ICT standards in the health sector: current situation and ... - empirica

ICT standards in the health sector2.4 Summary of ICT standards and standardisation in thehealth sectorChapter 2 provided a structured overview of e-health standards and standardisationprocesses. Such a map is necessarily incomplete because e-health is a very complex aswell as fast and constantly changing field. The following key issues of the situation,barriers, harmonising activities, electronic health records, and SDOs have been analysed:Situation sketch: Currently the market for e-health standards has the followingcharacteristics: A large number of often conflicting standards, a lack of “right”standards for particular applications and concrete processes, high complexity ofstandards, and widespread proprietary standards with undisclosed specifications.This situation makes health systems interoperability difficult to realise.Barriers to improve the situation: Barriers to promote and adopt prominentstandards so that they are more widely used can be broken down by stakeholdersin the health sector: governments, Standards Development Organisations, industry,and ICT users. All in all the principal barriers are related to returns on investment instandardisation on the part of SDOs and industry as well as costs of adoptingstandards on the part of users.Harmonising activities: There is currently no powerful process to harmonisestandards, and a process to decrease the number of concurrent standards is not yetfully established. However, the stakeholders are increasingly becoming active inthis respect. The collaboration initiative of ISO, CEN and HL7 is an importantactivity. Further SDOs joining this collaboration as well as the large-scale pilot forpatient summaries and e-prescribing in EU Member States which are currentlystarting, funded in the framework of the European CIP Programme, may becomefurther catalysts in this respect.Electronic health records (EHRs) introduction is an important issue on the politicalagenda of many European countries and also of the European Commission.However, there are yet no comprehensive EHR implementations. This is also due toa lack of EU-wide standards for EHRs, more precisely for the collection, coding,classification, and exchange of clinical and administrative data. It can be expectedthat the EC’s “Recommendation on cross-border interoperability of electronic healthrecord systems” will have a strong influence on further developments in this field.SDOs: Six principal standardisation organisations and one interoperability initiativehave been selected for more detailed analysis in this report because they can beexpected to play a leading role in further eHealth standards development: ISO asthe largest developer of world-wide standards, CEN as the principal official SDO inEurope, IHTSDO as the developer of the very comprehensive SNOMED-CTterminology standard, HL7 as the developer of the most widely used standards forelectronic messages in healthcare, DICOM as a de facto standard for electronicmedical imaging, OpenEHR as a promising open source activity, and IHE as amajor eHealth systems interoperability initiative. Understanding their objectives,rationales and constraints may help to form viable alliances for harmonising andconsolidating standards.44