Imagine, if you will, an organization without a marketing department, that lets its product developers determine what kinds of products it will produce. There may be an organizational strategy, but there is no way operationally to implement from the top down via executive leadership. Instead, it is best (or perhaps even only) implemented bottom-up, by convincing the developers in the organization that this is, in fact, the best way to proceed. In fact, executive leadership has very little influence on what products the organization actually produces.
Would such an organization survive in the fast-paced, market-driven technology world today? They do. They are called SDOs.
-- Keith
It's also called Linux, except that in Linux the resulting code must be proven to work before it's accepted. (This also applies to some other Open Source systems.)
ReplyDeleteSeriously, Keith.. you're saying that an SDO fits with the idea of "fast paced"?
ReplyDeletePerhaps you should check out Grahame Grieve's recent post, which offers a bit more realistic view of an SDO:
http://www.healthintersections.com.au/?p=1011
TJL
Thomas,
DeleteI've seen (and retweeted) Grahame's post already.
If you read what I wrote, you will see that I said that such organizations survive in a fast-paced, market driven environment. That doesn't mean that they are themselves, fast-paced, or market driven.
Keith
ReplyDeleteRE: "I said that such organizations survive in a fast-paced, market driven environment. That doesn't mean that they are themselves, fast-paced, or market driven."
True - but with that being said, I'd like to ask you sincerely:
Then what's the point of that remark, or the entire post for that matter, if not to "suggest" (by association) that HL7 is fast-paced?
TJL
The key thing probably is that "there is no way operationally to implement from the top down via executive leadership"
DeleteIn 2007 I summarized one of my blogposts (http://www.ringholm.com/column/link_HL7_open_source_software.htm) with "The introduction of a directive work environment [i.e. top down], given the history of HL7, would be like trying to push a rope. The success of, and experiences with peer production models in a Web 2.0 world has to be seized upon and reused when reviewing the processes and governance of open standards organizations such as HL7."
@Rene
DeleteRE: "The introduction of a directive work environment [i.e. top down], given the history of HL7, would be like trying to push a rope."
I may be missing your point, but my response to your analogy was that proper, effective leadership does not involve "pushing".
If anything, "leading" is comparable to "pulling", since those that are led are compelled to follow - and pulling works extremely well with ropes.
I do very much agree that successful, modern Web/Internet models need to be adopted by HL7 if it intends to survive, and be able to attract new talent.
The most important of those models are openness, and abandoning the proprietary IP model of the last century, which makes HL7 look like the troll hiding under the bridge, demanding a toll for sharing information created by the work of a volunteer army - who also had to pay a toll to be able to do that work.
TJL
Thomas, I happen to work with several different SDOs. The post wasn't about any particular one of them, but rather a characteristic common to all of them. I find it interesting that SDOs don't have the ability to control what the "business" is producing, and yet they still remain viable.
Delete@Keith
DeleteRE: "I find it interesting that SDOs don't have the ability to control what the "business" is producing, and yet they still remain viable."
And I find it fascinating that while you admit that HL7 has no control over the IP that is being produced AND that HL7 gets paid by it's workers to produce that IP, you continue to defend HL7's claim of full ownership of that IP, and their right to keep it hidden behind a paywall, inaccessible to countless talented open source developers who would innovate on and improve that IP for them - again, for free.
You really can't see what's wrong with that picture?
TJL
Actually, I do see what is wrong with that picture. I asked you elsewhere what HL7's business model should be. I'm still looking for an answer. Do you have one?
DeleteKeith,
DeleteLet me offer a high-level outline of ideas:
Large organizations could continue to support HL7 either via "sponsorships" (much like what many open-source projects receive), or via membership fees (if they want voting rights to determine the standards).
The government could provide additional support needed via "grants" - which would add a mere pittance to what the government is currently shelling out for other healthcare related initiatives.
While those are very broad strokes, they can be developed into a viable solution to the problem of funding HL7. It's at least a framework of ideas for building out a reasonable funding model - and it doesn't rely on anything that hasn't already been done successfully.
TJL
@Glen RE: "So how do SDOs measure success..?"
ReplyDeleteHow about by the level of acceptance and adoption of the standards that they create?
That seems like a simple and straightforward indication of SDO success or failure.
(And you probably know what conclusion about a specific SDO that this metric will lead to..)
TJL
What conclusion would that be? And what other than opinion do you have to back it up?
DeleteLooking at national implementations, CDA seems to be doing pretty well, V3 has arguably failed, there's some excitement around the new FHIR product line, and V2 (in it's many forms) is present throughout a significant portion of the healthcare IT industry. So there are successes and failures throughout HL7's offerings.
There are no easy answers.
Keith,
DeleteI'm not trying to attack or disparage HL7 - on the contrary, I'm trying to help save it.
But just like you may have to smack someone that you're trying to save from drowning to get them to stop resisting so that you can help, some of my comments may "hurt a little".
With this in mind, please try to view everything that I say in the most positive light.
Thanks,
TJL