On Monday 27 November 2006 20:03, Chris Tansell wrote:
> My query was about messaging.  If I am correct, you have a relationship
> that exists between each GP and the specialist serving that GP.  If they
> use a particular messageing system - why should I care?  Surely the
> relationship is effectively on a message-by-message basis - the message is
> encoded and transmitted, the message is received and decoded - end of
> relationship until the next message.  There is little or no data "held" in
> any proprietary format.  There may be a few messages that cannot be
> accessed, but I have a fax machine for this reason - same as if my
> broadband goes down (Doesn't happen in Auckland much, but we are a few klms
> away and things are not so good).
>
> So - for messaging only - why should I care?

My practice receives about 30 pathology results electronically a day, some 15 
radiology results, some 10 specialist reports - about 55 messages a day, some 
14,000 / year  Doesn't seem much.

However, a single message out of these 14,000 that fails to get read in time 
may jeopardize a patients health

If I am forced to have a variety of proprietary messaging clients on my 
computer - programs that on top of all will only run on an unreliable 
platform - in my books that increases the likelihood of disaster, no matter 
how small that likelihood is to begin with.

However, if I can have one single messaging client that I really understand 
and that runs on a platform of my choice, using a message format that is 
built upon standards where I theoretically could use standard tools to 
decrypt, verify and read the message - the likelihood of failure is smaller. 
You surely can see that.

What exactly would be the point or advantage of artificially limiting access 
to a message through proprietary formats or restriction to proprietary 
software in order to send/receive/decrypt/encrypt/process that message? In my 
books, I can only find grave disadvantages. The "she'll be right, mate" 
attitude is not what doctors should build their business upon. Currently I am 
not a ware of even a single commercial competitor where that "she'll be 
right" assumption would even be remotely likely to hold true long term

There is one and only one single reason why we are not using a standard 
messaging format and transport mechanism: proprietary vendors hope for unfair 
competitive advantage by excluding others from that game. The worst ones even 
re-route messages without need through their own servers just so that they 
can use (or abuse?) hem as toll gates. There seem to be a few notable 
exceptions (eg MedicalObjects appears to be rather cooperative, but I known 
very little about them) - those cooperative exceptions I wish all the luck.

Look: I have been using email long before I went into medicine. I have been 
using encrypted secure communication even before I started contemplating 
studying medicine. It always worked, and it still works, and will still work 
when all those wannabe monopolists are long forgotten - we don't need them in 
order to communicate if we are only prepared to spend a few hours learning 
basic net skills and agree on a few simple standards based formats and 
transport mechanisms

Horst
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