tag:blogger.com,1999:blog-4201874739367831894.post4707043855472468557..comments2024-03-28T01:46:02.526-05:00Comments on Healthcare Exchange Standards: MU2 - Why must healthcare use custom software when Thunderbird and Outlook would do?John Moehrkehttp://www.blogger.com/profile/04526719420117446030noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-4201874739367831894.post-35597747327016837912012-10-29T13:07:50.583-05:002012-10-29T13:07:50.583-05:00I do agree that this is a concern for any informat...I do agree that this is a concern for any information not published by that provider themselves. HIE in all forms are challenging to this. I don't think this is related to the problem I outline here. This is simply a case of either (a) Not thinking through the ramifications, or (b) someone protecting their business model that is dependent on this choice. John Moehrkehttps://www.blogger.com/profile/04526719420117446030noreply@blogger.comtag:blogger.com,1999:blog-4201874739367831894.post-10751322601497216462012-10-25T15:54:23.042-05:002012-10-25T15:54:23.042-05:00Josh,
1. But, the HISP software is custom made fo...Josh,<br /><br />1. But, the HISP software is custom made for healthcare... One could even create a much smaller service that looked like an LDAP directory but proxied the request to DNS-CERT... but that too would be customized code just for healthcare.<br /><br />2. The test step is common. It will always be. The problem is core to the specification. The problem is caused by consensus group dominated by a viewpoint that was not broad enough and didn't think through the ramifications and future.John Moehrkehttps://www.blogger.com/profile/04526719420117446030noreply@blogger.comtag:blogger.com,1999:blog-4201874739367831894.post-58936294360379349812012-10-25T15:49:30.564-05:002012-10-25T15:49:30.564-05:00I don't disagree with how hard it is to do S/M...I don't disagree with how hard it is to do S/MIME using off-the-shelf software. You and I tried this 2+ years ago, and as knowledgeable people we had trouble.<br /><br />BUT, there are off-the-shelf e-mail services that do off-the-shelf S/MIME. <br /><br />Larger point is that this solution is much harder than it should be. But I prefer an exchange like HealtheWay,John Moehrkehttps://www.blogger.com/profile/04526719420117446030noreply@blogger.comtag:blogger.com,1999:blog-4201874739367831894.post-34303356825070629952012-10-25T15:13:16.420-05:002012-10-25T15:13:16.420-05:00Two comments:
1. I understand your argument that...Two comments:<br /><br />1. I understand your argument that it would be nice to give Providers the option of using a standard e-mail client. But I think the current approach *does* allow that, if e.g. you configure Thunderbird to talk to your (CEHRT-supplied) HISP, which in turn is responsible for certificate discovery. (Isn't this how the Java bare-metal Direct implementation works?)<br /><br />2. The test procedures you referenced are for patient-facing functionality (which everyone understands will be web portal-based). In this scenario, the portal is responsible for the heavy lifting of extracting clinical summaries and forwarding them to an address that the patient specifies. Standalone email clients aren't a possibility (because the portal functionality, not the email functionality, is the critical piece).<br /><br />P.S. I think "TE170.314.b.2 – 2.07" should read "TE170.314.e.1 – 3.05" ?Anonymoushttps://www.blogger.com/profile/14140643254419933279noreply@blogger.comtag:blogger.com,1999:blog-4201874739367831894.post-24365971486372373842012-10-25T11:25:40.369-05:002012-10-25T11:25:40.369-05:00Good points here. John, do you think that they are...Good points here. John, do you think that they are so focus down stream on the integrity of the data a provider may be looking at? For example I've met several providers that are skeptical of data entered in information system that came from another provider using another type of information system. It's questionable to them. I ask if it appeared on paper would be just as questionable? Providers like to confirm a drug allergy with the patient. And if tje patient is unconscious, paper or electronic can not be confirmed. Further if electronic is from a different vendor or info system even more questionable as the provider is further from the source of the info he/she is reviewing. <br />Could it be that ONC wants to overemphasise the trustworthiness of what they see electronically?<br />I may be in left field so please comment. I enjoy your insights on the blog.<br />Anonymousnoreply@blogger.com