Geoff Sayer wrote:

> Geoff Sayer wrote:
> 
>  
> 
> What is of concern is the way that the different clinical applications
> handle ORU and REF messages.
> 
> Where does an ORU message end up in MD2 for example?
> 
> Unless I am mistaken the ORU ends up in the Results Tab and database
> that supports that.
> 
> So if you are using an ORU for a psychiatrist report it will be mixed in
> with pathology and imaging results.
> 
> The same with hospital discharge summaries if using ORU as the message
> format.  
> 

I am surprised that you do not have more knowledge on this area. An ORU
message can be made to go into Results/letters or documents using
undocumented mechanisms and at times non-standard message types which I
think originated with healthlink (The RSA tab)

Only if it goes into results can it be onsent in another referral and
many users elect to use results because of this. The way it's directed
by the PMS system is quite primitive as HL7 provides much better ways of
deciding where it fits but these are usually ignored by the application
in question. When we tested REF messages with a variety of applications
we found that in some cases the doctor was not alerted to the letter at
all and in those cases used ORU because it was safer! Obviously its a
moving target, but we have no trouble transporting REF messages. You
have to look at the end to end use however rather than just the transport.

The interface to any PMS system should be open and not morph into
another tollgate. The current support for current standards wrt HL7 is
less than perfect and It's compliance with standards that is going to
fix it, not back room deals.

Andrew McIntyre

>  
> 
> Is this a good thing?
> 
> Will clinicians go looking for that letter from Dr Psychiatrist in
> investigations or a discharge summary in investigations?
> 
>  
> 
> If a REF message is used it ends up in the letter section of MD2. Is
> that where a clinician would expect it to be?
> 
>  
> 
> Geoff
> 


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