A few months ago I posted on what makes a standard or set of standards in e-health investible. The headline requirements I can summarise as follows:
- platform-based: the standards must work together in a single coherent technical ecosystem, based on common information models, knowledge definitions, and interfaces;
- semantic scalability: there must be a sustainable way of dealing with both the massive domain diversity and change, and the massive local variability;
- implementability: is the standards ecosystem available in a developer-friendly form?
- utility: does the standards ecosystem actually bring real value?
- responsive governance: does the ecosystem, and its constituent standards have a maintenance pathway?
In the above, I use the word ‘standard’ to mean anything that is in wide use, as per this post.
In the above, #1, and #3-5 are about technical and management issues. They need to be well understood and carefully addressed. But they can be solved. Most importantly, they are of ‘constant size’, more or less, if we agree that the relentless churn in software platforms essentially produces the same thing every time, solved in slightly different ways.
It is #2 that really matters – the question of semantic scalability. This is the one characteristic that directly reflects the domain subject matter itself: biomedical knowledge, clinical information, workflow, practices and processes.
