e-CareManagement blog

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Feedback Rolls in on Halamka’s New Stance on Standards: Cats Pissed, Dogs Thrilled

Continuing his stunning reversal of long held perspectives, Dr. John Halamka’s blog post today suggests Guiding Principles for HIT Standards Committee:

  • Keep it simple; think big, but start small; recommend standards as minimal as possible to support the business goal and then build as you go
  • Don’t let “perfect” be the enemy of “good enough”; go for the 80% that everyone can agree on; get everyone to send the basics (medications, problem list, allergies, labs) before focusing on the more obscure
  • Keep the implementation cost as low as possible; eliminate any royalties or other expenses associated with the use of standards
  • Design for the little guy so that all participants can adopt the standard and not just the best resourced
  • Do not try to create a one size fits all standard, it will be too heavy for the simple use cases
  • Separate content standards from transmission standards; i.e., if CCD is the html, what is the https?
  • Create publicly available controlled vocabularies & code sets that are easily accessible / downloadable
  • Leverage the web for transport whenever possible to decrease complexity & the implementers’ learning curve (“health internet”)
  • Position quality measures so that they will encourage adoption of standards
  • Create Implementation Guides that are human readable, have working examples, and include testing tools

Commentary:  These new guidelines are the right answer…let’s hope they are Dr. Halamka’s “final” answer.

Feedback from the community has been mixed:

Cats are pissed and stressed!



Dogs are thrilled!




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