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Wednesday, May 29, 2013


Before I go any further with this post, let me say loudly that:
I agree, we [the HIT community] need more CDA examples to work with!

One of the discussion topics over on the Structured Documents list this week is about the need for more examples of the Consolidated CDA specification.  Two arguments being promoted are: The documentation isn't good enough to stand on its own without MORE examples, and that implementers don't read the specifications.  Oh, how true that last statement is in Healthcare IT. And how wrong it is as well.  Someone explained that "I do not expect them to look at 3000 pages of manuals on 7 different web sites..."

I have so little patience with that attitude.  Let's take a standard like XML.  I have four books on my bookshelf about XML in general, including this one that I reviewed not too long ago.  I have two books that cover XML Schema.  I have two books covering XSLT.  I have two books about Java and XML.  I have one about Java and SOAP.  I have all the W3C XML standards printed and bound.  I have links to my favorite web-sites on XML, which include at the top, the W3C and w3cschools, and also mulberrytech, and

My collection of material on XML runs to more like 30,000 pages, rather than 3000.  And I know XML developers who have more. I'm what I call an HTML duffer.  I write HTML pages (and have done so professionally for quite some time), but I'm not an expert at HTML.  I only have about 10,000 pages or so of content on HTML in my library.  I'm NOT extraordinary by the way.  I know HTML duffers whose book collection exceeds my own, and experts whose collection exceeds it by an order of magnitude.

I EXPECT all engineers who need to use a specification to do their best to use it correctly.  I expect decent engineers to do more than look at one example.  I expect GOOD engineers to read the specifications and use them.  I expect GREAT engineers to read the specifications, comment on them, fix them, and read as much as they can about them.

Don't tell me proudly that you've never read a specification.  It's NOT a badge of honor.  Yeah, OK, you've come to an outstanding understanding of the technology without reading the specification.  Great, how to you have a meaningful discussion with someone who's actually read it, or even better, created it. If you haven't read it, you've lost the opportunity to develop common ground.

Yes, we need better specifications, and we need shorter specifications, and we need easier to read specifications.  And we need a lot more examples.

But we also need professional engineers who will live up to the job title.  Not just weekend warriors who want to be able to show off what they did in their spare time.  Healthcare is simply too important for that attitude.