as the result of trials for harmonization the joint initiative on standards developing organization sdo global health informatics standardization was established among six sdos isotc hl centc cdisc ihtsdo and gs healthcare to address and resolve longterm accumulated issues concerning gaps overlaps and counterproductive efforts the itu and world health organization who are strengthening coordination in technical areas for ehealth standardization and uses of ehealth protocols they also have gaps overlapping and counterproductive efforts even in the case of joint collaboration groups