> Tim Churches wrote: >> Peter MacIsaac wrote: >> ... >> >>> Under a full web service model the IT systems of small business >>> enterprises (like GPs) would need to have the capacity to be always >>> connected to the internet ... >> >> As discussed previously, I am not at all convinced that this is true.
eClinic has been running a PKI secured HTTPS 'web service' nationally for more than five years now for pathology delivery. This particular service doesn't need to be online continually, and there are means to interoperate amongst providers without the needs for a registry. I think that what is perhaps missed is the fact that the IHE standards are all driven by big US RADIOLOGY vendors who have an interest in setting a new industry up (ref http://hl7.org.au/2004-IHE.htm Charles Parisot, Co-chair, IHE IT Infrastructure Technical Committee; GE Healthcare). So the issues I put are (A) is it applicable to the Australian environment and (B) is Radiology the model to use for various health services? That's the debate I'm waiting to see happen... Tim Churches really understands the issue of SMTP vs Web when he said: > Apart from the immediate verification of delivery, Web services are only an advance when you start to > do more than just lob documents around. Try to do anything in real-time or near real-time via email > and it becomes very cumbersome very quickly. I have posted previously that medical services/transactions can be complex and have many participants. As components become electronic and communicate electronically, systems will need to retrieve and exchange many sources of information (and across vendors) in real-time (eg some of the NeHTA building blocks such as provider or drug data sources). That's where *interactive* web-based transactional systems/services come to the fore. Food for thought. Regards, Gavan --------- Gavan Lim-Joon Chief Technology Officer, eClinic Pty Ltd [EMAIL PROTECTED] / www.eclinic.com.au (03) 9381 4567 x106 / 040 234 8186 > > A weservice is needed for 'pulling' summaries off the > central server, > > but the GP doesn't need to get involved - there's no > benefit for them > > over sending the summary in though plain e-mail. > > Apart from the immediate verification of delivery, Web > services are only an advance when you start to do more than > just lob documents around. Try to do anything in real-time or > near real-time via email and it becomes very cumbersome very quickly. > > Tim C > > > > ------------------------------ > > Message: 2 > Date: Tue, 09 May 2006 22:46:39 +1000 > From: John Mackenzie <[EMAIL PROTECTED]> > Subject: Re: [GPCG_TALK] Question for MD3 users > To: General Practice Computing Group Talk <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset=ISO-8859-1 > > > > from personal experience you are one of the milder members of the > > nat-div ash > > > That wouldn't be hard. > > John Mac > > > ------------------------------ > > Message: 3 > Date: Tue, 09 May 2006 22:51:08 +1000 > From: ash <[EMAIL PROTECTED]> > Subject: Re: [GPCG_TALK] Question for MD3 users > To: General Practice Computing Group Talk <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset=ISO-8859-1; format=flowed > > > > John Mackenzie wrote: > >> from personal experience you are one of the milder members of the > >> nat-div ash > > > > > > That wouldn't be hard. > > born to be mild ? > > > ------------------------------ > > Message: 4 > Date: Tue, 9 May 2006 21:23:38 +0800 > From: john hilton <[EMAIL PROTECTED]> > Subject: Re: [GPCG_TALK] Smartcard chief quits PS in disgust > To: General Practice Computing Group Talk <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset="iso-8859-1" > > On Tue, 9 May 2006 08:39, Greg Twyford wrote: > > Not a word about data matching to date. I'm wondering why taxation > > hasn't put in a bid for the funding, alongside Human Services, > > Medicare and Centrelink. > > > > Greg > > I can't see why we can't have a national DNAdatabase by now. > jh > -- > I saw you standing there at the bar > Your eyes were glazed with passion > A look of afar - A secret smile > I blew a few kisses > Said my name is Lyle > > Split Enz - > Late Last Night (P Judd) > > > ------------------------------ > > Message: 5 > Date: Tue, 09 May 2006 16:51:09 +0100 > From: Ian McNicoll <[EMAIL PROTECTED]> > Subject: Re: [GPCG_TALK] IHE and XDS - sharing of documents and > webservices discussion > To: General Practice Computing Group Talk <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset=windows-1250; format=flowed > > Hi Hugh, > > I am a Scottish ex-GP now working in informatics and have > been lurking on this lively list for a wee while. I am doing > some work for SCIMP which developed the Emergency Care > Summary (ECS) and I thought I should pitch in, although ECS > is not one of my projects > > ECS works by culling data from polled GP systems and > transmitting an XML file to a shared server application > called SCI Store and stored in the patient record as an XML > blob. This data is available to a limited > (so-far) number of out of hours providers via a web browser > Patients can ask to opt-out of the process altogether, in > which case there data is not extracted. In addition the Out > of hours provider must get specific consent from the patient > before accessing the ECS. > > The data transmitted is currently limited to demographics, > adverse reactions/allergies and current medication which has > been widely acceptable to the profession and patients. I > believe only about 20 have opted out vs 10,00 data extractions. > > It would be very simple technically to extend the data > extraction to include clinical histories (Read coded) but > this remains rather more contentious because of anxieties > around confidentiality and data quality. Patient surveys have > been very positive with 70% expressing support for their > clinical histories being transferred without their explicit > consent, but of course the remaining 30% may have perfectly > legitimate concerns for anxieties. > > So far so good but some tricky issues lie in wait!! > > Regards, > > Ian McNicoll > > > > ------------------------------ > > Message: 6 > Date: Wed, 10 May 2006 06:54:31 +1000 > From: Tim Churches <[EMAIL PROTECTED]> > Subject: Re: [GPCG_TALK] Smartcard chief quits PS in disgust > To: General Practice Computing Group Talk <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset=ISO-8859-1 > > john hilton wrote: > > On Tue, 9 May 2006 08:39, Greg Twyford wrote: > >> Not a word about data matching to date. I'm wondering why taxation > >> hasn't put in a bid for the funding, alongside Human Services, > >> Medicare and Centrelink. > >> > >> Greg > > > > I can't see why we can't have a national DNA database by now. > > We do. You know all those Guthrie tests done on neonates... > > (See http://www.abc.net.au/catalyst/stories/s867619.htm for > some further discussion). > > Tim C > > > ------------------------------ > > Message: 7 > Date: Wed, 10 May 2006 06:32:35 +0800 > From: <[EMAIL PROTECTED]> > Subject: Re: [GPCG_TALK] IHE and XDS - sharing of documents and > webservices discussion > To: General Practice [EMAIL PROTECTED] Talk > <[email protected]>, Ian > McNicoll <[EMAIL PROTECTED]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset="us-ascii" > > An HTML attachment was scrubbed... > URL: > http://ozdocit.org/pipermail/gpcg_talk/attachments/20060510/a7 > 31128d/attachment-0001.htm > > ------------------------------ > > Message: 8 > Date: Wed, 10 May 2006 06:45:22 +0800 > From: <[EMAIL PROTECTED]> > Subject: Re: [GPCG_TALK] IHE and XDS - sharing of documents and > webservices discussion > To: General Practice [EMAIL PROTECTED] Talk > <[email protected]>, Tim > Churches <[EMAIL PROTECTED]> > Cc: '[EMAIL PROTECTED], HISA Integrating the Health Enterprise' > <[EMAIL PROTECTED]>, [EMAIL PROTECTED] > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset="us-ascii" > > An HTML attachment was scrubbed... > URL: > http://ozdocit.org/pipermail/gpcg_talk/attachments/20060510/d0 > 62a868/attachment-0001.html > > ------------------------------ > > Message: 9 > Date: Wed, 10 May 2006 09:39:48 +1000 > From: Greg Twyford <[EMAIL PROTECTED]> > Subject: Re: [GPCG_TALK] Smartcard chief quits PS in disgust > To: General Practice Computing Group Talk <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset=ISO-8859-1; format=flowed > > Richard Hosking wrote: > > Of course it is about data matching - what is the point otherwise? > > I would be more comfortable if this were just explicitly stated and > > then we could get on with constructing a proper audit and > security framework. > > I think citizens with nothing to hide would be safer than with the > > current setup where we have no idea what is happening to our data. > > Richard, > > Ken's report makes clear that the mandarin at Human Services > wants to 'own' this initiative, and the first rules of our > Federal government's bureaucracy are secrecy and control of > information. Hence the demise of the free-standing body to > implement it and the panel of independent experts to oversee > its development. > > With the new arrangements it can all be done in the usual > secret Canberra way, and most of us will avoid it like the > plague, as a consequence. However, we must realise that if > the bureaucracy did things openly, how could we be afraid of them? > > We'd be too busy laughing. > > When I get a chance I'll have a look a Roger Clarke's site. > I'm sure he'll have something relevant to say. > > Greg > > -- > Greg Twyford > Information Management & Technology Program Officer > Canterbury Division of General Practice > E-mail: [EMAIL PROTECTED] > Ph.: 02 9787 9033 > Fax: 02 9787 9200 > > PRIVATE & CONFIDENTIAL > ************************************************************** > ********* > The information contained in this e-mail and their attached > files, including replies and forwarded copies, are > confidential and intended solely for the addressee(s) and may > be legally privileged or prohibited from disclosure and > unauthorised use. If you are not the intended recipient, any > form of reproduction, dissemination, copying, disclosure, > modification, distribution and/or publication or any action > taken or omitted to be taken in reliance upon this message or > its attachments is prohibited. > > All liability for viruses is excluded to the fullest extent > permitted by law. > ************************************************************** > ********* > > > > ------------------------------ > > Message: 10 > Date: Wed, 10 May 2006 09:59:52 +1000 > From: Greg Twyford <[EMAIL PROTECTED]> > Subject: Re: [GPCG_TALK] IHE and XDS - sharing of documents and > webservices discussion > To: General Practice Computing Group Talk <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset=windows-1250; format=flowed > > Ian Haywood wrote: > > > > Tim Churches wrote: > >> Peter MacIsaac wrote: > >> ... > >> > >>> Under a full web service model the IT systems of small business > >>> enterprises (like GPs) would need to have the capacity to > be always > >>> connected to the internet ... > >> > >> As discussed previously, I am not at all convinced that > this is true. > >> > >> Why does a Web service running on, say, a GP practice > system, always > >> need to be available, 24x7? Is the practice open 24x7? > Nope. So why > >> does the practice's Web services need to be available all the time? > > So we can get some info when the patient rolls into A&E at > 0200 on a Sunday. > > > > Of course this is probably best done by having GPs upload a > summary at > > regular intervals to a Divisional server which is up 24x7, > as others > > have said, giving finer control over what is sent. > > Ian, > > Division were proposed to have a similar role in some of the > early iterations of HealthConnect, but were quickly excluded > by a centralised model once the bureaucrats got involved. > > Most of Division-land is having very limited connection with > this debate these days. Despite the Managed Health Networks > grants on offer, which, of course, require NEHTA-compliance > in the fine print. > > The much-vaunted Eastern Goldfields site obviously cost a > bomb, and was done by handing the project over to Cisco and > IP systems [and Medical Objects], who seem to have done a > fine job, with Health picking up the tab. They wouldn't tell > us how much, at a recent conference, but it was clearly lots > more than the MHN funding is offering Divisions. They only > assured us they didn't spend all the $9m they had to play with. > > Adrian Beekmeijer at ADGP has informed me he doesn't read the > GP Talk List, and I don't think NEHTA would think about > Divisions [can someone ask Ian Reinecke at the next > appropriate conference if he knows what a Division is, for > me, please?], so I'm not sure how we'd figure in this > picture, leaving aside the funding of such servers, of course. > > Greg > -- > Greg Twyford > Information Management & Technology Program Officer > Canterbury Division of General Practice > E-mail: [EMAIL PROTECTED] > Ph.: 02 9787 9033 > Fax: 02 9787 9200 > > PRIVATE & CONFIDENTIAL > ************************************************************** > ********* > The information contained in this e-mail and their attached > files, including replies and forwarded copies, are > confidential and intended solely for the addressee(s) and may > be legally privileged or prohibited from disclosure and > unauthorised use. If you are not the intended recipient, any > form of reproduction, dissemination, copying, disclosure, > modification, distribution and/or publication or any action > taken or omitted to be taken in reliance upon this message or > its attachments is prohibited. > > All liability for viruses is excluded to the fullest extent > permitted by law. > ************************************************************** > ********* > > > > ------------------------------ > > _______________________________________________ > Gpcg_talk mailing list > [email protected] > http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk > > > End of Gpcg_talk Digest, Vol 8, Issue 13 > **************************************** > _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
