I work in the health system doing middle-ware and/or integration. Primarily working in Cloverleaf and Momentum. We use vb.net, asp.net, and tcl for the majority of the work. We use all the standard methods for transferring the data. We write web apps, desktop apps, system scripts, and are starting mobile apps.
I do freelance on the side as I have time. I have my own web server and host several sites for friends. At home I mainly code in php.