I think you have to see in the light of the evolution of practice generally.

Patient loyalty used to be to a practitioner. You may see that transferred
to a Corporate such as Primary Healthcare as things evolve. Lawrie Clift
[now pushing Monet (or was)who grew up in the shadow of Edelstein, 20 years
ago,  had pictures of healthcare facilities which were unique and looked the
equivalent of Pizza hut and were immediately recognizable as such.
Whatever grand ideas he had did not materialise and he sold out to
Foundation and was badly burned in any case. My understanding is that Monet
would be implemented by Foundation as part of the sale.

His whole concept did not materialise. I am not sure why - he had the best
facilities, equipment, volume of patients but there was always bickering and
no ability to see the greater bigger picture of happy staff and happy
patients.

For the practitioner it was ideal - you could work as you pleased and, for
me, weekends were brilliant because you could work your ass off for 14 hours
on Saturday and Sunday and make heaps and have excellent patients and pick
the staff to work for and spend the rest of the week with my young family.

My point is that it is really hard to bring the whole thing into a cohesive
group and I suspect that the pressures from scarce doctors for more money
renders the corporate cut smaller and smaller so that it is harder and
harder to pull it all together.

That said, we are an ASP and our greatest benefit is to rural and remote
situations where our kind of service and where technical people are not
available. With Aged Care Facilities, the rural ones are high on care and
low on documentation and are preyed upon by validators to reduce their
income further and further so that they are not viable.

Aboriginal are the same and 'protected' by the do-gooders and are as
difficult to deal with as with Government who are almost as difficult as
Doctors.

Doctors are the difficult and the rate limiting factor in the whole IT
implementation process.


-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of David Guest
Sent: Tuesday, February 21, 2006 6:27 AM
To: OzdocIT
Subject: Re: [GPCG_TALK] Healthy WSDLs?

David de Bhál wrote:

>We are purely services and apart from the criticism of our current
>attachment to IE 5.5 or greater have nothing in common with Monet except
>that we use the internet.
>  
>
Sorry David I thought the two of you were both ASPs.

<speculation>The way I read the documentation it seemed to me the $10
million to build an ASP medical record would suit large medical
organisations where the security issues would all be taken care of
in-house by default policies. The documentation talks about preferring
to roll out to rural and remote organisations and Aboriginal Medical
Services would seem to be the most likely target for this sort of grant
where the population is somewhat itinerant between their various health
care facilities.

The obvious group to benefit from something like this would be Primary.
You could walk into any Primary store and the docs would have full
access to your medical record. It would even give Bateman an opportunity
to enter the specialist market since there would be advantages in
vertical integration. I don't see it happening as it would entail them
writing off their $100 million investment in HCN.

If somebody else could make this work, it would be the death knell of
city solo and small group practice, but I guess that rang a while ago.
</speculation>

David

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