Complexity of Standards

Jan 16, 2012

I’m in Singapore this week, speaking at the 2011 Healthcare IT standards Conference. It’s a real pleasure to be in Singapore meeting with many people I’ve corresponded with over the years, but never met, and also exploring such a great city. In addition, I’ve had many deep and interesting discussions around how to progress either Singapore’s Healthcare system needs, or international standards (or both). Today, I spoke on sharing the experience I’ve learned over many years in my many and varied roles in HL7 and other standards contexts. Much of the content was things I have already covered in this blog, such as the 3 laws of interoperability, drive by interoperability, and requirements for interoperability, but several things were new, and I’m going to post them here.

I’ll start with this diagram that I showed. It’s a rough plot of the internal complexity of the standard (y, log) vs the complexity of content that the technique/standard describes.

Some notes to help explain this:

  • Text (bottom left) is my (0, 0) point
  • You can solve more complex problems with any of these techniques than their position on the X axis - but you have to invent more protocol on top of it. (That’s what’s XML is for!) So the position on the x axis is that innate complexity
  • The actual position of the particular items will be a comment magnet. But I think they’re generally correct in an order of magnitude kind of way
  • What the graph doesn’t show is all sorts of other quality measures, such as breadth, tooling, integrity, - there’s heaps of other criteria. This is just aboutcomplexity.

Complexity is an issue of growing importance - we know that we need to have it - the problems we are trying to solve in healthcare are complex, and we can’t make that go way. But this means that we can’t afford to choose approaches that are any more complex than they have to be - which most of the existing approaches are. I’m spending a lot of time thinking about the question of how to move to the lower right of this diagram - RFH is an answer to that, but is there more we can do?

Btw, where does Snomed CT appear on this diagram? Way off to the top and right… I can’t think of anything that would plot further up than Snomed.