Tom will be presenting this paper at the HL7 workshop on diagnostic messaging next Thursday in Melbourne. In addition a range of other users will be putting their views about the areas where current messaging approaches are deficient.
This information will form the basis of an Industry endorsed technical profile which will define which current standards and how they will be used to enable safe and interoperable communication in the path/radiology sector both within hospital and the community. This is where Tom's requirements would be enshrined in practice. Using the IHE methodology, each vendors implementation of the profile will be tested in a Connectathon and demonstrated in the Interoperablity07 demonstration at Medinfo. I think what we are doing is creating the type of reference implementation described in the last posting - NEHTA are involved as participants on the steering committee of the demonstration which is being sponsored by the MSIA, HL7, and HISA. For information about the messaging workshop http://www.hl7.org.au/2007-Path.htm For information about the interoperability demo www.interoperability07.com.au Moving past the talk: Members of the GPCG list who would be interested in participating in the Interoperabilty Demo at MEDINO or in running the Connecthathon are welcome to contract me. There is a need for clinical informatics and technical input for several of the key roles. Peter MacIsaac 0411403462 -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Tim Churches Sent: Friday, 16 March 2007 7:25 AM To: [EMAIL PROTECTED]; General Practice Computing Group Talk Subject: Re: [GPCG_TALK] Messaging Responsibilities Andrew Shrosbree wrote: > Tom, > > Your excellent document will leave the PMS vendors cold until they are > given sufficient incentives to collaborate with the messaging providers to > achieve the laudable objectives. > Without > > 1) monetary compensation > 2) threats of censure by law > > nothing will motivate action by PMS vendors. > > Finally, many of the PMS vendors (including the largest) claim to be so > busy that they are unable to undertake the smallest of changes to their > systems, even if money were to be thrown at them. > Regrettably, I can offer no solution. The cheapest solution is for NEHTA and/or some other govt agency or agencies to fund the creation of fully working "reference implementations" of key parts of the health IT infrastructure. These implementations to be made available under liberal open source licenses, - licenses that allow third-party commercial vendors to enhance the reference implementations and flog them as their own products. But the key thing is that the reference implementations contain all the features, such as data export and interchange, and application-level handshaking for messaging, for which there has been "market failure" - features that existing commercial vendors have failed to implement, because there is no market pressure to do so or because doing so works against their commercial interests. The beauty of such a scheme is that, rather than destroying competition in the medical software marketplace, it promotes it, on a level playing field, but it is a playing filed with all the basic, essential features already in place. Cost for a primary care EHR/EMR reference implementation? Under $10m in under 2 years. Very small beer indeed in the context of an $85b p.a. health system as we have here in Oz. It would be a bold move, but the sense is that Health Minister-in-waiting Gillard is prepared to make bold moves to fix our health system. Tim C > Tom Bowden wrote: >> >> Dear Colleagues, >> >> At HealthLink we have been watching the discussion on messaging >> responsibilities with great interest. It was timely that David More >> provided an excellent link to a video on use of messaging etc in the >> Dutch health system. The key point we think should be noted is that you >> cannot get to this level of automation without all involved having >> complete trust in the system, especially trust in the fact that it is >> safe and 100% reliable >> >> As readers are probably aware, HealthLink is a messaging and security >> system provider active in Australia, New Zealand and Canada and >> therefore we have a number of environments upon which to draw upon for >> examples and comparisons. >> >> In New Zealand, the issue of 'where the responsibility lies' was >> addressed more than a decade a go when, after a terrible incident in >> which a young girl's urinary tract infection went untreated for a week >> as a result of an undelivered lab result. Fortunately the labs conceded >> that it was indeed their responsibility to ensure that the information >> was correctly delivered into the database of the computer system >> operated by the intended recipient's practice (by monitoring receipt of >> application level acknowledgements. It was clear then, just as it is now >> that 100% reliability could only be achieved via fastidious monitoring >> of application level acknowledgements and using systems that are truly >> integrated with the intended recipient's clinical systems. >> >> As a consequence of this clear delineation of responsibility, trust in >> the system has continued to increase to a point at which the entire >> Health system is now electronic, (a bit of parochial commentary follows) >> NZ is even better than the Dutch system from that POV. >> >> As Craig Barnett points out, HL7 is designed by its very nature to do >> precisely this (provide guaranteed delivery into the clinical >> application). When HL7 is correctly implemented by sending application >> acknowledgements from the intended recipient's system back to the >> sender,the HL7 standard can be fully relied upon to perform this >> function. When we only rely on transport acknowledgements (also known as >> accept acknowledgements) generated by the intermediary messaging system >> then complete trust is NOT achieved. >> >> If we wish to build a trustworthy, reliable and scaleable e-Health >> system we must aim for the highest of standards. We must have >> appropriate respect for patient safety and the necessity of reducing >> clinicians' risk exposure. The requisite communications standard is >> there and can be implemented. >> >> It may or may not be known that HealthLink has proposed that all of the >> parties involved in electronic messaging in the Australian health sector >> be party to a code of practice that sets out the responsibilities >> entailed in doing clinical messaging correctly. Following is a link to >> a draft discussion document entitled 'Safety through Quality' that >> backgrounds three key quality issues and presents the draft code of >> practice we have proposed. >> Please feel free to read it and publish your comments on this list, we'd >> be keen to incorporate any useful input. >> >> If we take a quality approach to electronic communications and security >> across the health sector (reducing the unnecessary risk in patient >> safety associated with poorly implemented or outdated messaging >> systems), we may one day be in a position to match what is happening in >> other countries across the world. Until then we can only watch the other >> countries sail past us. >> >> Kind regards, >> >> Tom Bowden and Geoffrey Sayer (HealthLink Ltd) >> >> http://www.healthlink.net/healthlink_documents/brochure/Electronic%20mes >> saging%20safety%20Issues%20-%20HealthLink%20viewpoint.pdf >> _______________________________________________ _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk -- Internal Virus Database is out-of-date. 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. Version: 7.5.441 / Virus Database: 268.18.7/713 - Release Date: 7/03/2007 9:24 AM _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
