What we need is a higher level specification to focus on. I think the HL7 "Implementation Guide" could be this, but I am thinking something much higher than is normally documented by HL7. This because what is needed is not a "Standard", but a "Reference System". A 'system' in the broadest of definitions. A system as in a system of systems in a defined environment, and policy framework.
A reference system of systems:I think it is possible to have a "reference system of systems' as a proof of completeness, that could be used during connectathons and certification.
These are not best-practice policies, but rather simply realistic-policy that is representative of reality. Reality is that there is an infinite set of policies too, even an infinite set of realistic policies.
Doing the workBack in January I proposed Document Sharing - ala MHD profile centric; which got shot down by HL7 leadership due to the fact I proposed it in the HSI workgroup. ... I failed, should have pursued a solution. HL7 Project Scope Statement 1231
Argonaught could do similar using their flavor of DAF.
HEART can be used, but is, like FHIR, just one part of the system. HEART can't do it alone as they don't have the end-to-end workflow. They don't have the setting context. The HEART profiles would be something included in the reference system.
Focus on end-to-end system of systemsThe hard part is that no-one will agree on these Setting and Policy choices. Yet, the specifics of the setting and policies are not important. What is important is setting someting reasonable so that the next stage can be set.
I hope I can participate...