" Health care trails other fields in the application of information technology primarily because it lacks uniform standards and protocols. This month's gatefold looks at various initiatives now under way by the government and within the health care field. "

" The adoption of medical informatics standards by emergency department information systems (EDISs) is not universal, despite obvious benefits. Clinicians and administrators looking to obtain an EDIS need to know exactly what the various standards can do for them and how the systems they depend on can be integrated and extended. In addition to the standard methods for systems to communicate (chiefly Health Level 7 [HL7]) and those required for submission of claims (Current Procedural Terminology [CPT]-4, International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM], and X12N), there are several other available standards that are clinically useful and can greatly improve the ability to access and exchange patient information. Major advances in the Unified Medical Language System of the National Library of Medicine have made the patient medical record information standards (Systematized Nomenclature of Medicine [SNOMED], Logical Observation Identifiers, Names, and Codes [LOINC], RxNorm) easily accessible. Detailed knowledge of the arcana associated with the technical aspects of the standards is not needed (or desired) by clinicians to use standards-based systems. However, some knowledge about the commonly used standards is helpful in choosing an EDIS, interfacing the EDIS with the other hospital information systems, extending or upgrading systems, and adopting decision support technologies. "

" OBJECTIVE: To describe the current status of and future plans for health informatics and related standards in China and analyze the problems raised in the process of standardization for health informatics. METHODS: Data were collected through investigation and interviews, complemented by a comprehensive review of relevant literatures and regulations/law documents about health informatics and related standards in China. RESULTS: Health informatics has been greatly developed in China. Significant resources were committed to construct and improve the health information system. Approximately 35-40% of hospitals have constructed hospital information system. Over 80% of medical organizations above the county/district level, 27% of town level hospitals and all CDC above the county/district level can transmit real-time epidemic situation reporting through public health information system. However, lack of standards became a bottleneck to utilize and improve health informatics. China has adopted some vocabulary, classification, coding standards and message standards. Moreover, several national standardization actions for health informatics have been taken. In the process of standardization, the main barriers consist of financial, technical, cultural and language problems, legal and ethical concerns and others. CONCLUSIONS: Informatics has the potential to play an important role in China's healthcare reform process and standards are the basis for the information sharing and interoperability. Governments and partners of health informatics have realized the importance of standards and taken the initiatives in trying to solve the problem of lacking standards, but much work still needs to be done. "

" Standardization system includes development, publishing and promotion of standards, as well as their use in practice. Products, services and processes in a variety of human activities should be standardized. The goal of standardization is to achieve a high security level, a high quality, usefulness and effectiveness as well as limitation of variability, ensuring compatibility and replacement (of products), and to eliminate technical problems in the international exchange of people, work, products and services. The leading areas/objects of standardization in medical informatics are electronic health record, classification in health care, communication and message exchange as well as data security and protection of the whole health information system. Technical Committee for Standardization in Medical Informatics (TC215) has so far accepted fifteen standards and prestandards. The affiliate HL7 Croatia works on localization of communication standard HL7 and adaptation to the Croatian requirements. "

" Clinical guideline authors, health information technology (HIT) standards development organizations, and information system implementers all work to improve the processes of healthcare, but have long functioned independently towards realizing these goals. This has led to clinical standards of care that often poorly align with the functional and technical HIT standards developed to realize them.We describe the shortcomings and inefficiencies inherent in this current process and introduce two national initiatives that attempt to unite these communities. The mission of these two initiatives is to create examples of unambiguous, decidable, and executable clinical guidelines which both utilize and inform HIT terminology and logical expression standards. All of the products of this work aim to facilitate enterprise-wide guideline implementation and create a rising tide which lifts all ships. "