John Mackenzie wrote:
Sir,
I wish to draw your attention to the rural GP shortage ...
Whilst there is more than one cause for this, an important
factor is the burden of after hours care causing sleep
deprivation, exhaustion and burn out.
In the many smaller rural hospitals unable to distribute this
after hours burden amongst several GPs, I believe that it would
be possible to implement a system with a remote "1st on-call"
doctor/GP able to manage most after hours problems. There
would still need to be a local GP available as "2nd on-call"
for circumstances unable to be managed remotely, but the
overall reduction in after hours calls and sleep deprivation
to rural GPs would be of great benefit to themselves and the
safety of their patients.
The technology is now available to implement this concept, but
there are hurdles to overcome:
1) The rural hospital should use _electronic health records_ which
can be accessed remotely using _virtual private networking_ -
rural hospitals would need this to be set up by IT techies, and
nursing and medical staff would need some training to adapt
to the new computerised medical record system.
2) There would need to be a "panel" of suitably trained/experienced
doctors to be remotely on-call for these smaller rural hospitals.
Theoretically it would be possible for all rural hospitals throughout
Australia to be covered from 10pm to 8am by remote on-call doctors
working shifts in W.A. from 8pm to 2am and then an eastern state
from 4am to 10am.
This is the concept for which I have no vested interest other than a
wish to help rural
GPs and their patients. Hoping the idea is of interest.
Yours respectfully,
Dr John Mackenzie (Monash 1974)
Westernport Medical Centre
4 Mornington-Tyabb Rd, Tyabb 3913.
- past Chairman MPDGP
- past secretary AMA Peninsula subdivision
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John,
A great idea.
You would be very interested in seeing the video for the Eastern
Goldfields project in WA, which had a lot of the capacity you refer to,
except that the WA state hospitals weren't involved and the project is
Federally-funded. Lots of GP practice and Aboriginal Health Service
connectivity with VPNs to home and VOIP.
I'm sure WA hospitals in EG area weren't involved because 1. WA
hospitals didn't have the money to fund their end of it, which would
apply in NSW also, and 2. No way that DoHA would fund the state
hospitals, owing to the rigidity of the state/federal health divide.
I would suggest that the technology to do what you suggest is
straightforward, but that the politics and money issues would make
climbing Everest without oxygen seem easy.
But you never know, if the Feds can pretend they thought it up, they may
make a promise to do something, after all it is an election year! They
are doing little else in the E-health arena at present that isn't small
pilots, NEHTA or thinking about the AGPN's DNIMP proposal.
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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