Tuesday, April 05, 2011

HL7 Watch Blog Has Two More Very Interesting Posts. I Suspect These Conversations Are Valuable.

The following two very interesting posts appeared over the last few days.

First we had:


Thursday, March 31, 2011

The Rise and Fall of HL7

Interfaceware is a Toronto-based HL7 solutions provider whose customers include the CDC, Cerner, GE Medical Systems, IBM, Johns Hopkins Medical, the Mayo Foundation, MD Anderson Cancer Center, Mount Sinai Hospital, Partners Healthcare Systems Inc., Philips, Quest Diagnostics Incorporated, the Veterans Administration, and Welch Allyn.

At 2.57pm EDT today, March 31, 2011, on what will surely prove to be a historic day in the advance of healthcare information technology in the direction of reason and light Eliot Muir -- the founder and CEO of Interfaceware -- posted the following comment, which I here reproduce in full:

The Rise and Fall of HL7

That might seem an unusual comment from what is supposed to be an HL7 middleware vendor. But times are changing and that is not where I see our future.

Standards do not exist in a vacuum. To be successful standards must address market needs and solve real problems so people can make or save money. Writing code costs money. Less than 0.01% of code gets written for free. The majority of code is written by people that are being paid to solve problems with it.

There are plenty of standards which are not worth the paper they are printed on because are are not sufficiently useful or practical.

Complicated standards can be pushed for a while but ultimately markets reject them. Even governments will ultimately reject complicated standards, through a democratic correction process. Although they usually waste a fair amount of other people's money along the way.

Lots more here:


The second post came a few days later:

Saturday, April 02, 2011

The Fall of the RIM

In his comment of 4/02/2011 to our "The Rise and Fall of HL7" thread, Graham Grieve argues that, in spite of all the objections advanced by Elliot Muir and in the comments above, there is value in HL7 V3 nonetheless -- because the RIM provides a 'semantic standard', and "the future of HL7 isn't about syntax or technology, it's about semantics."

Grahame and Jobst and I (and, I am sure, also Thomas) agree that there is "benefit in commonly agreed semantics". The thesis that has served as the central pillar of this blog since its inception, however, is that after 14 years of development effort, and after so many failures, we should finally accept that the RIM is not able to serve as basis for the needed commonly agreed-upon semantics.

HL7 Watch and others have provided considerable documentation that the RIM is both counter-intuitive and unnecessarily complex; that it is thus difficult to teach and difficult to document (and thus inconsistently documented); and that it is therefore difficult if not impossible to implement.

Moreover, multiple arguments have been provided to demonstrate that, even if it were implemented, the RIM would still not bring about the end which its defenders seek, namely: consistency of semantics. This is because the RIM's own semantics is so counter-intuitive, and thus so inconsistently documented, that its different users will inevitably produce semantically inconsistent implementations, thereby resurrecting the very problems which had led to the conception of the RIM in the first place.

We have learned much in the field of semantics in the 14 RIM years, and what has been learned can now be used as the basis for a better and simpler solution. It is time to start again.

Lots more here:


There are some comments following each of the blogs.

This posting is really simply to alert readers to this discussion and to see what people in this part of the world think.

Other posts on this topic have met with considerable interest so I felt it was worthwhile to provide this post.


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