A Proposal to create a Universal Namespace for Health Information Architectures
To introduce an architectural priciple called a Universal Namespace: that all information objects have a unique name that can be universally referenced. This has the effect of creating an information space framework in which clinical data, medical knowledge, genomic information, and other knowledge can be linked. As a large-scale, fine-grained network of information, it allows security and privacy considerations to be dealt with great power and simplicity. By providing a simple but universal connectivity model, it provides a way of connecting information through linguistic references, rather than just special purpose, static application program interfaces (APIs). This allows users to design from a state of connectivity - they have some level of connectivity "out of the box" - which in many cases may be good enough.
Shifting our architectural perspective from a single, "integrated system" to a more general "information space" opens the doors to many forms of innovation. This opens the architecture up to all of the web tools that are so prevalent in today's world. It allows extension into the Linked Data movement, semantic web, and integration with genomic knowledge management system, personalized health, and innovations not yet considered.
This principle still supports integrated systems approaches. Amazon.com, for example, is an independent system embedded in the web. Inside it's web site, it has huge technical capacity, and technology that is proprietary - and invisible - to the rest of the web. But, by embedding itself in the web (rather than, say, using text messaging on cellphones or using a bank of dial-up modems) it opens itself to a broader world of connectivity.
This proposal offers very fine granularity for understanding and controlling patient privacy. Some objects may be very tightly controlled (or invisible) to the general public (say, one's psychosexual history), other objects may be generally viewable and searchable via Google (e.g. someone might opt-in to an exercise/weight loss competition)
In a future post, I'll be discussing how I think this principle can lead to a notion of what I'll call emergent simplicity. Yahoo, in its early days, tried to maintain a staff of web organizers, creating a hierarchical "table of contents" to the web. This effort collapsed out of its own weight. Google emerged with its scalable search technology, introducing a much simpler way to find material on the web - an example of emergent simplicity. Tim Berners-Lee could not have designed Google in 1995, the web had to evolve from its simple beginnings, and go through a chaotic, evolutionary process in order for Google to emerge.
Similarly, we can look at the current explosion of complexity in health IT, privacy, genomics, personalization, cost containment, knowledge management, research, and "big data" as the breeding ground for the emergence of a new, higher-level understanding of health and technology. Creating a universal namespace for health information can be seen as a babystep towards a new model of emergent simplicity in our health care system.
The Web is a universal information space. It is a space in the sense that things in it have an address. The "addresses", "names", or as we call them here identifiers, are the subject of this article. They are called Universal Resource Identifiers (URIs).
An information object is "on the web" if it has a URI. Objects which have URIs are sometimes known as "First Class Objects" (FCOs). The Web works best when any information object of value and identity is a first class object. If something does not have a URI, you can't refer to it, and the power of the Web is the less for that.
By Universal I mean that the web is declared to be able to contain in principle every bit of information accessible by networks. It was designed to be able to include existing information systems such as FTP, and to be able simply in the future to be extendable to include any new information system.
The URI schemes identify things various different types of information object, wich play different roles in the protocols. Some identify services, connection end points, and so on, but a fundamental underlying architectural notion is of information objects - otherwise known as generic documents. These can be represented by strings of bits. An information object conveys something - it may be art, poetry, sensor values or mathematical equations.
The Semantic Web allows an information objects to give information about anything - real objects, abstract concepts. In this case, by combining the identifier of a document with the identifier, within that document, of something it describes, one forms an idenifier for anything. This is done with "#" and fragment identifiers, discussed later.
This concept has gone on to be one of the most successful technological innovations of our time. Facebook, Amazon, eBay, and Twitter present trillions of URLs to the world that can be referenced within a single linguistic framework. This URIs can be used irrespective of one's geological location, device, or type of communications connection to the internet.
Tim Berners-Lee envisioned the web as an open space for information to exist:
What was often difficult for people to understand about the design of the web was that there was nothing else beyond URLs, HTTP, and HTML. There was no central computer “controlling” the web, no single network on which these protocols worked, not even an organization anywhere
that “ran” the Web. The web was not a physical “thing” that existed in a certain “place.” It was a “space” in which information could exist.
If someone wants to tweet a book reference, they simply drag an Amazon URL (say, http://www.amazon.com/Creative-Destruction-Medicine-Digital-Revolution/d... ) into Twitter. Someone else can make a comment, which can be referenced as well (e.g. http://www.amazon.com/review/R3UEA8TJP4YW12/ref=cm_cr_pr_perm?ie=UTF8&AS... ) The URLs may become difficult to read manually, but the web can use this information to uniquely identify the information.
Note that Amazon and Twitter did not require an "interface" between them - their connection was part of a linguistic relationship, managed by the web's design and infrastructure. The web's connectivity is defined by this linguistic layer as an intrinsic property of the information space. This connectivity does not preclude more specific API-sytle interfaces. If Twitter wanted to use Amazon's shopping cart, for example, it could develop a specialized interface.