Dear Colleagues, All people reading this list should be aware that unless a messaging system is fully integrated with the EMR (electronic medical record) software at either end of the communications link, it is hazardous. Would-be purchasers should not be taken in by the superficial allure of a piece of software that provides part of the communications loop and purports to handle the rest but in fact leaves the rest of the process almost entirely to chance. A few of the questions that need to be asked... 1. Typically such systems do not provide a full end to end acknowledgement loop as they rely upon the intermediate (messaging system) software to acknowledge the incoming messages - This means that such systems are absolutely not HL7 compliant. Does this system send its own acknowledgement messages (to itself) or does it rely upon the recipient application's ability to acknowledge (which is the right way to do it)? 2. Typically they turn everything into an observation message (ORU) instead of a referral (REF) message . While technically this is not "illegal" it certainly bends the rules and creates a very difficult file management headache for the recipient. How does this system deliver non observation messages, as ORU or REF messages? 3. Typically such systems vendors have no support or other relationship with the EMR vendors and in a number of cases, this one I fear included . They are therefore viewed as competitors by other EMR vendors - the net effect is an antagonistic relationship when it comes to any problem solving and little or no helpdesk collaboration, joint documentation etc . Does the provider of this system have a contractual relationship with the EMR software providers at either end of the delivery chain or not? In summary : Users should be aware of the limitations and dangers of using non-integrated communications systems. If they persist in using them, they should ensure that they continue to send paper copies of everything in parallel, they should advise all of their partner organisations to ensure their medical indemnity insurance is fully paid up and advise their patients that they are part of an experimental programme that aims to show that common sense approaches to healthcare messaging are no longer needed. Electronic messaging has to be a very disciplined business. In a fully connected Australian health sector approximately 1 billion messages will be exchanged annually. This cannot be done on a wing and a prayer. If the sector wants to see a fully interconnected messaging environment, then this must be done according to rigidly enforced standards, especially important is adherence to those standards that relate to delivery integrity. It is time to look at this issue in a bit more depth. Kind regards, Tom Bowden
Tom Bowden <mailto:[EMAIL PROTECTED]> Chief Executive Tel: +64 9 638 0670 Mobile: +64 21 874 154 Email: [EMAIL PROTECTED] Web: www.healthlink.net <http://www.healthlink.net/> <http://www.healthlink.net/> Connecting The Health Sector
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