Horst Herb wrote:
Yes, let's do some math. Any number of doctors fed up with having to install
(mostly ephemeral) proprietary crap in dozens of incarnations resulting in
waste of resources, incompatibilities, upgrading hurdles and unstable systems
come to the conclusion that a path result that will be received reliably and
consistently is ALWAYS better than a path result that may or may not be
received and automatically imported / integrated into the EHR ... will give
you zero business.
Of course I agree. And of course I want a future where everyone has a
choice of their own download clients.
But, just to correct you here....the average GP definitely does not
install their own download proprietary crap (you do but you are the
vocal minority). They just snap their fingers and the path firm sends
out a minion and does it for them ...I'd value that service at $300 a
site per visit - money well spent? well on this list I think its not
been appreciated over the years. As for the cries of instability, Im a
bit over that too. Im no IT guru. I know just enough to get by, but my
wifes server has quite happily ticked along with practically no
interruption to the pathology results flow with a half dozen download
clients clogging its brain. Christ if I can get it to run stable then
some smart IT fellas ought to have it beating Kasparov in the background.
And dont be placing blame on pathology for a lack of clinical packages
being able to reliably import hl7 or pit. I can attest to the fact that
not all the packages do this well or reliably- yet the GP subculture
insists that its the fault of the path lab (and the path labs should fix
it). I have numerous situations in recent memory where the result got
to the target import directory in AHML compliant HL7 or PIT and the
clinical package choked on the import.
I suppose you want me to contribute to the clincial software packages so
that the import works too.
> Now you can multiply that zero with any factor you like. The result will
unsurprisingly remain the same.
John, in business the "customer is always right".
The relationship between a doctor and a patient is not a business
relationship, but the relationship between a GP and a pathologist is in most
circumstances. Face it.
Yes well unfortunately thats the great tragedy of modern times...that
even someone like you takes the core position that the relationship with
the path firm is a business one - I guess that reflects my peers selling
the farm to the ASX. Im afraid Im old school and I still envision
myself as a real Doctor with something to contribute and am trying to
develop a relationship with referring GPs in just the same context as a
cardiologist or surgeon. Do unto others is where I sit. Treat
pathologists with the same respect you treat other specialists. Would
you expect or demand half what you are from clinical specialists that
you seem to expect and demand from Pathology....
I dont hear cries to dump your favourite non IT literate cardiologist
just cause he wont send you an encrypted letter. You might threaten
too, but when it actually comes time to *not* send Mr Favourite old and
dear Patient to Dr X and send him to young and not so good Dr Y who
actually will send a report by email...Im guessing that most of you are
stand up Docs who will in fact overlook the difference and send to Dr X...
Sure Ive got an axe to grind here. And I have tried so hard not to read
this list lately too, I just get so depressed for the image of my
discipline and these posts add to a long day.
> Nobody has demanded that you should roll out Argus yourself or convince your
customer base to use it. All we said is that if you don't consider our
preferred way of message delivery (that is a message in a standard atomic
format (e.g. HL7) encrypted with a standard method (eg X.509, OpenPGP) sent
via a standard protocol (eg SMTP) in a standard wrapper allowing acks (eg
HL7) - Argus des all this and is available for free, but you can always roll
your won if you don't like it) as at least one option you offer, we might not
consider you as an option either.
In essence this thread is saying if I dont "use or support argus
financially" I will lose referrers who will vote with their feet and
move to a firm that does support argus. Did you miss that bit..seriously?
Bring on an open standard so you can use what you like and I can use
what I like and we can all communicate reliably. You know I want open
interoperable communication.
In any case its all a pointless argument which will have little real
effect on the marketplace and who uses what, because sadly the total
number of IT literate GPs prepared to a) have an opinion on this b)
follow that through with action in migrating to an Argus friendly
provider is such a minimal number in comparison to those who have a
friendly collection license in their practice which they of course want
to support in deference to any IT issues (seeing as the path firm
supplies a reliable working client anyway- and hey, it works and we get
results so why care about the method seeing its free) is so miniscule
its only ever likely to affect the very small number of small players
who depend on a small but critical referral base anyway. The big boys
dont really give too much of a damn as long as their costs are kept low.
If Argus keeps middlemen at bay and overall costs down Great! And Im
all for that too. If Argus succeeds I can only smile as it lowers the
floor price for messaging. If Argus fails then at least the code lives
to be raised like the phoenix...
In the big picture of "the bulk" of pathology services these IT issues
are not important.
Welcome to your harsh reality...
We parry, we lament, but at the end of the day its all irrelevant as you
are all as much a minority group as me.
JD
--
=================================================
dr john dooley mbbs frcpa
aka "ron"
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