honestly: activity pub, matrix, xmpp, markdown and soo many more probably. All of these would be able to solve our walled gardens problem, but the apps with a basically monopoly don't have much of an incentivw to implement them
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FHIR instead of all legacy standards. Also ISO IDMP to make referencing medicines way easier.
There are a bunch of message broker services out there, and having a consistent set of common keys along with a documented process for transforming events to/from different systems means that this kind of data can move through different systems without getting mangled. It does have a spec for JSON, so it can be considered just a standardized JSON blob with transformation rules. But it also has a protobuf spec, specs for MQTT, NATS, HTTP, Avro, etc. It’s a common language for all these systems.