Halbert, Gareth wrote:
*** This is my first post here so my apologies in advance if I seem to be
'recreating the wheel' with my posts. ***
Gareth, welcome to the list.
That does raise an interesting point, in an ideal world information should
be able to be sent to patients and should be fully encrypted, however my
feeling at this point in time it seems that we are not able to get "Doctor
-> Doctor" and "Doctor -> Specialist" encryption working efficiently due to
a number of factors.
I disagree. I have a comment and question to ask about this at the end
of my message.
By the way, when you say Doctor, it appears that you may mean GP. GPs
have relatively little traffic with each other - mainly if we are
sending reports of itinerant patients (e.g. in our area while on
holidays) who happen to have had to see us, or when transferring a
summary to a patient's new GP. Most of our traffic is with other health
professionals and organisations, including but not limited to medical
specialists. Our communication with medical specialists may represent
less than 50% of our communications about our patients.
If these issues seem to cause a lot of problems with GP's, specialist's etc
(Who generally have 1. An IT person/s looking after their IT needs and 2. A
good understanding of their software and encryption requirements)
I disagree on the first point and strongly disagree on the second point.
On the first point, some medical practices have very little support from
an IT professional, often because the practice does not want to pay for
that service, sometimes because the practice has been disappointed with
the IT person or company that they have used, sometimes because their
practice is remote and there is no professional IT support available
locally, and sometimes because the doctor or doctors think that he, she
or they can manage the system themselves.
On the second point, I believe very few GPs or specialists have any
understanding at all of their software or encryption needs. A few have
a slight idea and a very few have anything more than that.
I would
not like to try to apply these problems to patients who may or may not use
said encryption systems again and certainly would not have the understanding
of encryption software/keys required to receive the information.
The difference is that patients are wanting to send or receive
information only about themselves, which simplifies things a lot, while
while health professionals need to to send and receive information about
many patients, which complicates things. I believe that many patients,
especially those who use computers and the Web etc., can be enabled to
access information about their own health.
I think if a patient requires information electronically it would be
sufficient to have this provided on a CD or floppy disk.
If all that the patient wants to know is her smear test result or his
INR, does he or she really need a whole CD or floppy disk (or USB drive
etc.) for this, or would a short email message or Web access to his or
her own record at the practice do?
(I know of at least
one specialist that provides this service for ultrasounds). I for one would
not like to have these scans/videos emailed to me as the size of the files
would make it difficult to work with (especially if the patient uses older
dial up connection)
It is not that bad or that simple. There are ways to compress data,
bandwidth is increasing (although lagging far behind that in other
countries), and already there are systems that allow online viewing of
XRay and other images.
Gareth
I note that your email address is at Symbion Health, which describes
itself on:
http://www.symbionhealth.com/415.asp
as:
"Symbion Pathology owns and operates Australia's second largest group of
pathology practices (...)
Symbion Medical Centres works with GPs to provide local communities with
quality health care and family medicine. More than 430 GPs operate their
practices within 49 Symbion facilities across the country. (...)
Symbion Imaging is one of Australia's largest diagnostic imaging groups
(...)
Symbion Pharmacy Services provides wholesale distribution of
pharmaceutical products (..)
Symbion Consumer is Australia's leading provider of nutriceuticals (..)"
Please would you describe your role in Symbion Health, and in particular
tell us Symbion's attitude to clinical messaging systems and in
particular to the role of the Argus clinical messaging system compared
to the others, from Symbion's point of view, and how Symbion is
responding to requests from GPs and others to deliver its results via Argus?
I note your opening comment "...my feeling at this point in time it
seems that we are not able to get "Doctor> -> Doctor" and "Doctor ->
Specialist" encryption working efficiently due to a number of factors."
I understand that one reason why we have had some difficulty in
establishing efficient communication is that many pathology practices
have to date insisted on rolling their own messaging system to deliver
their results to referring doctors, rather than to use an existing
system such as Argus. This has led to what we have realised is a very
undesirable proliferation of proprietary secret downloading clients on
general practices' systems. What is your or Symbion's response to this?
--
Oliver Frank, general practitioner
255 North East Road, Hampstead Gardens, South Australia 5086
Phone 08 8261 1355 Fax 08 8266 5149 Mobile 0407 181 683
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