Dear Bernie, The experiences that I have had the last 13 years in HL7, CEN/tc251 and ISO/tc251 indicate that many standards depend on many other standards. And many times the standard defines things on an abstract level, needing other standards to make it concrete in a particular situation. In other words things are not so simple and straightforward as the nut and the bold standard.
What you describe is a specific extreme situation. In the case of the latest European standard for the EHR produced one implementable specification for this EHR standard. In the case of HL7v2 and HL7v3 message standards it has been proven necessary that an organisation like IHE was needed to produce for a specific context one specification to be used for implementation. One of the reasons is that standards are consensus products for the general case of requirements. In particular contexts the open ends need to be closed and specified. In the near future it will become clear that in order to create semantic interoperability that flexibly can support the ever changing requirements in healthcare the standardisation processes and the process leading to an implementable specification will not be enough. In addition to the above we need databases where the most recent (and old) local context specific constraints are kept and published. Semantic interoperability in healthcare (and outside it) needs other more flexible organisations and publication methods to keep pace with developments in healthcare. The next weeks and months I will be involved in the creation of all this for Europe in the European Institute for Health Records. Greetings, Gerard On Nov 24, 2007, at 5:14 PM, 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?
