A tad harsh Horst.  How about you step back a little and try and see it
from the other side for a while...

Everyone is quick to criticise us but somewhere the balance has been
lost and now general practice just demands electronic delivery even if
they have never sent a path specimen to a company.  So we have GPs
ringing up demanding the download client after 2 hardcopy copy to dr:
reports.

Id say a little more understanding and consideration is due for the
benefits these clients have brought and the solutions people have chosen
to get them to their current state.  The problems outlined about
networking are very very real and this list is biased with the better
end of IT support with people who know what they are doing and able to
fix things like permissions etc.  You guys can deal effectively with
permissions and dramas but lots of practices cannot.

Its basically a lot _easier_ to have these apps run on the server from
the point of view of trying to fix them when they break.  Mind you I
know at least one java based xray app that doesnt like a TS environment.

Mostly the server is the most reliable PC, always on at the right time
and some networking setups at practices are god forbid suboptimal
networking wise meaning sticking a d/l client on a non server PC results
in failed downloads (if it cannot reach the server for whatever reason)
and do more harm to the path company than good (unreliable downloads is
a big issue).  IT support for the download clients is expensive and time
consuming and they cost lots to produce in the first instance.  The
practices dont want to have to call their IT guys ($), often download
"issues" are treated as low priority and there is an extended
communication and resolution cycle to get practice IT, Path IT and Drs
all to a happy ending.  Time is money for everyone.

I too believe in a world with one open interoperable client, but I have
to face the harsh reality that until that time downloads just have to
work reliably and if that takes insisting on a server install to happen
then so be it.

In reality the companies do what they must to get the job done as easily
and reliably as possible.  Its not like Company A is going to offer
their download client to Company B if Company B is having trouble is it!

I know that GPs get mighty ornery about sending patients to the closest
collection centre if its competitively located  inside a different
general practice so you too are not insulated from competition over
altruism.

Honestly it comes across like there is some evil conspiracy happening
with these bits of software trying to bork your servers when in reality
its just Path companies trying to get the easiest most reliable delivery
method going in a generic sense that requires the least support setup
happening for their deliveries and has the highest reliability.

Horst, the big firms dont think in tbird/pgp/python script terms and you
very well know that. They think in MS/ java / vbasic terms.

As for finding a "competent IT person".  Im guessing that even an
incompetent IT person could do the send leg of the email just for little
old Horst, but for the bits behind the scences interacting with the
mainframe running the patient database, I guess they needed a competent
IT person to work through feeding back the ack and tracking info about
the whole process of sending those results just to you (and separating
off your delivery method from the rest of their system).  How much time
do you reckon it cost Symbion to set up their end for you to have the
python solution so their mainframe is okay with it?  half a programmer
day?  a day?  for one outspoken GP...

How many different solutions have to be implemented like that to keep
everyone happy?

How about you GP IT guys get together and write or at least participate
in getting GPland a universal download client so that everyone can send
results you and promise not to phone if you cannot get results when its
installed on the pc in the tea room, and take ownership of the issue a
bit? That way you would solve your IT support problems yourselves?

I love the way path services are deemed generic enough that you can
"force" them to install their software for you your way and provide
support on your terms or you'll take your bat and ball and go elsewhere
to someome who does it your way. I guess thats the harsh reality of
life.  But mind you I dont see referrals to specific surgeons being
treated the same when they dont send electronic letters and have to have
paper scannned :P  ...

Is there really significant issues with "server crashes" (meaning
nonfuntioning servers) as a result of misbehaving download apps or is
this more FUD being spread...  hands up who has a solid example of a DL
client killing a server.  I dont mean costing 10% more CPU cycles in
perfmon(who cares), but actually causing a server to hang.  Eventlog
should point someone in that direction?  I call shinanigans and say its
rare and again I call shinanigans on substantial performance impact of
these clients  (well at least the handful we use)

My wifes practice server has never crashed because of the myriad
download apps on it (iirc 5 or 6).  Sure some of the apps occasionally
go pear shaped (aforementioned radiology app in fact) but afaik its
never killed the server (/hopes he hasnt jinxed server)

Come on guys, remember that the path companies for lots and lots of
reasons want a robust d/l system too and work with not against them to
achieve that.  Drop the us and them attitude....

JD
mbbs frcpa

nexuspathology.com
using medical objects and promedicus.net for delivery

ps I have next to no spare time to troubleshoot tearoom pcs

Horst Herb wrote:
> On Thursday 18 May 2006 22:25, Chris wrote:
> 
>>What's the score with Pathology download apps?
> 
> 
> Dunno. Refused to use them until my pathology provider (Mayne, now Symbion) 
> got a competent IT person who had no problem sending me the results using 
> standard technology (SMTP transport, OpenPGP encryption, PIT format) where a 
> 20 lines python script is enough to receive, decrypt, decode and import the 
> results into the software of my choice on the platform of my choice.
> 
> One day we might even agree on some HL7 dialect ...
> 
> 
>>Is there a reason why each one wants to use their own proprietary
>>downloader and put their own application within the supposedly secure area
>>of the practice network?
> 
> 
> Yes, there is a reason (or two). It is called "ignorance", other 
> times "greed".
> 
> Horst
> _______________________________________________
> Gpcg_talk mailing list
> [email protected]
> http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
> 


-- 
=================================================
dr john dooley mbbs frcpa

aka "ron"

_______________________________________________
Gpcg_talk mailing list
[email protected]
http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk

Reply via email to