A National Standards Maturity Model

Rene Spronk had a great post on the HL7 Affiliate Life Cycle a few weeks back.  Yesterday Catherine Chronaki displayed a simple slide based on that model at the HL7 Working Group meeting.  While Rene talks about it from an HL7 Perspective, I think about it from a national perspective.  There are essentially five levels in Rene's model:

1. Raising Awareness
2. Creating Consensus Based Localization
3. Paid Development
4. Official Endorsement
5. 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:

• HL7
• IHE
• CIMI

It becomes pretty clear that we need a US Standards Collaborative.  Here are some of my thoughts on it from two years ago.