This is how I see it as well. Realistically, various vendors implement only some pieces of larger, more comprehensive systems - like compay A makes nuts and company B makes bolts, but the standard for nuts + bolts must either be one standard or 2 totally compatible standards. Any given implementation in e-Health is likely to be responsible for just a few things out of the universe, e.g. some kinds of messages, patients, who knows what. Bigger vendors may implement a substantial amount, but I don't expect any single implementation will be the one stop shop - because no implementation can satisfy all business needs, even if it completely satisfies the standards.
On the other hand, if you take an interoperability component, like the openEHR kernel, or some message parser or whatever, is there any sense in having more than one good, free, and open implementation in each of the major technologies, i.e. .Net, Java, Python...(add your favourite)? I think the more related to interoperability the component is, and the more widely it is needed, the less argument there is for multiple implementations, since they don't serve any purpose. Good quality can be achieved by an engineering-based open source approach like Eclipse does; once you have an open component, then all other requirements can be engineered into it, rather than companies inventing their own varieties. For components not needing to be directly interoperable, e.g. an enterprise EHR server (most of the software is about data storage and local serving), and also satisfying varied business needs, competition is more appropriate. I am coming to the view that open source projects for full domain specific systems like EHR, etc do not make sense - all they do is try to replicate commercial systems for a given business context - this is ok for small systems, but for fully scalable EHR, knowledge services, etc I don't see it. Reusable components seemn to me to be the the more sensible purview of open source in a specialised domain. (Things like Apache are different - they are not domain specific and the business context is pretty much the same everywhere.) - thomas beale b.cohen wrote: > No. A good standard should ensure that all implementations that satisfy it are > mutually interoperable (see, for example, the Whitworth stanard for nuts and > bolts!). This requires that: > 1. the standard include the the tests that supposdly conformant implementation > must pass; > 2. that test be necessary and sufficent to guarantee compliance; and > 3. Proven compliance to the standard be necessary and sufficient to guarantee > interoperability. > One way to do this is to for the standard to overdetermine implementation to > such an extent that exactly one implementation satisfy it. This is how 'de > facto standards' work. > But I was of the impression that that was not the intention of the > international > health care community. Am I wrong? > > Quoting Williamtfgoossen at cs.com: > > >> In een bericht met de datum 24-11-2007 8:30:05 West-Europa (standaardtijd), >> schrijft stef at vivici.nl: >> >> >> >>> Op 24-nov-2007, om 7:45 heeft <A >>> >> HREF="mailto:Williamtfgoossen at cs.com">Williamtfgoossen at cs.com</A> het >> volgende >> >>> geschreven: >>> >>> >>> Can you, in this light explain what Barry Smith is talking about in his >>> HL7-watch blog (<A >>> >> HREF="http://hl7-watch.blogspot.com/";>http://hl7-watch.blogspot.com</A>/, the >> text is also underneath). >> >>> Probably I don't understand it correctly, so if you could enlighten me that >>> would be very helpful. >>> >>> >>> I think that we all agree that a good standard should have only one >>> implementation >>> >>> >>> >>> >>> >>> >>> Cheers, >>> >>> >>> Stef >>> >>> >> Hi Stef, >> >> Yes, here you have a point! >> >> >> Sincerely yours, >> >> dr. William TF Goossen >> director >> Results 4 Care b.v. >> De Stinse 15 >> 3823 VM Amersfoort >> email: Results4Care at cs.com >> phone + 31654614458 >> fax +3133 2570169 >> Dutch Chamber of Commerce number: 32121206 </HTML> >> >> > > > -- please change your address book entry for me to Thomas.Beale at OceanInformatics.com *Thomas Beale* /Chief Technology Officer/ Ocean Informatics <http://www.oceaninformatics.com/> Chair Architectural Review Board, /open/EHR Foundation <http://www.openehr.org/> Honorary Research Fellow, University College London <http://www.chime.ucl.ac.uk/> * *
