In article <v03007805aede20dcf389@[194.151.26.66]>, Gerard Freriks
<[log in to unmask]> writes
>> The earlier discussion was generating some light, alas replaced by heat.
>> At the risk of picking the scab, from a user requirement perpsective I
>> wondered whether both sides were right.
As Senior User to the GP Provider links project I find the title to this
thread most extraordinary - a bit like saying 'commuters v trains'.
Commuters can use a wide range of transport mechanisms such as cars,
buses or trains.
EDIFACT is in some senses the electronic analogue to a paper form.
Paper forms can be placed in envelopes and then posted. EDIFACT forms
can be placed in envelopes (e.g. X400 or MIME / SMTP) and then posted
across a network which can be Local or Wide. The WAN can be 'closed' or
'open'. Thus one of the options for EDIFACT 'forms' would in theory be
to place them - suitably signed and sealed - on to the Internet.
The GPPL project is actually developing just such a 'signing and
sealing' solution which would make it possible to send clinical EDIFACT
messages securely across any WAN or LAN - whether NHSnet or Internet.
The GPPL approach does NOT depend on X400.
It is important to separate out the GPPL project's approach to clinical
EDI and IMG's policy. It is IMG / Syntegra policy that X400 and NHSnet
should be used. In reality, at least in the short term, in practical
terms it may prove to be impossible for GPPL to use either.
EDI should not be bracketed with email. It may be possible to go quite
a long way with standardised email layouts but if you really want
reliable computer to computer exchange of information the work involved
in getting the layouts agreed and then policing them to ensure everyone
complies makes EDI a much better longer term solution.
The failure so far to deliver EDIFACT frankly has much to do with IMG's
obsession with 'the wires' and failure to recognise the need for co-
operation between clinicians, suppliers and the Data Interchange
Standards people. In the last 12 months the GPPL project has succeeded
in getting all of these people to work together with the result that all
the major GP suppliers are now producing the missing clinical EDI
management software. We are still struggling to get IMG to understand
that this is at least as important (if not more so) as 'the wires'
Meanwhile IMG / Syntegra are still struggling with the wires
The clinical EDI we are talking about is very simple - initially
enabling pathology and radiology results to be received, and matched to
the individual patient. Discharge letters will also be received
initially as text that can be linked to the patient's record. This is
NOT claimed to be the 'be all and end all' of communications but just
one small step on the way. The hurdles that the GPPL project has had to
negotiate are not peculiar to EDIFACT. The most difficult ones have
been mainly human and political. They exist for any project trying to
implement something new - and SGML / HTML would be no exception.
I am not sure what EDIFACT has done to deserve this 'ugly duckling' type
of treatment. If we can soon make it work safely and effectively and
make it available at a resonable cost will people not want to use it?
Meanwhile we should be pooling of knowledge and experience. It would
take many months to get web based solutions in place even if the main
proponents had a clear plan of action. There does not appear to be any
clear plan as yet, so it will take even longer particularly as there
appear to be problems to solve that have not yet been addressed .
Meanwhile while keeping an open mind on new developments, we can make
progress with EDI, benefitting patients, encouraging the development of
secondary care clinical systems, and learning many valuable lessons in
the process
--
John Williams, Senior User GP / Provider Links Project
Email: [log in to unmask]
Fax: 01483 440928
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|
