for example.
This could also be drastically improved by the government spearheading a FOSS project for medical data management (archival, backup, etc). A single offering from the US federal government would have a massive return on investment in terms of impact per dollar spent.
Maybe the DOGE staff could finally be put to good use.