Howdy,
No, it's not off the boil, it's just that all of this is done in people's free time. I'm forwarding the discussion to the medevice list so perhaps we can get the ball rolling with more people.
I like the ideals you mentioned... having full accountability/full control, and being able to move from system to system. There are some industry standards emerging; I've linked to them here:
https://gist.github.com/bewest/4965993 with a quick demo of finding the standard "code" for glucose finger sticks. The next metrics to identify would be insulin doses. The SmartPlatform/Indivo stuff makes it fairly easy to define language-independent bindings for dealing with data, and making it available across systems. Their system is for general-use but extensible, open, and adaptable... I suppose my proposal is that we use their data model and other standards to define the diabetic-specific use cases, and we should be able to write software that is interoperable more quickly.
With insulin doses and finger sticks, we could customize/define several serializations as a baseline phr-monograph.
It sounds like you've done some excellent work on prototyping some suggestions along these lines. I'd love to see it. Feel free to fork any of the materials, change everything and submit pull requests back on github, this is an excellent way to generate meaningful discussion on these issues. I would suggest forking the databetes project and making some proposals/examples?
-bewest