General screening criteria can be applied to screen available standards for implementation with a solution. It is assumed that the standards in use with existing systems participating in the solution will be evaluated as part of the initial screening, as well as options for resolving any differences between existing, implemented standards and those selected.
Fit for Purpose Criteria
Fit for purpose criteria evaluate the appropriateness of the standard for the intended business, clinical and technical context by considering whether the standard: aligns to the eHealth Blueprint; is an existing standard; supports the business requirements; supports the technical requirements; is likely to be adopted; and supports coded and free text content. [Office1]
Table 1 - Fit for Purpose Criteria
Criteria | Description | Rationale |
Alignment to the eHealth Blueprint | The purpose of this criterion is to assess whether the standard supports the exchange of information between two or more components of the EHR. The standard should also be intended to be used in a federated approach to EHR architecture where multiple organizations are expected to build, operate and/or host the various applications. | The standard supports eHealth mandate in providing a single, harmonized, coherent province-wide EHR. |
Existing Standard [RB2]
| This criterion assesses whether the standard is adopted/adapted from existing standards, and whether it is intended for international, pan- Canadian.
| Re-use of existing standards allows implementers to re-use code (i.e. in point of service /Health Information Access Layer (HIAL) applications, conformance testing environments, etc.). It also allows reuse of existing tools/skills/knowledge sets to establish the standard.
|
Supports Business Requirements | This criterion assesses whether the standard expresses all information required by the business/clinical domain. While the exact business requirements are project specific, example questions may include:
| To ensure that the standard addresses the health care business requirements.
The standard should be health care delivery setting independent to enable use across multiple health care delivery settings. |
Supports Technical Requirements | This criterion assesses the degree to which the standard is feasible to adopt and implement according to the technical requirements of the project. While the exact technical requirements are project specific, example questions may include:
| To enable successful implementation of the standard. |
Likely to be Adopted[Office3] | This criterion assesses the likelihood that the selected standard will be adopted and maintained by vendors and other implementers. Some questions that may be asked when assessing the likelihood for adoption, include:
| To ensure success of the implementation. If the standard is not widely implemented or supported by vendors, it will result in increased time, cost, and effort. |
Supports coded and free text content.
| This criterion assesses the degree to which coded data is required. Some questions to ask when assessing whether there is a need for coded data versus free text, may include:
| Different standards support different levels of data granularity and coding. However, there can be trade-offs to application developers and users to provide granular and coded data. At one extreme, end users may reject using the application because it forces them to enter data in too many fields, increasing their time/effort to do so. At the other extreme, just capturing free text can cause privacy breaches and be a barrier to implementing decision support. |
Stewardship Criteria
Stewardship criteria facilitate comparison of the standard‘s steward in terms of governance structure, licensing and intellectual property rights, and defined maintenance process.
Table 2 - Stewardship Criteria
Criteria | Description | Rationale |
Costs and Benefits of Implementation | This criterion assesses whether the cost of implementation and disruption to current business is affordable given the benefits. It is important to consider not only the initial cost but the on-going cost for maintenance as well. Cost is not only measured in currency, but can be in time or effort as well. Some sample questions to ask when assessing the costs and benefits of implementation, include:
| To take into consideration any cost constraints when adopting a standard, as well as initial implementation and longer-term maintenance costs.
|
Governance Structure | The purpose of this criterion is to assess whether or not the standard is governed appropriately. When assessing if a governance structure is in place, it is important to consider whether there are:
| To ensure proper processes are in place for the voting, maintenance and changing of the standard amongst its various stakeholders; as well as certification and other capabilities of the standards development or maintenance organization. |
Intellectual Property and Licensing Costs | This criterion assesses whether the intellectual property and licensing terms for the standard allows the wide use of the standard. Example questions may include:
| To ensure that the standard is vendor neutral and allows for the wide use of the standard. Openness and intellectual property policies affect the status, uptake and implementability of specifications, especially in the long term. |
Defined Maintenance Process | This criterion assesses whether or not the standard custodian has processes in place to accept requests for change to address errors or new needs in the standard. When assessing if a maintenance process is in place, it is important to consider the following:
| Business requirements and technology change over time, as such, standards need to evolve to meet changing needs. It is therefore important to ensure the selected standard has defined maintenance processes in order to evolve. |
Stewardship Criteria
Stewardship criteria facilitate comparison of the standard‘s steward in terms of governance structure, licensing and intellectual property rights, and defined maintenance process.
Table 2 - Stewardship Criteria
Criteria | Description | Rationale |
Costs and Benefits of Implementation | This criterion assesses whether the cost of implementation and disruption to current business is affordable given the benefits. It is important to consider not only the initial cost but the on-going cost for maintenance as well. Cost is not only measured in currency, but can be in time or effort as well. Some sample questions to ask when assessing the costs and benefits of implementation, include:
| To take into consideration any cost constraints when adopting a standard, as well as initial implementation and longer-term maintenance costs.
|
Governance Structure | The purpose of this criterion is to assess whether or not the standard is governed appropriately. When assessing if a governance structure is in place, it is important to consider whether there are:
| To ensure proper processes are in place for the voting, maintenance and changing of the standard amongst its various stakeholders; as well as certification and other capabilities of the standards development or maintenance organization. |
Intellectual Property and Licensing Costs | This criterion assesses whether the intellectual property and licensing terms for the standard allows the wide use of the standard. Example questions may include:
| To ensure that the standard is vendor neutral and allows for the wide use of the standard. Openness and intellectual property policies affect the status, uptake and implementability of specifications, especially in the long term. |
Defined Maintenance Process | This criterion assesses whether or not the standard custodian has processes in place to accept requests for change to address errors or new needs in the standard. When assessing if a maintenance process is in place, it is important to consider the following:
| Business requirements and technology change over time, as such, standards need to evolve to meet changing needs. It is therefore important to ensure the selected standard has defined maintenance processes in order to evolve. |