Wiki Content by: Janet Apter, Rose Giannini, and Cindy Sunderman and GOS (guide-on-the-side)
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Home | Hardware & Software Standards | Health IT Standards | Privacy and Security Standards | Terminology Standards
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GOS Note: This team has done an awesome job of filtering through horrific info overload on these broad topics. Here is my $.02 advice in terms of summary take-aways from all this information:
Remember:
1. You can search the web for anything specific you might ever want to know about hardware or software components and standards (we will never memorize and remember them all).
2. It is important to recognize that not all standards are created equal. Defacto, ad hoc, and mandated standards are created differently than consensus standards (which predominate in health care). Understand the differences and consider participating in the consensus process to represent nursing!
3. IT folks tend to have a stake-in-the-ground for their favorite hardware and software. They often resist open-source when it offers reasonable and cheap alternatives. But open-source software doesn't exist for every application. Evaluate carefully and choose wisely, but never trust a tekkie who tells you the stuff is not worth using!
4. Standards exist because we desperately need them! They make products and software more usable!
Standard - A definition or format that has been approved by a recognized standards organization or is accepted as a de facto standard by the industry. Standards exist for programming languages, operating systems, data formats, communications protocols, and electrical interfaces.
There are four ways that a standard can be developed:
Ad hoc method - a group of interested people and organizations agree on a standard specification. It is informal and are mutually agreed on by the participating groups.
De Facto Standard - A single vendor controls a large enough share of the market to make its product the market standard. An example of this type would be Microsoft.
Government Mandate Method - A government agency creates a standard and legislates its use. The CMS's UB92 insurance claim form is an example.
Consensus Standard - A format, language, or protocol that has been approved by formalized committees that are open to participation by all interested parties and operate on a consensus basis. Most health care standards are produced this way. An example is HL7.
Standards Organizations
Most official computer standards are set by one of the following organizations:
ANSI (American National Standards Institute)
ITU (International Telecommunication Union)
IEEE (Institute of Electrical and Electronic Engineers)
ISO (International Standards Organization)
VESA (Video Electronics Standards Association)
IEEE sets standards for most types of electrical interfaces. Its most famous standard is probably RS-232C, which defines an interface for serial communication. This is the interface used by most modems, and a number of other devices, including display screens and mice. IEEE is also responsible for designing floating-point data formats.
While IEEE is generally concerned with hardware, ANSI is primarily concerned with software. ANSI has defined standards for a number of programming languages, including C, COBOL, and FORTRAN.
ITU defines international standards, particularly communications protocols. It has defined a number of standards that specify protocols for transmitting data over telephone lines.
Organization Web Links:
ANSI - American National Standards Institute. Founded in 1918, ANSI is a voluntary organization composed of over 1,300 members (including all the large computer companies) that creates standards for the computer industry. For example, ANSI C is a version of the C language that has been approved by the ANSI committee. To a large degree, all ANSI C compliers, regardless of which company produces them, should behave similarly.
In addition to programming languages, ANSI sets standards for a wide range of technical areas, from electrical specifications to communications protocols. For example, FDDI, the main set of protocols for sending data over fiber optic cables, is an ANSI standard.
ITU is the leading United Nations agency for information and communication technologies. As the global focal point for governments and the private sector, ITU's role in helping the world communicate spans 3 core sectors: radiocommunication, standardization and development. ITU also organizes Telecom events and was the lead organizing agency of the World Summit on the Information Society.
ITU is based in Geneva, Switzerland, and its membership includes 191 Member States and more than 700 Sector Members and Associates.
IEEE is a non-profit organization, and is the world's leading professional association for the advancement of technology.
The IEEE name was originally an acronym for the Institute of Electrical and Electronics Engineers, Inc. Today, the organization's scope of interest has expanded into so many related fields, that it is simply referred to by the letters I-E-E-E (pronounced Eye-triple-E).
http://www.iso.org/iso/home.htm
ISO (International Organization for Standardization) is the world's largest developer and publisher of International Standards. ISO is a network of the national standards institutes of 157 countries, one member per country, with a Central Secretariat in Geneva, Switzerland, that coordinates the system. ISO is a non-governmental organization that forms a bridge between the public and private sectors. On the one hand, many of its member institutes are part of the governmental structure of their countries, or are mandated by their government. On the other hand, other members have their roots uniquely in the private sector, having been set up by national partnerships of industry associations. Therefore, ISO enables a consensus to be reached on solutions that meet both the requirements of business and the broader needs of society.
VESA is an international non-profit corporation led by a Board of Directors, which represents a voting membership of more than 165 corporate members worldwide. VESA supports and sets industry-wide interface standards for the PC, workstation, and consumer electronics industries. VESA provides a forum to develop, promote and support open standards for the display industry.
Resources:
Shortliffe, E.H. and J.J. Cimino, eds. Biomedical Informatics: Computer Applications in Health Care and Biomedicine. Third Edition. 2006, Springer, page 269.
http://www.webopedia.com/TERM/D/de_facto_standard.html
http://www.ansi.org/about_ansi/overview/overview.aspx?menuid=1
http://www.itu.int/net/about/index.aspx
http://www.ieee.org/web/aboutus/home/index.html
Why We Need Standards!
In a nutshell, standards are essential in the production of electronic resources because they facilitate data interchange and representation and management of information. That they should be used is almost unarguable; which standards should be used is another question.
http://www.hhs.gov/healthit/ Health information technology (Health IT) allows comprehensive management of medical information and its secure exchange between health care consumers and providers. Broad use of health IT will:
- Improve health care quality;
- Prevent medical errors;
- Reduce health care costs;
- Increase administrative efficiencies;
- Decrease paperwork; and
- Expand access to affordable care.
Interoperable health IT will improve individual patient care, but it will also bring many public health benefits including:
- Early detection of infectious disease outbreaks around the country;
- Improved tracking of chronic disease management; and
- Evaluation of health care based on value enabled by the collection of de-identified price and quality information that can be compared.
Interoperability (defined) And these folks are leading the best efforts yet in healthcare: http://www.ihe.net/
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Hardware
The term hardware covers all of those parts of a computer that are tangible objects. Personal computers, laptops, monitors/displays, circuits, power supplies, cables, keyboards, printers, scanners, video, camera and mice are all hardware.
The intended application of the hardware will help determine the needs. The factors to consider when choosing hardware include the purpose, specific application needs, budget considerations and maintenance needs. There are many pieces of hardware to consider, including but not limited to workstations, CPU, laptops, tablets, memory (how much), storage needs, networking capabilities, video and audio needs, printing needs, DVD capabilities, projector needs and scanning needs.
Influencing Factors that help determine hardware needs include:
http://www.microsoft.com/technet/prodtechnol/windows2000serv/reskit/deploy/dgfd_adm_jacy.mspx?mfr=true provides a list of useful questions to ask when planning hardware needs
http://www.apple.com/accessibility/ computer hardware/accessibility options
http://www.cdc.gov/od/ohs/Ergonomics/ergohome Hardware and ergonomicsSelf assessment:
Ergonomic Evaluation Checklist.xls
Hardware standards are rules and/or definitions that specify hardware requirements that are necessary for an intended purpose. Most often hardware standards are developed by and for organizations, groups, businesses and universities (to name a few). These standards help to assure that the components (hardware) are interchangeable and compatible with the software. Some of the issues that hardware standards address include the amount of memory needed, will there be need to network, who will back up the information, how will failed hardware be replaced, what type of security will be needed. With the proliferation of standards it becomes important to determine which to adopt or adhere to. Here are a few resources to get you started.
Resources related to hardware and hardware standards:
http://www.dmoz.org/Computers/Hardware/Standards/
http://www.csubak.edu/IRTS/Standards/Hardware/
(example of hardware standards)
http://vonmag.com/hardware/ip-pbxs/open-hardware-standards.html
(example of open hardware)
http://en.wikipedia.org/wiki/History_of_computing_hardware
(history of computing hardware)
http://www.healthcareitnews.com/story.cms?id=8449
(new technology, pharmacy robot)
http://www.wi-fi.org/
Wireless
OPEN SOURCE HARDWARE INFORMATION
http://en.wikipedia.org/wiki/Open_source_hardware
Devices
In the medical industry, the need for interoperability is becoming severe. New technologies are being introduced at an ever-increasing rate. Many hospitals, for example, are now adopting electronic medical records, which promise to allow physicians to access more information with greater speed. In addition to electronic medical records, hospitals are continually introducing new imaging and therapeutic devices, many of which have the potential to interact synergistically if they can be integrated effectively.
The need for “plug-and-play” interoperability in a hospital setting has attracted great attention from both healthcare providers and from the biomedical industry. Hospitals and HMO’s form a large market for interoperable products, and standards defining interoperability in the medical sphere are being developed by a variety of international organizations such as IHE. Despite this interest, however, many manufacturers currently avoid investing in interoperability, touting the inter-compatibility of their own products while attempting to exclude competitors.
Leaders of hospitals and healthcare organizations are slowly realizing that achieving interoperability would greatly improve healthcare. Interoperable technology enables doctors to work more efficiently, and it helps prevent mistakes. Interoperability also encourages innovation in the industrial sector by allowing small companies to introduce specialized products. Without interoperability, hospitals are forced to turn to a few large vendors. Interoperability promotes competition, and competition encourages innovation and quality. As large hospitals begin to understand this fact, efforts to promote biomedical interoperability are gathering strength.
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From a user’s standpoint, standards are extremely important in the computer industry because they allow the combination of products from different manufacturers to create a customized system. Without standards, only hardware and software from the same company could be used together. In addition, standard user interfaces can make it much easier to learn how to use new applications.
In the networked environment, the ability to easily share information is crucial. Central to information sharing is the software environment, particularly software used for word processing, spreadsheets, databases, network browsing, and electronic mail. Developing software standards, will greatly improve functions between these systems. Standards can facilitate exchange of information.
The advantages of software standards are:
Software standards enable software to interoperate. There is not consensus on what the standards should include. Software standards are one of the unsolved problems in software engineering. There are multiple reasons behind software standards such as safety, economic and social reasons.Non-standard implementation of standards or specifications by multiple organizations results in a requirement for implementation specific code and special case exceptions as a necessity for cross-platform interoperability. Notable modern examples include web browser compatibility and web-services interoperability. The arbitrariness of most software concepts, which is related to historical hardware and software implementation, lack of common standards worldwide, and economic pressures.
Sometimes software standards are controlled by private corporations (the Windows GUI interface is owned by Microsoft). Sometimes software standards are controlled by open, public, or non-profit organizations (the Secure Shell 2 protocol is 'owned' by the IETF).
An open standard is a standard that is publicly available and has various rights to use associated with it.The terms "open" and "standard" have a wide range of meanings associated with their usage. The term "open" is usually restricted to royalty free technologies while the term "standard" is sometimes restricted to technologies approved by formalized committees that are open to participation by all interested parties and operate on a consensus basis.The definitions of the term "open standard" used by academics, the European Union and some of its member governments or parliaments such as Denmark, France, and Spain preclude open standards requiring fees for use, as does the Venezuelan Government. On the standard organization side, the W3C ensures that its specifications can be implemented on a Royalty-Free (RF) basis.Many definitions of the term "standard" permit patent holders to impose "reasonable and non-discriminatory" royalty fees and other licensing terms on implementers and/or users of the standard. For example, the rules for standards published by the major internationally recognized standards bodies such as the IETF[1], ISO, and IEC permit their Standards to contain specifications whose implementation will require payment of patent licensing fees (none of these organizations states that they grant "open standards", but only "standards"). ITU has a definition of "open standard" that allows "reasonable and non-discriminatory" licensing.The term "open standard" is sometimes coupled with "open source" with the idea that a standard is not truly open if it does not have a complete free/open source reference implementation available. [2]Open standards which specify formats are sometimes referred to as open formats.
Many specifications that are sometimes referred to as standards are proprietary and only available under restrictive contract terms (if they can be obtained at all) from the organization that owns the copyright on the specification. As such these specifications are not considered to be fully Open.
Purpose of an Open Standard
The purpose of an open standard is to increase the market for a technology by enabling potential consumers or suppliers of that technology to invest in it without having to either pay monopoly rent or fear litigation on trade secret, copyright, patent, or trademark causes of action. No standard can properly be described as "open" except to the extent it achieves these goals.
The industry has learned by experience that the only software-related standards to fully achieve these goals are those which not only permit but encourage open-source implementations. Open-source implementations are a quality and honesty check for any open standard that might be implemented in software; whether an application programming interface, a hardware interface, a file format, a communication protocol, a specification of user interactions, or any other form of data interchange and program control.
To help industry participants (suppliers, consumers, and regulators) identify and specify standards that permit open source implementations, the OSI has defined a minimal Open Standards Requirement (OSR). The OSI has also created a set of Criteria that can be used to judge whether a standard fully complies with that Requirement.
The ITU-T is a standards development organization (SDO) that is one of the three sectors of the International Telecommunications Union (a specialized agency of the United Nations). The ITU-T has a Telecommunication Standardization Bureau director's Ad Hoc group on IPR that produced the following definition in March 2005, which the ITU-T as a whole has endorsed for its purposes since November 2005 [3]:
The ITU-T has a long history of open standards development. However, recently some different external sources have attempted to define the term "Open Standard" in a variety of different ways. In order to avoid confusion, the ITU-T uses for its purpose the term "Open Standards" per the following definition:
"Open Standards" are standards made available to the general public and are developed (or approved) and maintained via a collaborative and consensus driven process. "Open Standards" facilitate interoperability and data exchange among different products or services and are intended for widespread adoption.
Other elements of "Open Standards" include, but are not limited to:
The ITU-T, ITU-R, ISO, and IEC have harmonized on a common patent policy [4] under the banner of the WSC. Anyway, the above ITU-T definition cannot be considered also applicable in ITU-R, ISO and IEC contexts, since the Common Patent Policy [5] does not make any reference to "open standards" but only to "standards".
As one of the important provider of Web technology ICT Standards, notably XML, http, HTML, CSS and WAI, the World Wide Web Consortium (W3C) follows a process that promotes the development of high-quality standards.
The W3C process defines the following set of requirements that a provider of technical specification must follow to qualify as Open Standard.
One result of this controversy was that many governments (including the Danish, French and Spanish governments singly and the EU collectively) specifically affirmed that "open standards" required royalty-free licenses. Some standards organizations, such as the W3C, modified their processes to essentially only permit royalty-free licensing. Oasis-Open allows committees to operate either on a RAND basis or a royalty-free basis, but OASIS does say to grant "open standards" when they are not royalty-free.
Patents for software, formulas and algorithms are currently enforceable in the US but not in the EU. The European Patent Convention Article 52 paragraph (2)(c) expressly prohibits algorithms, business methods and software from being covered by patents. The US has only allowed them since 1989 and there has been growing controversy in recent years as to either the benefit or feasibility.
A standards body and its associated processes cannot force a patent holder to give up its right to charge license fees, especially if the company concerned is not a member of the standards body and unconstrained by any rules that were set during the standards development process. In fact, this element discourages some standards bodies from adopting an "open" approach, fearing that they will lose out if their members are more constrained than non-members. Few bodies will carry out (or require their members to carry out) a full patent search. Ultimately, the only sanction a standards body can apply when patent licensing is demanded is to cancel the standard or try to rework around it.
http://standards.ieee.org/software/
http://standards.ieee.org/reading/ieee/std_public/description/se/
http://www.usabilitynet.org/tools/r_international.htm
http://en.wikipedia.org/wiki/Open_standard
http://sourceforge.net/softwaremap/
http://en.wikipedia.org/wiki/Software/http://en.wikipedia.org/wiki/Microsoft_Windows/
http://en.wikipedia.org/wiki/Royalty-free/
http://opensource.sys-con.com/
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