It'll be an eternity before any degree of standardisation of health informatics systems will be achieved on a meaningful level. We're still facing the fact that most healthcare information systems cannot exchange information with all the systems for which this would be desired. But it's not all doom and gloom. A recent review in Methods of Information in Medicine (2002;41:261-70) concludes that in some parts of the world, standards are widely used, and the various bodies set up to guide and review what's going on are now largely cooperating to achieve global consensus.

Editors of medical journals are put in a difficult position if the associations that own their journal can dictate to them. Both JAMAand the NEJMrecently lost their editors through over exuberant owner involvement. In a survey of editors of 33 journals owned by not for profit organisations, 70% reported that they had complete editorial freedom, while the rest said they had a high level of freedom. Despite this, 42% admitted they'd recently been under pressure from the leaders of their owning associations over editorial content. The authors warn editors that if they've not yet …