Standards for Global Health Information Systems

Most standards are made by a consensus process of volunteers in formal organizations called Standards Developing Organizations (SDOs). Unfortunately, because of different origins and through scope creep, the product of these various SDOs overlap. Competition seems to trump collaboration, and the user community are forced to make choices and to map between similar purpose standards with loss of information. Standards address a wide scope of topics but largely relate to the representation of data and to the transport of data. Dominant data transport SDOs include DOCOM, ASTM, HL7, IEEE, IHE, CDISC, CEN, ISO TC 215, openEHR, and GIS. Dominant data representation standards include ICD, IHTSDO, LOINC, and RxNorm. What standards are required are largely driven by the interests of the volunteers who create the standards; however, from a global perspective, gaps in the existing standards become an issue for who should create the gap standards and how will the standard development be funded. The ultimate goal of all standards is to enable interoperability in the exchange and use of data. Success involves not only the functional and semantic interoperability but also the commitment of all stakeholders for all purposes to enable the free and understandable flow of data across all boundaries to provide timely and effective delivery of care in the global setting. Furthermore, with the aggregation of data across international boundaries, the discovery of new knowledge will lead to a healthier world.