What is standards harmonization?

I describe it as the parsimonious number of standards required to meet the requirements of stakeholders. It is achieved by closing gaps and eliminating redundancy.

Can we always reduce the number of standards in a domain to 1? Not necessarily. Sometimes the best we can achieve is 2 with mapping between them or 2 initially converging over time to 1.

In the past, we've had multiple interoperability standards for devices. Earlier this year, HITSP challenged IHE and Continua to converge their work as part of the HITSP Remote Monitoring Use Case.

The Continua Alliance, a non-profit, open industry coalition of the more than 200 healthcare and technology companies joined together in collaboration to improve the quality of personal healthcare, has been focused on interoperability standards for consumer products. It wanted "fast and light" device standards that could easily be deployed with products in the home.

Integrating the Healthcare Enterprise (IHE), an initiative of healthcare professionals and industry to improve the way computer systems in healthcare share information, has focused on more complex devices such as those used by providers in hospitals and clinics.

Yesterday, Continua and IHE announced a breakthrough. They have agreed to a single set of content, transport, and vocabulary standards that work for all devices - home-based and hospital-based, simple and complex. This means that the industry is free to innovate and regardless of the devices created, they will be interoperable.

What standards did they choose?

Content - HL7 v2.6 messages using IHE PCD-01
Vocabulary - Constrained to IEEE/ISO 11073-20601/11073-104xx nomenclature
Transport - Web Services transport based on WS-I Basic Profile

Here are few comments by the leaders of this effort:

"IHE believes that this collaborative breakthrough offers enormous benefits to US citizens and their physicians. This helps accelerate the deployment of convenient and reliable home-based health monitoring and care, and facilitates many other forms of remote monitoring as well. Together, Continua and IHE have finally made it possible for vendors of Medical Devices and Personal Health Devices to efficiently send patient data to the Personal and Electronic Health Records vendors using a single unified interoperability standard that is endorsed by HITSP."

Elliot B. Sloane, PhD
Co-Chair, Integrating the Healthcare Enterprise (IHE) International Executive Director, Center for Healthcare Information Research and Policy

"The Continua Health Alliance appreciates the opportunity HITSP has afforded to work with IHE to provide a harmonized approach for the Remote Patient Monitoring Use Case with an open architecture, international, standards-based solution. This will facilitate an ecosystem of connected technologies, devices, and services that provide a compelling way to meet the challenges of increased access, improve outcomes for patients, and ultimately reduce overall healthcare costs."

Rick Cnossen
Director, Personal Health Enabling, Intel Digital Health Group (DHeG)
President, Continua Health Alliance (www.continuaalliance.org)

I want to offer my congratulations and thanks to IHE and Continua for this achievement. Their leadership illustrates the finest characteristics of harmonization achieved by assembling smart technical people, aligning mutual interests, then moving forward to converge on a single approach.

Bravo! All device stakeholders will now benefit from a single universal set of standards used to connect devices to EHRs and PHRs.

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