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The ecosystem of open-source software needs to be considered when choosing an appropriate standard for a given context. We discuss two specific contexts, namely standardization of (1) health data for federated learning, and (2) health data sharing in low- and middle-income countries. Specific design principles, practical considerations, and implementation choices for these two contexts are described, based on ongoing work in both areas. In the case of federated learning, we observe convergence toward OMOP and FHIR, where the two standards can effectively be used side-by-side given the availability of mediators between the two. In the case of health information exchanges in low and middle-income countries, we see a strong convergence toward FHIR as the primary standard. 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