The Role of Standards: What We can Expect and When

The key advantage that standardization provides is the ability to share and reuse knowledge once it is created. This chapter discusses what happens in the absence of a standards-based approach and then reflects on how standards might help. If the needed standards were to exist, the expectation is that the tasks of implementing clinical decision support (CDS) can be more easily carried out. Local adaptation would be based on a well-defined starting point, so that dependencies could be tracked. Implementation, debugging, and operational use of CDS could be localized to an external execution engine and to well-defined interfaces to the host system for invocation of CDS, data access, and result communication and mapping to actions. Knowledge management/ update, and incorporation of updates in applications could be done more easily by relying on a central source for authoritative knowledge, and updating based on tracked relationships to the knowledge sources. As compelling as the benefits of standardization appear to be for stimulation of knowledge sharing and reuse, the chapter considers evidence that will make a substantial difference in the rate of dissemination and adoption of CDS.