Colleagues,


I wrote on this list server that the CEO of a group of GPs had written
the following statement; " Messaging involves a series of trade offs
between high quality IT process and the need for the messages from a GP
functional end. " I expressed serious concern that clinical messaging
should require any significant level of trade-offs.

Chris Scott wrote "Tom, Are you referring to HUDGP? If you are, then
this is well out of context to what was discussed last year - which was:
(see numbered comments from #1 below.  My responses are prefixed >>>>>>
)

>>>>>>>   Chris, I don't think it'd serve any real purpose identifying
the author of that emailed comment on this news-group, however, it was
clearly a statement that provided its own context.  I am happy to
respond briefly to your statements below:

1. Messaging in this county does not work uniformly well across all GP
Medical applications

>>>>>>>    That is unfortunately correct, however thanks to diligent
work on the part of a number of parties the situation is not looking too
bad now.  The following URL points to a table that shows most if not all
of the major packages able to send, receive and acknowledge the core
AS4700 HL7 message types.  Admittedly this list is a little more
comprehensive than when you and I last discussed it.  As you can see
most packages have full functionality as will MD 3 from the next
release.

http://www.healthlink.net/healthlink_documents/Clinical.Software.Functio
nality.Australia.pdf

2. There is a need for messaging now, 

>>>>>> And there is an increasing volume of real, standards adherent
messaging getting done in every state. There is nothing that should hold
you up, although I'd urge putting in sufficient effort to do it
properly.

....so messaging providers need to provide a service that adjusts to
differences in the way GP applications receive and respond. It has to be
more than 'what goes in drops out the other side'.

>>>>>>  I think we have to agree to disagree here Chris.  To really do
scaleable messaging, crystal clear demarcation is really important,
besides, as our table now shows, there is really no need to pursue
work-arounds.

3. We don't live in perfect world and have to get on with it.

>>>>>  Yes , but not at the risk of harming patients by taking needless
shortcuts.

4. This country needs standardisation and is well behind.

>>>>>>> I agree with you and I am proud that we are in the forefront of
getting standardisation happening.  Again, take a look at the matrix in
the URL above.  We have as you know, been working diligently on that for
years. And we are getting there. What we now really need is to have
influential user groups such as Divisions at the forefront demanding
both stringent format standardisation and high quality standards...

5. A solution will involve all parties.

>>>>>>  I would amend that statement to say "will involve all parties
that are committed to using standards correctly", the rest will
eventually be left out on a limb.


While I think it is now about time that we knocked this debate on the
head for now, I have to say that I have yet to read one convincing
argument against maintaining a standards-based messaging system that is
free of short-cuts and work-around.  

Kind regards,

Tom Bowden
CEO HealthLink 

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