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Question |
Medical-Objects |
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Name of Messaging Product/Service: |
Medical Objects |
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How would you describe its nature? |
A purpose built distributed messaging
framework for healthcare. |
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What are its main features? |
A platform independent, secure, scalable
messaging framework that uses open standards to achieve reliable,
realtime, traceable message delivery and solves current problems while
still looks to the future. |
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Since when is the product/service being
used? |
Internal use since 1999. General use since
2002. |
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What is the main area the product/service
is being used? |
Specialist to GP messaging. We have 3
radiology practices using it. QML and S&N results are distributed to
specialists by the use of a gateway to Pathology providers. |
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What hardware can it run on? |
J-client run on any platform that can run
Java 1.4 and HIC PKI. Includes Windows, Linux, OS/X
Other clients run on Windows 95+
Database Server runs on
Window/Linux/Solaris
Email can be delivered to any platform.
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What operating Systems can it run on? |
see above.
PKI will not run on Windows 95 but PGP
will. |
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What other hardware/software is required? |
Internet connectivity or modem.
Single exe if PKI is not desired, mimimal
external dependancies. |
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What is the cost of the Product/service?
1 user - 5 users - 10 users
Setup - Annual - Per Message |
Download clients are free. Onsite support
is costs + $60 per hour + costs.
Specialist fees depend on features being
used but minimal installation of single word plugin or network access is
less than $500 per year.
Image data incurs storage and traffic fees
because of the potential size of messages.
100mb of HL7 per year (100,000 text
messages) is allowed per practice
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Are there other additional costs? |
Only normal internet access. |
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Is the product/service accredited? |
Buderim Gastroenterology is an ISO 9001
accredited organisation. Word DOT files are code signed. No official
software accreditation as such. Developers have all had IT engineering
degrees. |
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What accreditation does/will the
product/service have? |
Would consider accreditation if appropriate
one available. |
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Comments: |
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Where is the product/service being used? |
3 Radiology Practices
One day surgery
30 Specialists
300 GPs
1 Nursing Home
6 Physios
1 Dietician |
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What Messages are being communicated? |
ORU
- Diagnostic Messages Pathology/Radiology/Clinical
ORM
- Order messages
MFQ
- master files query
MFN
- master files update
QRY
- Query Messages
ORF
- Query response
ACK
- Ack processing
ADT
- Patient demographics
SPQ
- Stored Procedure request
SIU
- Appointment
SQM
- Appointment
SRM
- Appointment
REF
- Referral - under development
VQQ
- Virtual table Queries
PIT
- Conversion to and from HL7 |
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How many Messages are handled per month? |
Internally - Millions
To GPs - 5000/month currently
Pathology - 10,000 a month |
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What validation of messages does your
products do? |
Server validates every datatype in ORU on
save. Generally errors are fixed if possible. We have pointed out many
errors in QML and Sonic messages. These are usually then fixed. Also
provided feedback on A limited number of Gribbles messages. |
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How does your product interface with other
systems? |
Usually file based using HL7 or PIT and
interface. Tight Word and Wordperfect integration. Extensive ability to
parse rtf. We also sync demographics from most PMS vendors. (via ADT
messages to server) |
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Into which systems is your product
integrated? |
Medical director
Genie
Locum
Monet
S&N (Clone of email client)
Medical spectrum
Rx Medical
Blue Chip |
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How do you handle the privacy requirements? |
PGP and Hesa Certificates
All traffic is encrypted
Secure Server environments with strictly
limited access
Firewalls
Privacy agreements with clients and staff |
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Do you support certificates? |
Yes PGP and HeSA PKI |
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What type? |
HeSA (Individual & site) ie X509
PGP 2.6 (Self generation integrated) |
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Individual/site? |
Both. |
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How can the user monitor the system? |
Built in message tracking for sender.
Recipients can use test message.
Internal monitoring of client server hits
and automated reporting. |
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What problems have users identified and
reported? |
During the trial phases of our products a
number of practical issues have been identified:
Incorrect provider numbers and lack of
access to provider number information
Service applications accessing shares
PMS Batch number issues (however, no
results were actually missing)
Import directory incorrectly setup
Frequent GP hardware failures
RTF issues wrt report conversion
PKI DLL problems - failed chain checking
and dependancy on MS C DLL
PKI Driver issues
PKI - Single threaded only
Expired HeSA certificates on LDAP
Unannounced HIC LDAP config changes
Inability of GP packages to import into an
the usual area (eg. MD won't import into Documents)
Lack of HL7 Image support in PMS
Many issues have been addressed and most
solved. |
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Comments: |
We have had extensive experience in making
Specialist to GP messaging happen. |
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How do users initiate using your product? |
Ultimately via web-site. Contact with
Buderim Gastroenterology is main current method. Completion of a fax
back form has been the most common method.
Java Web-start for J-Client. User can
install any time if they have a site certificate and client will be
registered but have no Providers assigned. We can setup users in advance
with PKI and web-start will result in a functioning client after install
With Magellan
Internet download (2.7mb) for windows
client. takes a minute on fast ADSL. An install token is generated by
which users register their public keys. Usually done on the phone if
someone at GP end has basic Computer skills.
Word Plugin/Medical Objects Explorer can be installed in a
similar way |
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Please give a step by step description of
the installation/Configuration/testing? |
see above. |
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How can the user verify that the system is
operating correctly? |
There is a test message available. Users of
Trinity can send a test message to themselves. |
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How is the user alerted that the system is
not operating correctly? |
Magellan will show errors in interactive
mode. Trinity will indicate the message could not be sent, as will
Medical Objects Explorer.
The operation of the clients can be
monitored by querying for server hits as well as by regular reports of
client hits and messages delivered or not delivered. Automated server
uptime monitoring. |
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How do you prevent message and data
corruption when the computer crashes? |
All delivery uses an ACK generated from
what was saved on disc. If its not on disc it cannot be ACKed. Old
batches can be retrieved if desired.
Servers are backed up and backups are
offsite. Servers can be replicated for a quick response in the event of
disaster and servers can be rebuilt from archived messages if need be.
All servers use RAID arrays, dual power supplies and multiple network
cards/switches and routers. The nature of messaging makes the system
inherently more robust.
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Please give a step by step description of
the support call procedure. |
We have a phone number that has full time
receptionists who are able to contact support personal. (9.00am-5pm Mon
to Friday 07 54455037) Support personal can receive HL7 messages and
have mobile numbers. Servers are accessible 24/7 and we have a dedicated
dial-up line to access servers which have remote power management and
bios level access to diagnostics. Data centre staff are also available
weekdays. The data centre runs much of the non telstra ISP
infrastructure for SE Queensland. |
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When did Development start? |
1997 |
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When was first installation? |
In house use since 2000. Remote users
started in 2002. |
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How many versions/releases since then? |
The first working versions of clients are
still in use but continual cycle of regular releases with enhanced
functionality since. Only 3 major releases of download client. |
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What are the major changes since the first
version? |
PIT Support
PKI support
TWAIN emulation
Installation enhancements. |
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What is your design methodology? |
Test Driven Development
Extensive use of design patterns
Object Orientated
Early planning in UML |
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What programming language? |
Object pascal (Delphi)
Java |
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What database? |
Firebird (Interbase was ancestor) |
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What communications library/module? |
Sockets/Indy/DX Sock/Apache |
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What Encryption system? |
HeSA PKI, PGP V2.6 |
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What HL7 generator/parser? |
Part of Framework ie proprietary |
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Any Other software components? |
Uses various commercial Delphi Components;
Own HL7 Framework.
Bugzilla
CVS
DUnit
AutomatedQA
MemorySleuth
Rational Rose |
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What are your test & QA methodologies? |
Dunit tests - extensive
Practice and Report Audits
Test Setups
Long running trial on Sunshine Coast |
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Which part of the Product/System do you
want to improve?
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Wider range of message support & report
writing. |
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When? |
Next 6 months. |
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Which new features do you want to add? |
Support REF Messages
Integrate Snomed - partially done |
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When? |
6-18 months |
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What area/situation/practice OUTSIDE your
system would you like to see changed? |
A fairer approach to evaluation! |
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What do you believe are the most important
features for successful messaging? |
Security
Privacy
Reliability |
Why do you think messaging has suffered a
comparatively slow uptake with GPs?
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1. The use of PIT, its easy and the visual
results are similar so systems go no further
2. Lack of a level playing field in medical
software and subsequent lack of competition. Drug company sponsorship
should be eliminated.
3. The one vendor does everything
mentality. Little specialization.
4. Many systems are still using very old
technology
5. Lack of vision
6. RSA
patents (Now expired !)
7. Lower level of computer uptake by
specialists
8. Low Quality initial PKI implementation
by Federal Government |
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Why do you think are the three most
important features/benefits of your product? |
Security
Privacy
Reliability |
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Which system/service would you see as the
most serious alternative to your product? |
Probably healthlink,
We have all the pieces, from tools to
create compliant and highly atomic messages, to routing/provider
lookup/Key management and delivery. We are delivering HL7 based messages
from real practices to real practices today. We have the domain
knowledge and technical ability to continue to extend and enhance the
Framework. All messaging, at all levels, internal and external, is done
with HL7. The framework is designed specifically, from the ground
up to do this specific job, its not adapted from any other domain. We
are 100% Australian owned and developed. We don't feel other players
have the same combination of domain knowledge and a working HL7
Framework, designed specifically to be rapidly deployed in the
Australian situation.
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Why do you believe your product is the
better system/service? |
It has been developed to fulfil the
intended role and has been trialled successfully in that role with user
acceptance and proven ease of use.
It has an open API
It gives a choice of encryption and allows
paperless referrals via PKI signatures
It has HL7 based provider lookup.
It provides for message tracking.
It is standards compliant
It is extendable
It is scalable and distributed, has no
single point of failure.
It is deploying. |
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Why was it not evaluated by the GPCG
messaging project? |
This is a question that the GPCG need to
answer. |
