Dear colleagues,

In the north eastern suburbs of Adelaide we are working hard to get local 
specialists and others to start communicating with us electronically, 
specifically by using Argus.  Our local Division (Adelaide North East) is 
supporting this.  Every time I refer a patient to a specialist outside the 
north eastern suburbs, I preface my referral letter with information very 
similar to that which is below, and we are getting a fair bit of interest from 
many of the specialist practices.  

It is interesting to hear about the difficulties that some of them are 
discovering.  One practice is still using Windows NT and has to upgrade from 
that in order to be able to start using Argus.  Others have to talk to their 
software suppliers about configuring their systems to be able to use Argus.  
Some others have said that our suggestion has come at a very good time, just 
when they are wanting  to increase their use of electronic systems and their 
Web presence.  One specialist practice is about to install Genie, which thanks 
to Paul Carr's good work is already well integrated with Argus.  Overall the 
feeling that I am getting is that there is a huge interest in moving on from 
paper and fax, and that a lot of that movement is about to happen.

What's left is to get our hard-pressed public hospitals into gear with this.  
Today I have written to our local Repat hospital to give them a nudge towards 
the 21st century - the text is below.

*********************************************************

GP Liaison
Repatriation General Hospital
Daw Park

Dear Mary, Janet and Rebecca,

We have received the attached invitation to confirm our fax number for the 
Hospital to send us notifications of patients admitted and discharged.  We 
appreciate the offer to improve the Hospital's communication to us, but want to 
let you know that our practice has moved beyond using fax as our preferred 
means of exchanging clinical information.

In our practice we have invested heavily in computerisation, which has helped 
us to increase the quality of care that we can provide to our patients.  We no 
longer write on paper and no longer have paper case notes in which to store 
incoming correspondence.  We therefore don't want paper coming into our 
practice in the form of posted or faxed letters or reports.  To date, we have 
been scanning in incoming letters and faxed messages, but this is not 
satisfactory because it is costing us a significant amount in staff time and 
hard disk space and the scanned documents are often not very legible.

Our practice is keen to communicate with other parts of the health system 
electronically, and in particular to receive reports security-encrypted that 
can be easily imported into our clinical record system.   The reports need to 
be security-encrypted because ordinary unencrypted email messages can be read 
at any of the ISPs involved in the transmission chain between sender and 
recipient.  However, email messages that have been encrypted provide good 
privacy and security for this purpose.

There are a number of commercial systems available that provide secure clinical 
messaging.  They work fairly well but cost significant amounts to use.  The 
good news is that there is also a system called Argus that is free to use 
because its development was supported by public funding.  This advantage is 
leading to the Argus secure messaging software increasingly being used by GPs, 
medical specialists and public and private health hospitals, clinics and 
organisations around Australia.  The Adelaide North East Division of General 
Practice is encouraging and helping its members to install and use Argus in 
order to improve communication between GPs and other parts of the health system.

We have installed Argus secure messaging software in our practice and we would 
like to encourage the RGH to send its reports to us using Argus.  There are no 
charges for document sending or document receipt beyond normal email costs.

The benefits of an electronic clinical messaging system are:
*  For the sender, saving the cost of the telephone call for sending a fax, or 
the cost of stamp, envelope and staff time for posting       letters.
*  Reduced cost of scanning letters by GPs.
*  More timely receipt of your messages.  
*  Much less chance of the letter going astray in the post or in our practice.
*  Swifter GP access to patient information with more timely response to advice 
on changes in patient clinical management.

You can read about Argus on the Web site www.argusconnect.com.au  .

Please would you discuss this with the relevant people at RGH and let me know 
the Hospital's plans for starting to use Argus to transmit its messages to GPs?

Oliver Frank, general practitioner
255 North East Road, Hampstead Gardens
South Australia 5086
Ph. 08 8261 1355  Fax 08 8266 5149
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