In article <v03007802aeedf0fe3d5a@[194.151.26.122]>, Gerard Freriks
<[log in to unmask]> writes

>I will tell you my own experiences.
>
>Years ago I was one of the first in my area to use EDIFAKT to receive
>messages : Lab results, Discharge/admissions, X-Ray results.
>It was not possible to insert them into the record. I had to retype them!
>
>Now there are certain systems which can insert the date with the patient.
>In the last couple of years no new EDIFAKT messages were made.
>
>Messages originating in one area can not be transported to a neighboring one.
>Only recently some links became possible.

We have EDIFACT messages established nationally = GP HA links.  Dealing
with a high percentage of all GP Registrations / amendments /
deregistrations.  Slower in uptake are Item of Service links.  So we
seem to have learnt from others the importance of standardising things
so that they work between ANY links compliant GP system and ANY Health
Authority regardless of locality.

We would expect the same to be true for our lab results and Xray
results.  Since we have ALL of the major GP suppliers co-operating these
message implementations will also work between ANY GP system and ANY NHS
Trust that complies with the specification.
>
>When I started to use the Macintosh it wasn't possible to use EDIFAKT.
>There were no generaly available aplications for it.
>The workaround is to emulate DOS and use the DOS application and then
>import it.

Yes - I recall seeing this kind of thing demonstrated some years back on
one of the Dutch systems and it did seem then that the integration
between the messaging application and the clinical system left much to
be desired.  It would be very interesting to show you what we have been
developing as I think we have much better integration now - at least for
pathology results.  One great advantage that we have is widespread use
of Read codes in General Practice.  So we can import Read coded data
without having to translate it in any way, and attach to patient's
record

>
>When a letter about a patient is received it can be attatched to the
>patient. It will stay free text. It cannot be handled in an inteligent way.

Having the free text of letters attached to the patient's record is of
some value.  But obviously we all do still have that big problem of how
to make the information contained in letters available to be 'handled in
an intelligent way'.
>
>So I decided to stop using EDIFAKT beause of the above, but foremost
>because not all hospitals are capable to use EDIFAKT.
>The standard is there, but no infrastructure.

For us the problem is not so much the EDIFACT as the lack of clinical
systems in hospitals that can import / export clinical information.

You have not mentioned confidentiality or authentication - how did you /
do you manage those?
>
>And look at the Internet!
>Applications galore for all systems!
>Very easy to use. Where as the EDIFAKT program was not pleasant to work with.
>
>And an infrastructure the world over!
>
>EDIFAKT works, but stinks.
>
>Internet shines, works like a breeze! And has a lot of future.

Yes - as the transport mechanism capable of carrying lots of different
types of cargo

--
John Williams
Email: [log in to unmask]
Fax:   01483 440928


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