- Raising Awareness
- Creating Consensus Based Localization
- Paid Development
- Official Endorsement
- Standards Collaborative
So far, only Canada is at level 5. The US through Meaningful Use is sort of at level 4 for endorsement of HL7 standards, and the ONC S&I Framework is certainly a level 2 activity, if not officially acting as an HL7 Affiliate.
The S&I Framework contracts (there are at least 10) will eventually end. There are a lot of activities which have produced outputs that still need maintenance (e.g., the Clinical Element Data Dictionary). One of the tasks for the S&I Framework is to establish a long term, public-private mechanism to sustain these activities, which could push the US to level 5.
When I think about all the national standards activities impacting the US:
- S&I Framework (US Localization)
- IHE USA (US Deployment and Testing)
- SCO (National Coordination)
- US TAG to ISO TC215 (International Coordination)
- HIMSS Interoperability Workgroup
- NCPDP (eRX)
- X12N (Insurance and Payment)
- NeHC (Education)
And several of the International ones:
It becomes pretty clear that we need a US Standards Collaborative. Here are some of my thoughts on it from two years ago.