Thursday, November 23, 2006

Alan Rector on SNOMED, HL7 and Quality Assurance

In an excellent keynote lecture at the recent Semantic Mining Conference on SNOMED CT, Alan Rector makes a number of points of direct relevance to HL7 and its continuing problems. As he puts it, 'Unless we can formalise the mutual constraints ... HL7 v3 + SNOMED = Chaos'. 'The documentation is beyond human capacity ... to write or to understand'.

Rector puts forward a series of proposals concerning Quality Assurance for the new SNOMED Standards Development Organization, from which the HL7 organization, too, could benefit immensely. What is needed is:

– Member of board for Quality Assurance - sole responsibility
– Senior member of operations unit for QA- sole responsibility
• Changes in process
– Fully open and honest QA process
– Public statement on problems and public health warning until fixed
– Public commitment to specific quality criteria and success in specific applications.
– Engagement with providers, vendors on key criteria for QA
• Major technical effort
– Set up an independent quality assessment unit
• The developers can’t lead it because they can’t see it!
– Invest in crash effort at improvement of quality
• Initial goal of say 25K guaranteed QAed & reliability assessed codes

Quality, as Rector points out, 'is best addressed by openness.' One might add (drawing on the experiences in England): HL7 v3 should refrain from promoting itself as an ISO standard until its own QA problems have been fixed.

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