> Sure, but my question was "Why is it necessary to poll every path and > imaging provider?" Surely there is only a need to poll the much more > limited number of providers to who the GP(s) in a practice have actually > referred patients/specimens. If a lab forwards a specimen to another > lab, then the results would need to be made available at the original > lab for collection from that lab's Web service.
Agreed, if we restrict ourselves to traditional medical request/response then you are right that the polling can be limited to those organisations that your system has an outstanding request at. But I think there is an opportunity here to develop a messaging infrastructure that is much more powerful than that model. I mean, why shouldn't patients be able to send unsolicited "results" back to the GP, documenting their daily BP for the past month (collected automatically by their home BP monitoring device). Or what about a physio who sees a walk in patient and would like to send a report to the patients GP so that the GP is kept informed. Its all very pie in the sky but I think we would be limiting ourselves by only considering messaging that fits into the request/response. > 1) Web services can be easily implement using packaged software on a > standardised Web server at the edge of each practice. That implies that 100% agree on all 3 of your points. I think the reality will end up that those GP organisations that have economies of scale will run their own IT infrastructure (webservices), and those that don't will rely on someone else to run their infrastructure (which given the sensitivity of medical records may need to be a specialist "medical" ISP/division to give GP's confidence that there are procedures being followed). Which of course is exactly what currently happens in every other industry in Australia and the world so it shouldn't be that great a conceptual leap for health care (i.e. small law firms have email and a website with an ISP, large ones host their own etc) > Commissioning a suitable group to write an open sourced reference > implementation of such a Web services server would cost perhaps a few > hundred thousand (including documentation and testing) and would > kick-start the process and encourage lots of redundancy by allowing Well I'm writing some medical web service stuff right now to iron out some of those practical difficulties that always come up in IT.. if someone wants to give me hundreds of thousands of dollars I can do it quicker :-), but irrespective of that I'll let you all know how it goes.. > Of course, all of this is still predicated on a pervasive PKI, isn't it? > Does NEHTA think that HeSA cuts the mustard in this respect, I wonder? > Given that a national provider index is planned in the next three years, > a national PKI intimately hooked up to the national provider index makes > enormous sense. NEHTA has, from memory, $30-40 million to implement > this. So let's have the national health PKI we ought to have had from > the outset. How about it, NEHTA? Yes, a national provider index and PKI are such a natural fit that it will be criminal if they do one and not the other.. and it would be nice if it wasn't done half arsed as well (e.g. hesa) Andrew _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
