HL7 RIM: an incoherent standard.

The Health Level 7 Reference Information Model (HL7 RIM) is lauded by its authors as 'the foundation of healthcare interoperability'. Yet even after some 10 years of development work, the RIM is still subject to a variety of logical and ontological flaws, which has placed severe obstacles in the way of those who are called upon to develop implementations. We offer evidence that these obstacles are insurmountable and that the time has come to abandon an unworkable paradigm.