Plug-and-Play Medicine

The MIT Technology Review article Plug-and-Play Medicine claims that:

… a Boston research group has come up with a software platform for sharing information among gadgets …

Uh, what software platform? I discussed the MD PnP program a couple of years ago. Other than the Integrated Clinical Environment (ICE, ASTM F2761:2009) standards work I don’t see a lot of progress, let alone software to look at.  The draft ASTM standard (Dec-2008) is still just a shell. The overall model structure makes sense, but the models themselves are not described in any detail (that I could find anyway).

I have a lot of respect for academic endeavors, but creating a comprehensive standard for something as multidisciplinary and complicated as medical device connectivity will not be an easy task.   I once participated in an ASTM standard that was limited to a single communications protocol, and it took years to finalize.  Developing models for how systems behave and interact is at a level of complexity that I’m not sure can ever really be standardized (how do you nail down a moving target?).

A good example is HL7 V3 RIM (Reference Information Model).  RIM has been under development for more than 10 years and as HL7 RIM: An Incoherent Standard (warning: PDF) points out, many mistakes have been made.  These issues may partially explain the woeful rate of HL7 V3 adoption.

The other thing HL7 V3 shows is the magnitude of work required in these standards efforts. The MD PnP group understands this and that standards are just part of the solution. The slide from here (warning: PDF) summarizes this well:


Unfortunately, the devil is in all these messy details and is the reason why plug-and-play medicine is still a long way off.

Hat tip: Mike Attili

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