Ross,

Given what has been achieved by Australia's communication vendors, it seems
a bit of a long bow to claim that adequate security for key communications
is not accessible to the Austin or wanted by referrers.

I endorse the suggestion of getting the healthcare provider organisation
groups in the Austins catchment area  together to discuss the local
communication needs and work together to develop at least a locally workable
solution.

Waiting for statewide or national programs to sort out health communication
is not sensible, as such require too much organisation and cost. We do
however have to move a series of unique and uncoordinated health service
solutions, of which the Austin's efforts or that provided currently by most
path and radiology practices are examples.  

Integrated health communication could start at the regional level, with the
hospitals, GP divisions, diagnostic services sitting around one table, and
implementing locally agreed and perhaps funded solutions based on a solid
health IT standards platform to support scalable and affordable solutions. I
think we have seen a few of these emerging, perhaps the latest is the NT
e-prescribing system. The standards are there also, what is needed is
implementation.

This is the approach being examined in  countries where mega national
systems are not on the agenda eg the US with their Regional Health
Information Organisation model (RHIO).

I  recently conducted a technical and business feasibility study with Paul
Clark under a Managed Health Network seeding grant on such an approach for a
common e-referral network covering pharmacy, radiology and pathology and
hospital discharge. This used a common infrastructure, with a service model
building on the IHE Cross Enterprise Document Share (XDS) infrastructure.
The intention is to have the infrastructure owned and governed by the
professions involved, purchased by the regional health provider group and
delivered by the private sector.

So if GPs are concerned that communication is happening in an ad hoc and
uncoordinated way at their regional level - then asking the local Division
of GPs to start a round table discussion with other health services may be a
place to start.  There are emerging models and systems for this.


Regards

Peter MacIsaac

Please note:  due to  increasing problems with SPAM,  I am using  SPAM
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inexpensive service which extends my current email service and prevents
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Peter Macisaac
MacIsaac Informatics
Consulting in health informatics, HL7  and terminology
[EMAIL PROTECTED]
peter_macisaac (skype)
61 2 61611327 (landline)
61 411403462 (mobile/cell)
www.macisaacinformatics.org

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of Ross Davey
Sent: Friday, 6 April 2007 8:48 AM
To: [EMAIL PROTECTED]; General Practice Computing Group Talk
Subject: Re: [GPCG_TALK] Unencrypted e-mail from Austin Health in Victoria


> Dear Dr Hosking,
>
>
> Austin would have to invest substantial funds in software and
> administration to extend encryption to admission and discharge notices.
> With very little prospect of significant up-take by GP's, it's
> impossible to justify this expense. So, for now, the hospital offers
> only unencrypted email, fax or post as GP communication options.
>
>   
The evidence does not support this. Inner East Division, Central Bayside 
Division, Monash Division, Westgate Division, Mornington Division, 
Dandenong Division, Whitehorse Division are all actively supporting the 
implementation of PKI in their areas.  They are also actively supporting 
the takeup of Argus with both their members and specialists etc.

The Austin should take its head out of the sand.  GPs are surrounding 
them with demand!!!
> There's a wide range of encryption options available but the hospital is
> reluctant to pursue any of these options until it sees where GP
> preferences lie. We simply can't afford to introduce multiple solutions,
> or solutions which are adopted by only a very small percentage of GP's.
> And, presumably, GP's will favour a solution which is common to all the
> hospitals and other service providers with whom they communicate
> electronically. I'd appreciate your Committee's advice on which
> encryption/decryption mechanism would most likely attract a significant
> proportion of GP's.
>
>   
The Austin should just have a meeting with all the urban Divisions and 
ask them the mechanism that most of them want.  Simple!!!

-------------------------------
Ross Davey
CEO
ArgusConnect Pty Ltd
Ph:  03 5335 2220
Mob: 0417 548608
Web: www.argusconnect.com.au
-------------------------------







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