Taking a fresh look at the community

May 1, 2011

A couple of private emails I’ve received suggest that my take on the Fresh Look task force is ducking the real issue, that I’m not thinking wide enough. The real issue, they say, is that

Its immensely frustrating how much fractioning (or factioning) there is in Health Informatics generally and certainly in Australia. It’s just as bad in Interoperability and yet by its very nature these are the guys who should sing off one song sheet! Interoperability has a big opportunity to unify Health Informatics and help drive the National direction forward, provided it can get people together from the lowest level (physical) up to the highest (applications).

Um, yes. Let’s go back to my first law of interoperability:

Interoperability: it’s all about the people

Yes. It’s all about the people. The whole task of interoperability is to get people to work together. So when the leaders of the interoperability community can’t actually work with each other…. then it’s the proven blind leading the probably blind. It’s a sad state of affairs that we are in.

I’m serious about this. When I first started formulating my laws, I realized that a corollary of the first law is that

If you can’t work with people (i.e. everybody), you can’t help with interoperability

It was a bit of a surprise when I first thought of that sentence. It made me wonder, because there’s a few quite strong and obvious personality clashes inside HL7, and between various healthcare interoperability communities (all right, there’s more than a few). And so I’ve worked really hard to maintain good relationships myself - because human relationships are what interoperability solutions are based on. Not being technically correct.

That needs emphasis too. A given interoperability problem can be solved multiple ways. Some solutions will be good in one way, some in another. There’s no single right solution - except for the solution that everyone will accept.

But I’ve lost count of the number of times people condemn a solution based on it’s technical merits alone. Wrong. It’s not that it doesn’t matter - but that solutions are never conceived or chosen in the absence of a community with human dynamics. Of course, very often the technical criticisms are just proxies or facades for more human dynamics. Anyone involved in the community will know what I mean there.

When I used to work in the lab (biochem lab in a teaching hospital), we used to joke that HPLC scientists are all the same: for all of them there’s “my way to do things, and all the other wrong ways”. But once I got involved in standards I met a new class of people; for them, there’s “my way to do things, and all the other ways that I am dedicated to destroying because they are wrong.”

It’d be nice if the Fresh Look taskforce could do something about this - but no, that would be self-defeating. The whole point of being able to work with people is that you can work with the people you have, without having to change them. I appeal to my co-workers in this space - work together. This is a human problem, not a game to be won.

I’m not saying it’s easy. It’s a creative journey that we’re on. And it’s one that we believe in strongly, commit our lives to. We try hard – it’s not a gravy train that we’re on. So it’s an inevitable outcome that there’s going to be sparks and fire. But we have to look beyond that.

Btw, I thank the people in HL7 and elsewhere who’ve taken me aside and explained to me when I wasn’t maintaining as good relationships with other people as I though was. It’s part of working with people - eating humble pie (even when we weren’t particularly wrong, though I have been many times).