Introduction to Informatics Standards by Virginia Lorenzi

The lecture was about health informatics standards, how they are developed, how they are adopted, and the challenges involved. Story about the Great Baltimore Fire of 1904[1]. Standards are about increasing the utility of something by enhancing how it is reused, compared, and shared. Healthcare needs standards too and enacting standards here improves it. A key word here is "interop": it is ultimately about semantic harmonization. Two different systems come to the same conclusion with the same data (Dr. Weng @DBMI is a Red Belt at this).

You develop standards in all manner of ways: ad hoc, de facto, regulations, etc. Speaker thinks that consensus is the best and most enduring manner. This is tedious and difficult but necessary. Discussion on various SDOs (Standards Development Orgs).

There are several Clinical information exchange standards and terminologies (ICD, SNOMED). Note that these extend to images/binary data as well (e.g. DICOM)! AND: standards encompass things like Decision Support Logic (e.g. HL7 Arden Syntax).

Discussion on the many, many standards involved and the manner in which standards are implemented (many ways: e.g. by affiliates or departments). When you extend standards... there's a standard way to do this!Establishing the 'right' level of specificity/granularity is the key!

Further implementation motivations, examples, details, and challenges. Principle of Least Privilege is a very important idea when it comes to data flows and privileges. Speaker thinks the future is "Consumer Directed Exchange": patient is in control of their data flows (e.g. you can download your health data from Apple).

The biggest impediment to adopting standards in healthcare is: The Business Case to share not strong enough. Hospitals and healthcare systems (generally) love their walled gardens. The Government stepping in makes an enormous difference.

[1]: https://en.wikipedia.org/wiki/Great_Baltimore_Fire. Firemen came over from everywhere to help but their firehoses did not fit!
[2]: HIPAA is really an interop rule. They just added security and privacy to it.