DICOM is now a highly successful standard, and I occasionally think about why this is. I was first involved in 1991, and have been involved on and off ever since. It is different from most standards in that participants tend to be highly pragmatic, and willing to compromise for the sake of making things work. I think that this is part of why it has succeeded.
One reason for this pragmatism is the original forcing function for DICOM. In the late 1980's and early 1990's hospitals were "owned" by the MR vendor. Each vendor had its own proprietary networking system for imaging systems. The MR system was the really big ticket purchase for a hospital. So the effect was that a hospital with a GE MR system would have GE for all the rest. A Siemens MR owner would have Siemens for all the rest. And this was a tremendous problem for the hospitals. They wanted to be able to buy from a variety of vendors without suffering from network problems.
They laid down a nuclear threat. They threatened to disqualify any product that did not interoperate with imaging equipment from other vendors. The threat was to officially label that product as not suitable for medical use. The NEMA standard that preceded DICOM had failed to be widely accepted (for a variety of good reasons) but there was a lot learned from attempts to use it. It was clear that a standard was needed in order to accomplish interoperability.
But this is different from most standards processes. The goal was not creation of a standard. We were going to be put out of business if our products did not interoperate. The standard was merely a step on the road toward that goal. Most of us involved with creating the standard were engineering managers or product managers. We would be failures if all we did was write a standard. Success required product integration and successful interoperation with products from other vendors. The standards consultants, standards experts, and the like were not welcome unless they contributed toward our success.
This did establish a tradition of pragmatism. Making the system work was far more important than following any particular theory or standards practice. Academic and theoretical purity was of value only to the extent that it helped ensure that things worked when we were done. The "fad du jure" (e.g., SOA) was unwelcome. We had products with long lifespans, strict regulatory requirements, and tight pricing pressures. Technology fads had no influence on medical buyers. They were influenced by medical fads. So, as engineering and product managers who needed to sell products we stomped out the technology fads, unless they could show pragmatic value as enhancing our chances of success.
This is very different from many SDOs. In many SDOs the development team reaches their goal with the successful balloting of the standard. That is the target. That is what they get paid for. We knew that we were not done until we had a cost effective implementation of the standard, working in our product, selling to our customers, and acceptably interoperating with the other machines on the customers network. Having this different goal and different staffing made a difference in our practices, attitudes, and traditions.
This is one reason that DICOM succeeded.