Hi,

> Both initiatives feel like "let's try and boil the ocean"
> strategies...perhaps I'm getting too old too.

Nice metaphor!

The fundamental problem with most "universal solutions" is the belief that
some universal recipe exist, and that everybody will buy into it as soon as
it is presented due to its inherent beauty and perfectness. This in turn is
based on the nearly "religious" belief that we live in a world where all
citizens/organisations/companies basically have the same objective interests
and where everything and everybody somehow have its/their pre-ordained place
in the scheme of things, if we could only figure out the scheme (the
"Genesis option", one might say).

The approach described by David - to move towards a more integrated Health
Infostructure by linking up independent entities (hospitals, existing
networks) using open standards - is completely different and quite similar
to the "chaotic" but successful evolution of the Internet. It's chances of
success is far higher than those other quests for "universal solutions"
(call it the "Darwinist option", if you prefer - you join slugs and whether
the outcome in the end are humans or slugs nobody knows).

If I might draw a parallel that should be well known to most of you:
The US has spent at least half a trillion 2002 dollars per year for 60 years
on the Army, Navy, Air Force, CIA, NSA, FBI, FDA, etc - and every single of
those organisations have presumably a strictly hierarchical and disciplined
power structure with the Command-in-Chief on top. But have they been able to
co-ordinate their informations systems?

Best regards
Calle

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Calle Hedberg
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