Andrew, I think our readers could be confused by your comments. 

Firstly, you say "An ORU message can be made to go into Results/letters
or documents using undocumented mechanisms and at times non-standard
message types" then you say you are "following documentation provided by
HCN". Which is it?

Secondly, why is Argus automatically excluded from the draft code of
practice? If so, why did Andrew Shrosbree make complimentary remarks
about the process and become the only other provider so far to indicate
some support for it?

Thirdly, you talk about "the fact" that "just messaging doesn't work".
Clearly it does if done properly, with examples locally and around the
world. While purporting to be right in behind the various standards
initiatives, you say that "The way we achieve that is to make the
messages we carry and produce standards compliant". Are you
manipulating/massaging/ changing the messages at either end of the
process? If you are, in our view this merely serves to confirm you are
creating enormous levels of risk. If not, explanation may give us all
greater confidence and admiration.

Finally, as Andrew Shrosbree states, the EMR vendors should be sending
compliant messages.  They should be encouraged in every way possible as
the Code of Practice suggests by all parties involved in messaging
thereby reducing the exposure of the sector as a whole to unnecessary
clinical risks.

The Code of Practice is about doing the job properly and we would
welcome constructive progress in this area. We would think that many
parties in the sector including the clinical systems would be
signatories to it not just the messaging companies. We would also be
more than happy to get endorsements from professional organizations,
NEHTA and governments as well and we have approached them to progress
this.

Regards,

Tom Bowden
HealthLink Ltd

 
 

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Andrew McIntyre
Sent: Wednesday, 2 May 2007 9:09 p.m.
To: General Practice Computing Group Talk
Subject: Re: [GPCG_TALK] If it sounds too good to be true it probably is
-REFvs ORU

Geoff Sayer wrote:
> Hi all
> 
> Andrew wrote:
> 
> 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)...
> 
> 
> Geoff wrote:
> 
> So rather than work with Vendors in complying with the standards with 
> end to end responsibility you would rather wait and hope to see them 
> comply... but in the mean time jury rig systems around them based on 
> undocumented and most likely unsupported mechanisms.
> 
> What will the insurers and lawyers say if you relied on back door 
> undocumented mechanisms and it became unstuck in terms of corrupted, 
> lost data or patient harm?
> 

Geoff we are following documentation produced by HCN here so calling it
"jury rigged" is a bit harsh on your previous employer.

The solution is to have a code of practice that PMS vendors agree to
become AHML compliant and produce compliant messages as well as reliably
consume them. This is what the code of compliance needs to be about,
that all players interoperate using standards. After all we have
widespread pathology delivery happening now without contracts between
the pathology companies and every software vendor. The contract needs to
be that people, in the interests of patient safety actually start
supporting standards.

Medical-Objects is primarily involved with integration to allow
interoperability rather than just messaging. We have ample examples to
prove that just messaging without standards compliance does not work.
The way we achieve that is to make the messages we carry and produce
standards compliant. We have worked with many other organisations to
achieve that and it then works.

We do work with vendors to achieve this and can demonstrate this working
in places where "just Messaging" has previously failed. Your code of
conduct is about forcing Healthlinks Business model on everyone, for
instance it excludes Argus automatically. For any code of conduct to
work it needs to be extended to the MSIA in general, as rubbish =
rubbish out.

Andrew McIntyre
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