Crystal Balls

If you thought this post was going to discuss what I think ARRA regulations will look like, I'm sorry to dissappoint you.  If you want that crystal ball, look here.

Instead, I'm going to look a little further out than 3 months.  A colleague had asked me to project where I thought interoperability standards would be in five to ten years, and I thought it would be a good posting.  So, I looked into my crystal ball and this is what I see coming:

Five Years

• Systems generating clinical documents will start to do so using the HL7 CDA Release 3 standard.
• Guidlines and Alerts will be start being generated in a standard format with machine readable data.
• Systems will be able to generate quality reports from machine readable specifications for quality reporting.
• Real integration of clinical decision support in HIT systems will occur using standards.  The debate about languages for representing clinical decision support will have died down, but will not have completely disappeared from the landscape.
• Clinical Genomics data will be customarily exchanged using standard formats.
• Most standard specific transports will be replaced by more traditional IT based transport mechanisms (e.g., as web services are doing today, but more so).
• Standard specific security models and information will be replaced by more traditional IT based security standards that have been profiled for use in healthcare (this is also starting to happen today).
• Binary XML exchanges will take over where text based XML transports left off.
• In the US, the NCPDP and X12 standards will be based on XML formats.
• There will be at least two more intense standards battles in the healthcare space.

Ten Years

• Harmonization of clincal vocabularies will result in fewer terminology standards with better integration between them.
• US will be moving towards ICD-11.
• Medical knowledge (not just terminology or ontologies) will start being publicly available in a standardized format.