On Sun Mar 11 4:37 , Elizabeth Dodd <[EMAIL PROTECTED]> sent:
>On Sunday 11 March 2007 04:54, Peter MacIsaac wrote: >> 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. > > >But getting into the application still does not guarantee that it has got into >the practitioner's brain. No system guarantees that. One of my associates >happily stamps every path report on paper as read, never checks the on-line >version unless the patient is present, and feels that he pays his medical >defence premiums to deal with the aftermath. This is hardly the pathologist's problem, and so not the issue. The issue is what level of acknowledgement does the pathologist need to be able to 'sign off' legal responsiblity for delivery. Certainly messages do go missing in the EHR <->messaging client step, as this occurs entirely within the GP's system, one could argue that this is also not the pathologist's problem. However, as most messaging clients are provided by the pathologists', it becomes a bit grey. Certainly the authors of the HL7 standard wrote assuming it would be the app receiving the data that generates the ACK message: it is supposed to signify that the message was parsed correctly and incorporated into the EHR. Once again, we are at the mercy of vendors who will implement standards or not as they damn well please. Leaving that aside (or rather, in fairness to the vendors) this is not possible until there is a standard for communication between the clinical app and the messaging app, which, one assmues, it what the proposed meeting is about. This begs two questions: 1/ if you set a clinical app <-> messaging app standard, why not set a clinical app <-> clinical app messaging standard and do without messaging apps altogether? 2/ given 1/, and that transmission is guaranteed by the ACK, what does a commerical 'messaging provider' do? Ian _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
