Dave Winer is a true expert on standards. I remember coming across him in the early days of social media when every platform was considering some sort of API. To illustrate his early involvement in standards, Dave was one of the early developers of the RSS standard that is now available on every blog and many other places.
With this background in mind, I was extremely fascinated by a manifesto that Dave Winer published earlier this year that he calls “Rules for Standards-Makers.” Sounds like something we really need in healthcare no?
You should really go and read the full manifesto if you’re someone involved in healthcare standards. However, here’s the list of rules Dave offers standards makers:
- There are tradeoffs in standards
- Software matters more than formats (much)
- Users matter even more than software
- One way is better than two
- Fewer formats is better
- Fewer format features is better
- Perfection is a waste of time
- Write specs in plain English
- Explain the curiosities
- If practice deviates from the spec, change the spec
- No breakage
- Freeze the spec
- Keep it simple
- Developers are busy
- Mail lists don’t rule
- Praise developers who make it easy to interop
If you’ve never had to program to a standard, then you might not understand these. However, those who are deep into standards will understand the pitfalls. Plus, you’ll have horror stories about when you didn’t follow these rules and what challenges that caused for you going forward.
The thing I love most about Dave’s rules is that it focuses on simplicity and function. Unfortunately, many standards in healthcare are focused on complexity and perfection. Healthcare has nailed the complexity part and as Dave’s rules highlight, perfection is impossible with standards.
In fact, I skipped over Dave’s first rule for standards makers which highlights the above really well:
Rule #1: Interop is all that matters
As I briefly mentioned in the last CXO Scene podcast, many healthcare CIOs are waiting until the standards are perfect before they worry about interoperability. It’s as if they think that waiting for the perfect standard is going to solve healthcare interoperability. It won’t.
I hope that those building out standards in healthcare will take a deep look at the rules Dave Winer outlines above. We need better standards in healthcare and we need healthcare data to be interoperable.