Andrew McIntyre wrote: >Well I guess someone has to pay and its the sender that normally pays >postage. If you are sending out lots of reports then you would >normally pay the postage. Having the recipient pay to be able to >receive form anyone is probably a better model, but is the reverse of >the current culture. > > Exactly. The person who derives the benefit should pay. That's probably the radiologist and pathologist when they have bulk reports to deliver but the prices charged by some commercial providers are, in my humble opinion, scandalous.
In specialist GP communication it should be the GP. Half my specialists don't really give a stuff whether my system can cope with their letters and once something is out the door they have discharged their duties. Only GPs with fully electronic records actually want e- letters. Healthlink prices this at $240 per year and that would be very reasonable for producing a system wide culture change in how information is delivered. However, once that change has occurred the marginal costs are minuscule. In hospital to GP communication, despite all the death and destruction that occurs daily, the hospitals pay only lip service to efficient communication. I don't think they are aware that there is a world beyond their walls. >DG> As an open source enthusiast I want it all and I want it now. The >DG> economics of scarcity works against this desire so I have to fall back >DG> to wanting it all, eventually. This is, however, much better than >DG> wanting it all and never getting it. > >I would equate it to EMail, you initially did pay for an email client, >but with time this became standard and free and open source versions >appeared. Eventually it becomes a commodity item. Ditto for browsers, >I can remember paying for first version of Netscape. > > Exactly and I understand that some people still pay for their operating system. >DG> So let me get this straight in my mind, you have a client that will sit >DG> on the GP's firewall and accept connections from other "authenticated" >DG> machines. There is no need for the data to be tunneled through a >DG> specific gateway. The application is fully standards and buzz word >DG> compliant and the specs for talking to it are fully detailed. Although >DG> this is a commercial product and the source code would never be >DG> released, it would be quite possible to build one's own server that >DG> would freely interoperate with you and others who build to the spec. > >Yes, thats what it is. I exposes the same interface as the full >servers but simply acks results and saves to a folder. It supports >PGP, PKI and GNUPG. It has SOAP and HTTP interfaces. You can configure >it youself. It insists on encrypted, signed messages to avoid spam >etc. LDAP is built in. > >Argus implemented the HTTP interface for HIC2005 inter-operability >demo. > >Currently Windows only I am afraid. > >It is a commercial product, but its software and not hosting/hardware >so the price need not be that high. It will allow real time point to >point delivery and the interface is there to be cloned. Being >available as a destination on our network is probably one requirement. >Medical Object servers can setup connections automatically, but other >servers can be manually setup but importing keys and signing them. > >No database required, it can participate as a client, in automatic >discovery and routing protocols. At the moment it doesn't have the >send out results ability, but at least provides a "postbox" to enable >results to be received. That send out ability comes with the full >server. > >Its codenamed 'Capricorn'. The technical ability to safely open a port >on your firewall is the limiting factor for many surgeries, but this >open point to point interface potentially avoids the "toll". As you >provide the hardware and bandwidth there are not a lot of costs for us >other than managing the directory, and of course, technical support. > >Its working in trial mode now and we are looking for sites interested >in testing it in the real world. > > Put me down for one. David -- "UFW. Deb does linux."
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