Hi Steve

There is has been some branches from this conversation since your posting.

HealthLink is the transport provider with particular responsibilities and
the clinical application is responsible for the generation of ACKs.

Your description of the current implementation does represent the "average
practice". That is the message has gotten into the inbox/holding file of the
clinical appliation.

We are working with vendors to expand this into more "action" orientated
application ACKs. This would cover things like ACKs after action with the
message; deletion events; and NACKs for example. We are also working with
vendors to make better use of addressing so that messages are better matched
with providers within the inbox/holding file as well.

Clearly there are subtle differences between the way that clinical apps
handle these things with variations existing between HL7 LAB messages and
HL7 REF messages but we are keen to see improvements and consistency across
applications.

Thanks

Geoff




-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of Osborne, Steve
Sent: Friday, 23 March 2007 9:19 a.m.
To: General Practice Computing Group Talk
Subject: RE: [GPCG_TALK] Messaging Responsibilities

Geoff
I'm finding it difficult to understand how this works.  My understanding
has always been the ack is generated when the result is imported to the
clinical application. Please correct me if I'm mistaken in the
following.

-A message is delivered by the messaging application and placed in a
store and hold folder at the receiving end. This message contains a
unique message number and identifying details which are used to generate
the ack.  
-The clinical app reads the message on some sort of trigger and imports
it. 
-It then generates an ack with the message number & identifying details
included.  
-The original message is then either deleted or stored elsewhere
depending on the clinical apps rules.  -The ack is placed in a store and
hold folder until it is picked up by the messaging application.  

This is "closing the loop" as best you can with the current technologies
as far as I know.  What you are saying goes further than this. Can you
please clarify these points;

1. Does the message number get passed to the clincial application as
part of the result and is stored there until an action is taken?

2. What happens to results that sit in a Holding File for months without
being actioned?

3. What happens to results that are deleted from a Holding File without
being actioned?

Regards
Steve Osborne
EDI - QML Pathology

*Andrew Patterson wrote:
*
*I take it the Healthlink client integrates quite tightly
*with the clinical application to mesh in with it's recall 
*system etc. Is this integration done to a standard interface 
*or is it on a case by case basis with the clinical vendor?
*
*Geoff Sayer's response:
*This is where clinical applications differentiate themselves 
*from competitors in the way they link/mesh into the clinical 
*decision support systems (eg. recall) and the GUI for handling 
*these messages in the holding file/inbox. HealthLink looks to 
*make sure that once the action is done and messaged is 
*assigned to a patient from the holding file within the 
*clinical that the Application ACK is generated and passed out 
*back through the messaging system. The decision support and 
*GUI side of things is up to the creativity of the clinical vendor.
*
*
*Geoff Sayer
*HealthLink Ltd
*
*
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