Craig, Your points are well made and will be raised at workshop on diagnostic messaging - Thursday 23rd at the Alfred in Melbourne
http://www.hl7.org.au/2007-Path.htm Peter MacIsaac On behalf of the group at HL7, HISA and MSIA working on the Interoperability 2007 demonstration (www.interoperability07.com.au ) -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Craig Barnett Sent: Tuesday, 13 March 2007 3:05 PM To: [email protected] Subject: [GPCG_TALK] RE: messaging responsibility - courts or good judgement..maybe common sense The Law will always be an ass - the courts make decisions on a case by case situation. This does not imply they should be ignored! The law will never give a ruling till after the event!! Pull back and ask what is good messaging?? It is a message which goes to its intended reader.... and better than this ....one dispatched and the sender is aware it has reached its reader. The technology to do this is not hard or fastidiously complex! The .ack file from clinical software to clinical software is a sound starting point. Some might argue they want another message to indicate the message was read by said doctor (eg like the 2 options in outlook acknowledge message received THEN acknowledge read) The current situation is drop the results in a holding pen and hope the clinical software reads it. There is no surety in this. For those who claim 100% success in electronic path transmissions to make it to patient file level ...... has anyone of your doctors ever phoned pathology for a result? ... WHY DID THEY PHONE? - was that a missing result? Was it reported - to whom? Was it investigated? But by whom? Unless systematically look closely you are unlikely to notice the odd missing FBC or EUC maybe only 1 in 100 to 1:300 If you are a small surgery this is may be a once a year event? Acknowledgements issued by the transmission clients own sending receiving systems are technically useful for trouble shooting IT problems but are medical bunkum in terms of PATIENT SAFETY OR CLINICIAL SUETY. FROM EARLIER POSTS ..it was argued that the results dumped on the server are the same as "paper results" dumped by a "courier" at the front desk .. I have sympathy for the analogy but it is deficient... 1) results on paper are in a ready to read (english??) format at the front desk with a "minimal skill" set required (ie recognisable paper as pathology results )Business protocol dictates how they are distributed internally. CONTRAST .. HL-7 dumped on a server [outside of the clinical app] are not available to a doctor at "minimal skill set". You need to know computing skills well beyond the clinical app skill set to find them, discuss correcting the problems etc etc However it is reasonable to expect the doctor to be able to run and monitor issues WITHIN their clinical APP. 2). In our practice if something is important, such as chasing a slack patient about their CIN 2 pap (assuming we cannot reach them by phone or they fail to attend ) then return paid certified post is the next step .... this scenario ensures Australia post - the carrier of paper- identified the receiver and returns an ack to our surgery indicating the patient received the important message OR When There is NO ACK and we find the message could not be delivered and have to look to solve the ability to make contact !! Hence I am not yet dissuaded from the minimal patient safety is clinical APP to APP .ack systems WITH A BUSINESS PROTOCOL for reconciliation. In this scenario if my patient asks why did I get cancer when pathology sent the result which was not acted on ..... then like an aircraft crash I know the event involved either catastrophic Computing scenarios (still the result was lost after the .ack message ) OR human errors (assuming I have maintained due care) ..... MOST IMPORTANTLY IF IT IS MY DAUGHTER I CAN WITH A CLEAR CONSCIENCE {but sad heart!!) say I tried really hard to avoid this happening!! IS this not the spirit of our profession and humanity? Can someone mount a more convincing alternative view of messaging responsibility? Craig -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED] Sent: Tuesday, 13 March 2007 1:00 PM To: [email protected] Subject: Gpcg_talk Digest, Vol 18, Issue 35 Send Gpcg_talk mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk or, via email, send a message with subject or body 'help' to [EMAIL PROTECTED] You can reach the person managing the list at [EMAIL PROTECTED] When replying, please edit your Subject line so it is more specific than "Re: Contents of Gpcg_talk digest..." Today's Topics: 1. Re: Internet redundancy (Greg Twyford) 2. Re: Messaging Responsibilities (Greg Twyford) ---------------------------------------------------------------------- Message: 1 Date: Tue, 13 Mar 2007 09:45:21 +1100 From: Greg Twyford <[EMAIL PROTECTED]> Subject: Re: [GPCG_TALK] Internet redundancy To: [EMAIL PROTECTED], General Practice Computing Group Talk <[email protected]> Message-ID: <[EMAIL PROTECTED]> Content-Type: text/plain; charset=ISO-8859-1; format=flowed Andrew wrote: > No not dreaming, > Lost count of how many home networks we manage because they are connected to > the surgeries sometimes via a dial up vpn. > > Its better than not managing them. > > Andrew.C > > -----Original Message----- > From: Horst Herb [mailto:[EMAIL PROTECTED] > Sent: Monday, 12 March 2007 6:54 AM > To: [EMAIL PROTECTED]; General Practice Computing Group Talk > Subject: Re: [GPCG_TALK] Internet redundancy > > On Sunday 11 March 2007 22:39, Andrew wrote: >> Really only works when the client agrees that we also manage their >> soho network. > > Are you dreaming? Yep, I manage the home networks of my VPN users too, kids' PCs and all. The doctors in question realise they need it. Greg -- Greg Twyford Information Management & Technology Program Officer Canterbury Division of General Practice E-mail: [EMAIL PROTECTED] Ph.: 02 9787 9033 Fax: 02 9787 9200 PRIVATE & CONFIDENTIAL *********************************************************************** The information contained in this e-mail and their attached files, including replies and forwarded copies, are confidential and intended solely for the addressee(s) and may be legally privileged or prohibited from disclosure and unauthorised use. If you are not the intended recipient, any form of reproduction, dissemination, copying, disclosure, modification, distribution and/or publication or any action taken or omitted to be taken in reliance upon this message or its attachments is prohibited. All liability for viruses is excluded to the fullest extent permitted by law. *********************************************************************** ------------------------------ Message: 2 Date: Tue, 13 Mar 2007 09:47:45 +1100 From: Greg Twyford <[EMAIL PROTECTED]> Subject: Re: [GPCG_TALK] Messaging Responsibilities To: General Practice Computing Group Talk <[email protected]> Message-ID: <[EMAIL PROTECTED]> Content-Type: text/plain; charset=UTF-8; format=flowed Richard Hosking wrote: > Interesting read. > Still they appear to be basing their standard on a legal opinion. This > seems to me to be the tail wagging the dog. To some extent this opinion > will be based on contemporary medical practice, which will no doubt be > influenced by what the RACGP sets as a standard! > Shouldnt we be setting standards ourselves? Sorry Richard, law is overarching and precedes medicine and everything else, wheher we like it or not. Greg -- Greg Twyford Information Management & Technology Program Officer Canterbury Division of General Practice E-mail: [EMAIL PROTECTED] Ph.: 02 9787 9033 Fax: 02 9787 9200 PRIVATE & CONFIDENTIAL *********************************************************************** The information contained in this e-mail and their attached files, including replies and forwarded copies, are confidential and intended solely for the addressee(s) and may be legally privileged or prohibited from disclosure and unauthorised use. If you are not the intended recipient, any form of reproduction, dissemination, copying, disclosure, modification, distribution and/or publication or any action taken or omitted to be taken in reliance upon this message or its attachments is prohibited. All liability for viruses is excluded to the fullest extent permitted by law. *********************************************************************** ------------------------------ _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk End of Gpcg_talk Digest, Vol 18, Issue 35 ***************************************** _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.5.441 / Virus Database: 268.18.7/713 - Release Date: 7/03/2007 9:24 AM -- Internal Virus Database is out-of-date. Checked by AVG Free Edition. 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