@TheCedarPrince (or is the right address “Your Highness”? )
Good question. Conceptionally, the models are similar. They both are closed-world systems (fully normalized with all possible values predefined and absence of negative values, except in lab tests), which allows to calculate rates of things buy dividing the number of records meeting some set of criteria by the number of all records they are taken from (the entire database, or another, wider population also defined by inclusion criteria).
Obviously, I believe OMOP is the much cleaner, expandable and computationally more favorable solution, but still, both function in similar ways.
The problem is that despite the same principles, they are too different in their detail. No table and field name or definition matches, and the use of predefined codes or concepts to carry the content are different. Which means, all inclusion criteria for cohort definitions and all methods are rendered incompatible.
The FDA, NLM, NCI, NCATS and ONC put together the CDM Harmonization project to create a way to overcome that hurdle, either by harmonizing the data or harmonizing the queries. It made some progress on a small set of use cases. But the future and prospects of such an endeavor remains unclear.