Stream: social
Topic: History of standards
Brendan Keeler (Mar 13 2019 at 21:30):
Given the nature of this chat (and the fact that many here are mentioned in it), I thought I'd pass along something I wrote regarding healthcare standards history: https://www.redoxengine.com/whitepaper/brief-opinionated-history-of-healthcare-standards/
Brendan Keeler (Mar 13 2019 at 21:31):
Hopefully a fun take on our generally academic area of work.
Brendan Keeler (Mar 13 2019 at 21:32):
Appreciate any feedback (especially if you catch any errors)
Abbie Watson (Mar 15 2019 at 16:34):
Given the nature of this chat (and the fact that many here are mentioned in it), I thought I'd pass along something I wrote regarding healthcare standards history: https://www.redoxengine.com/whitepaper/brief-opinionated-history-of-healthcare-standards/
Great writeup. Get's all the important milestones, and I learned a few things myself.
$0.02 of feedback might be to scope the title to "History of Healthcare IT Standards" or "History of Healthcare Computing Standards". I say that having written a similar article for a Clinical Informatics board review book. From a clinician perspective, healthcare standards go back to the 1600s with things like the Bills of Mortality and the International Classification of Diseases. So a lot of the modern-day value sets... ICD10, LOINC, SNOMED, RxNorm, etc... they can trace their lineage and provenance back a few hundred years. Whereas the focus of your article is obviously on the computational and telecommunication aspects.
Brendan Keeler (Mar 15 2019 at 22:04):
That's a really good point. I definitely didn't get into standards for diagnostic encoding or classification, but indeed those are healthcare standards. Thanks!
René Spronk (Mar 17 2019 at 16:21):
@Brendan Keeler A nice opinionated bit of history..
The document is very US-centric, which is fine, but please explicitly state this in your introduction, to avoid misleading any non-US readers. History doesn't have a geographic center, it's all over the map. CEN (European) standards had a major impact on the thinking behind HL7 v3 and CDA, on the use of EDIFACT in healthcare before v2 hit the European shores in '92, and OpenEHR/13606 (notably missing from your overview, but then again not generally seen as important in the US) has had, and still has, a significant impact on standards like v3, CDA and FHIR.
The history probably starts a bit earlier than your document, even if we only focus on 'interoperability standards'. The very initial scenario was the communication between lab devices and a lab (mini/mainframe) computer (RS232, based on proprietary formats), and we shouldn't forget about the data formats used for archival on magnetic tapes. Many a format can be traced back to precursor tape formats, and tapes were send by snail mail, so there certainly was an interoperability aspect as well, going back to the early 60s.
On v3: not just the Netherlands: the UK, Canada, Finland and the Netherlands all heavily invested in v3, as did the US (e.g. with SPL being [an still is, AFAIK] a v3-based mandated format). See http://www.ringholm.com/docs/04500_en_History_of_the_HL7_RIM.htm for a v3 history.
In my bit of history I didn't go into NCPDP and X12 (or CCR / C-CDA), these being US specific (and me being oriented on the European market, which has plenty of country specific weird standards of its own, thank you very much). And where's IEEE 11073, and Continua (now: PCHA) ? I know, it's all a bunch of interrelated standards that have influenced each other, so any attempt to describe them in a linear fashion is probably bound to fail anyway... but we try.
Brendan Keeler (Mar 17 2019 at 17:33):
Haha, I was hoping you'd read this and give this sort of feedback, Rene.
Yes, my time machine strangely did not function across the Atlantic. :wink: (Although I did give a brief shout out to the Netherlands for their usage of HL7v3. Nictiz does indeed love their HL7v3).
That was not intended to ignore or underrate the contributions of other domains and communities internationally. It was more intended to limit scope, as writing the narrative for just the US was already daunting enough. I'll look to revise this to make that clear.
And perhaps I can look into an addendum or second volume in the future to elaborate on everything you mention and more. You've definitely given me some new content to read up on.
Last updated: Apr 12 2022 at 19:14 UTC
