Standards Organisations excel at establishing clear definitions, and providing frameworks and specifications against which conformance can be asserted, and which can be included by reference in contracts. Crucially they also provide a forum where those specifications can be discussed and issues resolved at arms length from the contracts that depend upon them.

Search Engine Optimization (SEO) is the rapidly growing profession of presenting data on the web in a way that results in appropriate placement in search results. Here there is no problem with engagement - those following "best practice" get to the top for the search terms that they care about. The process is policed by a combination of published rules and private algorithms, both controlled by commercial search engine organisations, who are in turn motivated (controlled) by commercial drivers to attract and retain users, advertisers, and other revenue streams.

While SEO practitioners do not care about the precise definition of the terms that they are optimising for, they do care about which terms effectively express the relevance of their sites, and which terms the potential users and customers of that site will use. There is a virtuous circle here of users looking for information that meets their needs, site maintainers making their sites easier to find, policed by the search engine companies and their algorithms who are looking to maximise successful search experiences for their customers. The search engine companies provide tools to site maintainers to help them improve the relevant ranking of sites - and the site maintainers have business reasons to use these. There is not the same strong feedback loop in the development of formal standards.

Similar searches are done within organisations using business intelligence engines to extract management and marketing information from the raw data that the organisation holds or has access to. Here some of the data may have been created for human readers, but much will also have been created conforming to specifications or standards that enable machine processing, albeit not necessarily for the purposes of business intelligence. This is often transactional data, and changing it requires changes to the workflow processes and the information systems that support them - which is very different to changing the way that websites are structured and populated. However those of us interested in translational research and innovation in healthcare need to learn from the drivers that are effecting large-scale change in the way that the web looks and functions.