Michael Tooth wrote:
I wonder how much of this comes down to Professional pride. It
surprises me the rubbish that people will send out; the excuse is often
that there is "not enough time" or "I didn't know how to change it."
If your carpenter couldn't sharpen his tools, or couldn't saw in a
straight line, you would question his ability. Computerised EHR is the
professional tool of the doctor.
It all smacks of lazziness and poor professionalism to me.
Michael,
I think there is a wide spectrum operating here. It's also not entirely
helpful to target the individual GP as being the problem in total.
Some older GPs have been challenged by having to use computers and are
still highly ambivalent. Some feel inadequate in their skills and do
double work, by which I mean they still keep paper notes as well, which
has obvious problems. Some are very skilled and diligent and see they
are more productive. Some make my skin crawl.
But I think the professional organisations and things like the GP
accreditation process are also avoiding confronting lots of the hard
issues of where the profession is on this stuff. The college's third
edition standards will form the basis for future accreditation surveys.
But how many surveyors will have the IT qualifications necessary to do a
proper survey under these standards? As a person who spent 3 and a half
years getting a tertiary IT qualification on top of my professional
qualification I'd be unhappy if a weekend workshop was all that was seen
to be needed.
No real evaluation of this mass change in GP work practices was built
into the whole thing, and seven years has gone by with only limited
evaluation. Similarly, the standards arena has moved on very slowly.
Mr Abbott has belatedly referred to some Sydney Uni research pointing to
limited skills and referring to paperweights on desks, which was by and
large, an overstatement. ACT Division did research in 2002 that blew the
whistle on the poor standards of practice IM security, which has led to
some improvements.
Against this the expectations re breadth of use and skills expected, as
well as the range of functionality pushed for adoption, continue to grow
apace, without much in the way to help GPs keep up, or much recognition
of the real costs, both financial and human that are required to reach a
high overall standard. Yep, a case for accreditation of GPs use, but
with suitably qualified surveyors, which would be another cost.
Similarly, the ADGP's data extraction framework, which will determine if
Divisions can meet the targets of their new reporting framework, and
hence survive or not, looks like it will rely on unqualified staff at
Division level, who may be expected to be installing software on
practice PCs, despite the very significant risk-management issues
involved for Divisions and GPs.
Watch this space, it will be interesting.
Greg
--
Greg Twyford
Information Management & Technology Program Officer
Canterbury Division of General Practice
E-mail: [EMAIL PROTECTED]
Ph.: 02 9787 9033
Fax: 02 9787 9200
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