In recent discussions about receiver responsibilities, both in Australia and
at HL7, it has been suggested that the acknowledgement response to a HL7
result message should come from the GP application, not the communication
client.

This ensures that the sending pathologist for example at least knows that
the report has made it into the referrers application. I understand that
there have been examples of reports falling into the void at that level ie.
Pathology system feels that delivery has been acknowledged and GP system
does not really have it.

Agreeing on such business rules is part of the professional process that has
to occur to create a fully funnctional and safe e-communication system.

Issues such as this will be discussed at the forthcoming HL7
pathology/radiology messaging workshop on 22nd March in Melboure (see link
from www.hl7.org.au).

It is important that GP users and GP vendor systems clearly state their
requirements at this meeting as the following day 23rd March,  an open
technical group will discuss the components of a diagnsotic messaging
profile which will describe such business rules, and focus on the
integration of the various standards, messaging, terminology, security,
privacy, and communication for use in both hospitals and community.  HL7,
MSIA and HISA are sponsoring this years Interoperability 07 demonstration at
Medinfo. The plan is to test this profile with participating vendors and
certify their conformance to it. (www.interoperability07.com.au) 

While it is acknowledged that pathology/radiology messaging (an those
involved from the specialist services, communication and receving systems )
are currently making a major contribution to e-health,  there are still
significant problems relating to the use of differing standards and
implementation in legacy systems. We would hope that GP/specialist user and
vendor views will be represented at the workshop.  The views and examples of
issues from GPCG members on this would be appreciated.


Peter MacIsaac
Interoperability07 Coordinator
For HISA, HL7 and HSIA.




Regards

Peter

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Peter Macisaac
MacIsaac Informatics
Consulting in health informatics, HL7  and terminology
[EMAIL PROTECTED]
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-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of John Mackenzie
Sent: Friday, 9 March 2007 9:38 AM
To: General Practice Computing Group Talk
Subject: Re: [GPCG_TALK] Messaging Responsibilities


> What is the 'lists' understanding of whose legal responsibility it is 
> to monitor the receipt of inbound messages (Path, DI, DS etc) into 
> Practice software from download applications?
> It appears that generally download applications will normally notify 
> the sender of receipt.  The GP clinical software may or may not be set 
> up or capable to pass acknowledgement back through the system to the 
> sender.


It's the GP's responsibility who requests the investigation ...
He/she must have systems in place to ensure that the investigation is indeed
performed (if it is of vital importance), that the result has been obtained
and notified to the patient, and that the patient has understood any further
advice that may pertain to the result so obtained and duly notified. 

This responsibility has clearly been dumped on the GP by our esteemed
judiciary, and for the GP to not to ensure that the above "loop" has been
fully completed has been stamped as neglect which could entitle neglected
patients to $millions in the event of an adverse medical outcome. 

Welcome to general practice. 

John Mac
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