The Inventory of Clinical Data Standards illustrates how many organizations are working on ways to represent specialized subsets of patient data. But there is no coordination or collaboration among those organizations. In fact, in spite of their good intentions, they often end up competing with each other. This is partly because the field of overall medical record standards is too broad for most vendors to care about or deal with. In addition, consensus takes an enormous amount of time and effort, and a business organization must use its time and effort to address the specific markets and needs associated with its own products.
Competition is a stronger motivation than cooperation in most cases.
Even where standards organizations have grown out of the cooperative efforts of multiple vendors, any standards they develop can only be recommendations. No one, not even the organization's members, is bound to adhere to them. In the solution we're recommending, each of these private sector groups has a specific role, as does the federal government. But the private sector does not have the requisite unified motivation to agree on a single set of standards. So we propose that the government assume the role of providing a common motivation in those areas where there are currently conflicting agendas.