On Wed, 07 Jan 2004 20:48, Thomas Beale wrote:
> I wouldn't know for most of these but it seems reasonable. My only
> comment is that this classification is fine for a sort of maturity index
> of software; things like openEHR have a lot of work in the specification
> space, shared (pioneered) by OMG HDTF, CEN 13606, HL7 and others, which

You know that I am all for standards, and you are certainly right in many 
ways.
However, the sad reality is that standards in our domain don't work. Very sad.

But in a world where you can't even get the some rogue but very influential 
countries to agree to most sensible standards with straightforward benefits 
such as adherence to the metric system, what hope is there for health care 
standards?

Corbamed is sensible and fairly complete in the sense that you can implement 
it here and now and do something useful with it. I know OpenEMED has 
implemented some, but honestly: hands up how many world wide installations 
are there of any Corbamed system? So much for Corbamed as a standard.

And HL7? It is still a sad joke. Despite it's (probably entirely unnecessary) 
complexity it still doesnn't fulfill any expectations.  I haven't seen yet 
any two not-inhouse systems that can talk to each other HL7 without need for 
a home baken translation level. And even then things can go wrong (see the 
pathology download tragical comedy in Australia).

And CEN standards? I'd love to see them work in our domain, but please point 
me to any significant installations using them.

Standards that work nowadays and make everybodies life easier have arisen out 
of somebody actually "doing something", and the process of becoming a 
de-facto standard has been helped by either sheer commercial market 
domination or complete openness. Complex domain specific "standards" 
developed on the white board and then imposed onto humanity have not often 
worked well AFAIK.

So, once again: I love standards. I wish standards to penetrate our domain 
thoroughly. But for standards to have any impact on evaluation of actually 
existing projects they would need to be more meaningful than what we have, 
and they definitely would need more acceptance than they currently have.

Horst

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