Aspects of implementing and harmonizing healthcare communication standards.

A variety of healthcare communication standards (HCS) have been developed during the last decade. They have improved the interoperability and the connectivity in open hospital information systems to a large extent. They have also reduced time and efforts during the implementation of standard interfaces. However, the implementation of communication standards is still far from the expected plug and play. The two reasons which are the main cause the current drawbacks are identified--the lack of a standardized terminology and the restricted flexibility of the currently used interchange formats. On the one hand the standardization of the terminology can not be solved by the standards development organizations. It is a general challenge for the medical informatics community. On the other hand the movement to a new interchange format can be initiated by standards development organizations. The application of SGML/XML as an interchange format for communication standards offers a much greater flexibility and adaptability to user needs than the currently used interchange formats. Concepts for a smooth change to a new direction are discussed.