tag:blogger.com,1999:blog-23447705.post433269960949142794..comments2024-03-29T09:18:22.495+11:00Comments on Australian Health Information Technology: Review Of Reporting Of The Release Of The PCEHR Review. Most Reporting Much Keener On The Report Than I And Other Bloggers Are.Dr David G More MB PhDhttp://www.blogger.com/profile/06902724829795199526noreply@blogger.comBlogger17125tag:blogger.com,1999:blog-23447705.post-29294855422874030362014-05-29T17:31:21.284+10:002014-05-29T17:31:21.284+10:00Bernard,
SMD guarantees that a message will be de...Bernard,<br /><br />SMD guarantees that a message will be delivered at least once or that the sender will know that it was not delivered. This is about as good as you can get from guaranteed delivery.<br /><br />SMD is a transport mechanism, so it does not support non-repudiation. <br /><br />NEHTA CDA supports partial non-repudiation. It requires the CDA to be signed. This is fine if the privateAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-81636030176215417672014-05-28T15:46:24.859+10:002014-05-28T15:46:24.859+10:00May 27, 2014 9:35 AM said Three dogs and one bone ...May 27, 2014 9:35 AM said Three dogs and one bone does not lead to a collaborative environment unless they all agree to follow the leader hell or high water - that's the tough bit.<br /><br />This is a good analogy. We have all tried in vain to follow the leader ie NEHTA. Unfortunately NEHTA was incapable of demonstrating effective leadership. It opted for the autocratic, dictatorial approachAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-29416028867564894262014-05-27T17:41:55.699+10:002014-05-27T17:41:55.699+10:00Medical-Objects is actively using SMD between prov...Medical-Objects is actively using SMD between providers, when both have SMD, which is mostly GP to GP at this time. We are working on interoperability with other messaging providers, but the issue of compliance raises some difficult issues there if we are unsure of the endpoint capabilities. Many senders want the end to end detailed information that we can provide with our own clients.<br /><br Andrew McIntyrehttp://www.medical-objects.com.aunoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-68123404582552186772014-05-27T16:49:24.552+10:002014-05-27T16:49:24.552+10:00What I'm referring to is
a) you know the mess...What I'm referring to is <br />a) you know the message has been delivered to the receiving system (guaranteed delivery) and<br />b) the sender cannot deny sending it and the recipient cannot deny receiving it. (non-repudiation)<br /><br />There's two sides to this issue.<br /><br />a) is there a requirement in eHealth for guaranteed delivery/non-repudiation?<br /><br />b) does the secure Bernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-50059441224844817332014-05-27T16:47:54.147+10:002014-05-27T16:47:54.147+10:00And the words ‘secure messaging’ do not explain wh...And the words ‘secure messaging’ do not explain why secure messaging is more complex than you would think. For every secure message and acknowledgment and/or error messages, there needs to be functionality and processes in the sending application and the receiving application to produce and consume the actual content of the message in the correct way.<br />For example if a hospital application Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-27548231089507531592014-05-27T15:51:47.606+10:002014-05-27T15:51:47.606+10:00HL7 has application acknowledgements, which help d...HL7 has application acknowledgements, which help determine if the message has been delivered. This is already being used with Secure Messaging.<br /><br />I'm not sure that you can guarantee messaging. You can guarantee the status of delivery, but if the other end is never available for delivery, the message will never be delivered.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-73442497020061102012014-05-27T15:45:27.483+10:002014-05-27T15:45:27.483+10:00Do Medical Objects or any other providers for that...Do Medical Objects or any other providers for that matter, actively send messages between providers in production yet?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-54125679620804501072014-05-27T14:45:17.099+10:002014-05-27T14:45:17.099+10:00Some more questions:
Is secure messaging essentia...Some more questions:<br /><br />Is secure messaging essential for eHealth?<br /><br />Is secure messaging sufficient, or should messaging also be guaranteed?<br /><br />Does/will Australia have guaranteed messaging?Bernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-53303466306177773952014-05-27T13:00:05.065+10:002014-05-27T13:00:05.065+10:00The critical elephant in the room, which DOHA and ...The critical elephant in the room, which DOHA and NEHTA still do not see is that message compliance, both in creation and receiving/display is a critical element in a messaging system.<br /><br />When the applications using the messaging system cannot take responsibility for reliably handling messages then "simple messaging" is not whats happening at all. <br /><br />The ongoing lack ofAndrew McIntyrehttp://www.medical-objects.com.aunoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-54592638292345454962014-05-27T11:55:34.109+10:002014-05-27T11:55:34.109+10:00David, Bernard,
There are two flavours of secure ...David, Bernard,<br /><br />There are two flavours of secure messaging: that traditionally provided by the secure messaging providers and SMD (based on Australian Standards).<br /><br />Traditional secure messaging is used to transport HL7 V2 messages. This comprises almost all the eHealth messaging at present. This requires the sender to use the messaging provider that the recipient is connected Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-14270440843403372482014-05-27T11:46:41.530+10:002014-05-27T11:46:41.530+10:00Bernard,
Messages in Australia use HL7 V2.x Stand...Bernard,<br /><br />Messages in Australia use HL7 V2.x Standards for the transmission/ receipt etc. The content can be standardised (atomic data, CDA or whatever, PIT format) or free text.<br /><br />The main issue is that NEHTA has a Secure Messaging approach which is not as widely used and the private providers. GPs who want can usually send and receive to anyone they want.<br /><br />There is Dr David G More MB PhDhttps://www.blogger.com/profile/06902724829795199526noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-41624671344837907302014-05-27T11:36:37.790+10:002014-05-27T11:36:37.790+10:00David,
Is the implemented secure messaging system...David,<br /><br />Is the implemented secure messaging system a secure channel, independent of content or is it based upon standard messages?<br /><br />In the Health report, Dr Shakib said they would have had to keep track of the different preferred methods of communications each of the GPs use. This was unworkable, for them, so they elected to use paper, which worked "really well".<br Bernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-5707564152314230732014-05-27T11:07:50.245+10:002014-05-27T11:07:50.245+10:00"Is it true that secure messaging is not gene..."Is it true that secure messaging is not generally available across the whole health environment in Australia?<br /><br />Is the PCEHR dependent on secure messaging?<br /><br />What is the status of secure messaging?"<br /><br />Very simply and basically, secure messaging is just encrypted transmission of clinical document messages (referrals, lab reports, discharge summaries etc. etc.)Dr David G More MB PhDhttps://www.blogger.com/profile/06902724829795199526noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-45694151095308572202014-05-27T10:56:00.790+10:002014-05-27T10:56:00.790+10:00And can someone please explain in layperson's ...And can someone please explain in layperson's terms with a nice healthcare example - what is secure messaging?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-71982493711957203862014-05-27T09:55:30.349+10:002014-05-27T09:55:30.349+10:00I was listening to this week's Health Report o...I was listening to this week's Health Report on Radio National<br />Available here http://mpegmedia.abc.net.au/rn/podcast/2014/05/hrt_20140526.mp3<br /><br />At about 23:50 Dr Norman Swan is talking with Dr Sepehr Shakib, of the Department of Clinical pharmacology, Royal Adelaide Hospital.<br /><br />Dr Swan says "you just used a really interesting phrase ... a Reply Paid Envelope."Bernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-48661595106864955432014-05-27T09:35:43.004+10:002014-05-27T09:35:43.004+10:00Dear Terry Hannan a comforting thought - you are o...Dear Terry Hannan a comforting thought - you are one of many voices crying in the wilderness and there they will all remain for the foreseeable future. Changing the way we approach the problem, the way we think about the problem, will not happen overnight and will not happen by those who complain about the way things have been and will continue being done. Battleships at full speed do not turn Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-90332773802800169352014-05-27T08:16:58.579+10:002014-05-27T08:16:58.579+10:00David, how does one or many, sift through these di...David, how does one or many, sift through these dissertations and make sense of it all when most are written by persons who have NO IDEA of CLINICAL INFORMATION MANAGEMENT-the exception of course being the academic body the Australasian College of Health Informatics (ACHI). I suspect the government does not listen to that organisation either. The critical importance of collaboration in e-health Terry Hannanhttps://www.blogger.com/profile/04068727812313410493noreply@blogger.com