In the past few weeks, the HIT Standards Committee has gathered a significant amount of written and in person testimony from standards stakeholders. We've run the FACA blog and multiple personal blogs.

On Thursday November 19, we'll present a complete distillation of everything we've learned but there are several recurring themes can could be called Guiding Principles. Just as HITSP was guided by Harmonization Readiness principles to choose standards that were good enough, the HIT Standards Committee has a been told to think about the following whenever it recommends standards:

• 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

We'll refine this during our meeting on Thursday and the end result should be a polished list of guidance for all our future work.

John Halamka, MD, blogs regularly at Life As a Healthcare CIO.