Standards for digital health, known limitations, and procurement

A number of limitations associated with technical standards are identified. These limitations are explored in terms of their likely causes. This chapter exposes a number of misunderstandings and adopted myths associated with the use of technical standards and semantic interoperability requirements. Good practice principles for standards development are highlighted. This is followed by an exploration of the impacts associated with known limitations and lessons learned from years of practice, within the context of past failures and current technical advancements from a software engineering perspective. We argue that achieving semantic interoperability requires the harmonisation of foundational standards relating to the following key components, unique identifiers, data types; domain information models; terminology, concept representation and definitions; open platform architecture; governance; and workforce capacity, and conclude that standards development processes are in need of a major transformation to enable widespread adoption of key foundational standards through changes in procurement processes.