Andrew,

Chris Lynton-Moll Director of AHML is away on holida.  On his return I
will ask him to clarify where we are with regards to accreditation, I am
equally sure that my earlier statement is correct. Until that is
clarified I suggest we drop it.

You say that we are not successful with our approach whereas I would
point out that what we are doing all over Australia is highly
successful, in some cases we have entire state health departments and
their hospitals are delivering REF messages to hundreds of general
practices.  In other cases we have groups of providers REF messaging
consistently and on a significant scale. I acknowledge that getting the
vendors up to speed has been hard, but the results are showing through;
it is a case of taking the tortoise's approach rather than the hare's.
As I commented in a posting yesterday, in New Zealand we exchange more
than 250,000 REF messages per month and this stunningly successful
system (recognised by international commentators  as the world's best*)
is growing 60% annually year on year. 

*(City University, London 2006 study of primary care IT in ten countries
and the Schoen report- Commonwealth Fund study of eight countries also
2006 - URLs available on request.)

Your comment re our intention to create a monopoly is unfair and
inflammatory as it is we that have provided a draft NEHTA compliant
interconnection framework for message providers to consider and with
AHML's help a Draft messaging providers' Code of Practice.  This is a
far more constructive contribution to creating messaging provider
interconnection that any other messaging provider has contributed.

Finally, for those interested in the essence of the debate, I take issue
with your statement that "What we (MO) do now really mirrors what the
pathology labs do now, they have extensive interface engine abilities
etc etc"  The pathology companies use their messaging engines to
transform their internal information into useful outgoing messages (as
we recommend they do) whereas what you are attempting to do is (as a
third party )transform messages en route.  We take the view that each
entity; lab, GP, hospital etc should get the messages right before they
are handed to a third party (messaging) system.  This encourages the
sender (and their EMR application providers) to ensure they have gotten
the outgoing messages right, in turn creating the appropriate
demarcation and definition of responsibility amongst the parties, the
same applies with acknowledgements which in each case should be created
by the recipient system and not by the party in the middle.

Summary: Originating system creates message to specification - messaging
system checks structure and sends message - recipient system processes
and stores message, creates acknowledgement and sends back to
Originating system.  (No intermediate transformation of messages or
creation of acknowledgements is necessary).

Anyway, feedback I have received is that a greater understanding of this
issue would be very useful to others, but only if the dialogue remains
relatively objective and this does not become a forum for hurling
insults, so please hark my suggestion that we do take a more dignified
approach to it.  

I think the issue of "what is an appropriate messaging model to promote
for Australia?" is a good one and would invite further
comments/questions to take it forward. NB readers can get references to
the URL for the draft interconnection model/white paper we have produced
from my earlier postings.

Kind regards,

Tom Bowden
CEO HealthLink






  Tom Bowden <mailto:[EMAIL PROTECTED]>
Chief Executive
Tel: +64 9 638 0670
Mobile: +64 21 874 154
Email: [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]>
Web: www.healthlink.net <http://www.healthlink.net/> 

 <http://www.healthlink.net/>
Connecting The Health Sector 
 

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Andrew McIntyre
Sent: Wednesday, 9 May 2007 9:51 p.m.
To: General Practice Computing Group Talk
Subject: Re: [GPCG_TALK] Lets try it from another angle

Tom Bowden wrote:
> 
> Andrew,
> 
> I think its time we called a halt to the polemics, or we'll get 
> ourselves biffed off this list.  BTW For the record, HealthLink does 
> have AHML accreditation for our AS4700.2 - HL7 v2.3 (lab messaging) 
> validation system and we are currently upgrading that accreditation to

> accommodate changes to the lab standard with the move to HL7 v2.4.  We

> are also working with them on the REF messaging. It needs to be 
> understood that we do not create messages, we just check them for 
> structure. So can we let that whole argument drop for now please??

I think letting it drop is the best idea, as you continue to make false
claims that you have AHML accreditation for your validation system and
AHML assure us that this is not the case. The validation system you have
may prevent you from sending your shopping list but that's about it.

All this talk of healthlink validating messages is an obstacle in the
road to standards based interoperability. As I have asserted what we
need is independent accreditation of messages produced and an
expectation that systems will reliably import valid messages and deal
with them appropriately. A messaging system with a standard open
interface would also good protection from monopolistic cartels
developing. PMS vendors have an obligation to their customers and in
turn to the Customers patients to improve their ability to consume and
produce valid messages, Its a quality issue that I cannot believe is
left to so much chance.

This may not fit well with your vision of an Australian monopoly but the
fact remains that the current crop of messages you are delivering are
non standards compliant and have serious flaws wrt the escaping of HL7
reserved characters that would concern me greatly. A whole pile of
contracts is not going to get us out of this mess, but standards
compliance and open interfaces just might.

What we do now really mirrors what the pathology labs do now, they have
extensive interface engine abilities etc etc and I am yet to here of
successful wide scale successes using healthlink for provider to
provider messaging. I suggest talking about that rather than attacking
other peoples success stories.



Andrew McIntyre

> 
> I have given some thought as to how we might debate what I still think

> is quite a serious issue in a more dignified manner.  I am starting 
> the ball rolling by outlining the issue a bit more objectively.  
> Please do feel free to modify what I have written below if you believe

> it is factually incorrect or incomplete or if you'd like to add
anything.
> 
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