what micro-credit has to teach Healthcare IT standards developers

The account by Muhammad Yunus of how he started the Grameen Bank has many lessons for those of us trying to improve health through the development and promotion of interoperability standards. 
Yunus saw a local problem - the need for small amounts of credit to get small businesses off the ground.  He devised a local solution that was repeatable, adaptable and scalable. 
Scalability is important because the local problem/opportunity that he saw is repeated everywhere, and the rapid growth of Grameen and similar micro-credit schemes has shown that the solution he developed could be replicated.
To better support the scalable use of IT in healthcare we need an information sharing framework that allows local projects and trust relationships to be quickly and easily established, with the information requirements easy to define and implement, yet consistent with broader national information needs, and using commodity information management tools as much as possible. 
The requirement to be able to develop implementation guides that work for local projects quickly and cheaply is vital to the successful uptake of interoperability standards - taking this as a core requirement will change the sort of standards that we develop, and help us to deliver something truely useful.