Fuck Standards — Celebrate Diversity

2019-02-24T13:42:54+00:00August 24th, 2018|

A brief comment by Niucare CEO & Founder Laurent Schüller why standards in health-tech don’t help anyone.

The healthcare sector is known for many problems. Quality needs to be improved all the time, at least kept at a constant level, while costs are increasing and need to be kept low and manageable. Doctors are unsatisfied as they spent more and more time with administrative tasks, patients are unhappy as they feel that medical care is more and more about money and less about there health.

And there is the number of organizational and technological pitfalls, coming along the way of improving a running healthcare business. One of those areas is the growing complexity of technological services, applications, and tools.

For this reason, many years ago the industry decided to work with “standards”. More and more of those standards for different use cases popped up and have been rolled out since then. Some of them are HL7 for medical data, FHIR as a sub-category of HL7, SMART on FHIR, Argonaut Project, Device on FHIR as a long tail standards of FHIR itself. DICOM, IHE for medical images and many others for different fields of patient information management.

On the other side: Hospitals, medical Companies, and healthcare providers still work on established IT infrastructure which is often 20 years of age and older. So, you see: a huge potential for incompatibility, failed integration and in the end huge costs for fixing broken systems with a high time effort.

Nowadays, more and more big players and institutions come up with their ideas for new standards. It feels like, standards and standardized infrastructure seem to be the magic pill to treat the symptoms.

It is not a race of standards. There is no finish line.

There was this one guy on a conference recently complaining about the frenzy of industry standards and business associations coming up with new guidelines and roadmaps, Twenty Twenty bs, workgroups and architecture committees. “There is no end in sight. They try all to be smart, but aren’t smart enough to realize we don’t need an ‘end’ “. I couldn’t agree more. What we need are solid, reliable and easy-to-handle-solutions for different fields of application. There is no “The Standard in Medical Data & Interoperability Holy Grale”. There is a range of very helpful frameworks and standards out there for different purposes. Aligning them and combining them within a use- and helpful architecture is the tricky part.

Example Germany: When the wrong guys try to take over

In Germany, politics and healthcare consortiums (not to say lobby groups) started an initiative to set up a patient information infrastructure. Two major projects were a new health insurance id card for every patient, storing all relevant medical information on it. The plan included patient info such as medication, last medical statements, current conditions and more. The reality: after roundabout 10 years of development and more than 2 bn € spent it is still not fully rolled out, and only name, address and the insurance number can be stored on the chip card.

The second project, a nationwide “telematic” infrastructure. The plan: connecting every doctor’s office through a “connector” called router to a network infrastructure for exchanging medical information, pictures and statements. Yep, you guessed right: not working as well. There is only one (!) provider in Germany offering the required connection-device and periphery. And most of the doctors do not like the idea that they are forced to buy a device and connect the overaged software to a not function network, spend time for training and technical maintenance and have to pay technicians coming in several times until its fully connected. Not only it is a huge waste of many and time, first of all, no one knows what it’s good for when it’s not working at all.

So… we appreciated your effort, but let’s do it our way

This is, what the big players in the market said now. The big health insurers started rolling out there own Electronic Health Records. No will to wait any longer for the lobby groups and politicians decide what to do with this big pile of mess. Funny enough: they now move over to open up the market by introducing new regulations in lightspeed.

But while more and more digital services are now being developed and launched, the big questions are still somewhat unanswered. For the moment. But things look more than promising, that there is now the needed movement that start-ups and corporates push new solutions and develop a patient focus instead of keep thinking “let’s come up with a standard and force everybody to apply to it”. Times are exciting to watch what’s going on.


We at Niucare are developing a part of the solution. We take care of connecting medical devices, wearables and data sources to the digital use cases for hospitals, digital health services, apps, MedTech and Pharma. If you want to know more, drop me an e-mail (team@niucare.com) or simply visit our website.