Dear colleagues, Medical practices increasingly are using electronic clinical systems and email as their primary methods of communicating clinical information. Electronic communication has many advantages which I don't need to outline to the people on this list.
Recently I have become more conscious of the potential risk of important or urgent clinical information not being acted upon because the message was sent to either to the clinical inbox or email address of a doctor or other practice member who was absent, for example away sick, at a meeting or conference, on holiday, unexpectedly dead or otherwise indisposed. I am interested to know how other practices make sure that somebody checks the clinical inbox and the emails of any doctor or other clinical staff member who is away, in case there are any urgent and/or important messages about patients that need to be acted upon. Microsoft Outlook has an 'out of office' function that can forward mail to another person's email address or reply automatically to the sender with an "I am not here" type message, but it works only if the user who is going to be away remembers to switch it on. If the reason that the user is absent because he or she has suddenly fallen ill or had an accident, it won't have been switched on and messages will not be forwarded. I am not aware of any such facility in any clinical software package. A possible solution may be to create software that monitors each user's logging on to the network on the days and at the times that he or she is expected to do so. It would not need to monitor specifically logging on to the email system or to the electronic medical record package. Essentially the philosophy would be along the lines of: "I expect Dr. Smith to log on to the network by 9.00 a.m. every morning from Monday to Friday. If she doesn't log on by 10.00 a.m., I will send an alert message to the practice manager, and offer to forward to her (the practice manager) copies of any unread emails and any further incoming messages for Dr. Smith until Dr. Smith does log on". If 10.00 a.m. arrives and Dr. Smith hasn't logged on, and the monitoring software starts forwarding Dr. Smith's emails to the practice manager, but the practice manager knows that Dr. Smith will be in a bit later than usual today for some reason, she (the practice manager) can just keep an eye on what is coming in for Dr. Smith without doing anything about it, because she knows that Dr. Smith will be there soon and read her own emails. Once the practice manager knows that Dr. Smith has logged on, the practice manager can delete Dr. Smith's forwarded emails. The monitoring software could even notify the practice manager once Dr. Smith has logged on. On the other hand, if the monitoring software has sprung into action and started forwarding Dr. Smith's emails because Dr. Smith has had an accident and won't be in today or possibly for some days or weeks, the practice manager knows that she will have to take appropriate action about any of Dr. Smith's incoming messages that need to be acted upon. She may, for example, either contact the senders with the bad news about Dr. Smith, or refer the messages to another doctor in the practice for action. Once Dr. Smith has recovered and comes back to work and logs on, or logs on from home or hospital, the monitoring software would detect this and automatically stop forwarding her emails to the practice manager. However, if 25 hours elapses before Dr. Smith logs on again, perhaps because she has relapsed, the monitoring software will detect this and again notify the practice manager and offer to start forwarding Dr. Smith's emails to her once more. The monitoring software has nothing to do specifically with any specific email package or with any clinical package, since it would monitor only the users' logging on to the network on expected days and times. It could be used in any organisation, not just medical practices, where important and/or urgent messages may be sent to people who may be absent, and others in the organisation need to be notified of such messages. Such monitoring software could useful in a wide range of organisations. I would be pleased to hear what others think of this suggestion. Oliver Frank, general practitioner 255 North East Road, Hampstead Gardens South Australia 5086 Ph. 08 8261 1355 Fax 08 8266 5149 _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
