> Exactly - I'm not reassured particularly that my pathology results
> are arriving in healthlink or medical-objects (whether they ACK or
> not), anymore than I am reassured by a transport level ack.

Hi Andrew,

Unless I misunderstand you, you are referring to the same thing (ie
transport ACK). 

> For all I know, noone is looking at the medical objects
> document store? Maybe the message is going to get mangled
> in the hand off from message provider to clinical app - the place
> for ACK'ing messages is in the clinical app where the doctor
> is dealing with correspondance, managing recalls and reviewing
> notes. 

Both are needed really, they serve different purposes. I guess the thing to
be aware of with application ACKs is when they are generated. EG An
application level ACK generated when the clinical package imports the
incoming message doesn't tell the sender the message has been read by the
recipient (or necessarily tell the recipient the message has arrived). As
such, additional checks and balances need to be in place to provide these
assurances.

> Healthlink and medical-objects should be licensing their
> message layers to clinical app vendors to integrate fully into
> their programs.

Can you indicate what you mean by "integrate fully" and give an example
where the functionality of such "full integration" couldn't be achieved
using the "uncoupled" architecture present in the market?

> The current situation (of separation) is a strange confluence
> of events and surely will pass?

Not any time soon, at least for the transmission of messages between
competing clinical packages. For obvious reasons, clinical vendors "A" and
"B" are more likely to deal with messaging vendor "Z" than each other.

Cheers,
Simon


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