> 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. 


Yes, from what I can tell, the Eastern Goldfelds project showed
that you can have VPNs and VoIP and Web cameras, but I don't
think that this technology was used in any mission critical way, eg.
the docs over there probably had a nice chat about the weekend
footy when time allowed using these technologies. 

My proposal is to use these technologies for the mission critical
task of providing after hours care to rural hopitals/ communities
from "call centres" staffed by suitably experienced GPs.

My medical experience tells me that this will work and lift/ lighten
the great burden of after hours care off rural GPs.

> 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.


The technology is straight forward except there is not yet a ready
to use hospital electronic medical record system ...

In Victoria, the Alfred is just starting to implement a hospital EHR -
this is very expensive, propietary, windows-based, and the only present
functionality is downloading pathology and radiology, and prescription
writing  :-((

The only current alternative to this is InfoMedix which is just an
electronic record of the scanned hard copy records, and not based
on an SQL database.  It is regarded as an interim/ transitional solution
prior to the availability of a proper EHR.  It is presently being used
at the new Casey Hospital, Berwick, Vic since it opened in mid-2004,
and they are happy with it and believe there are significant cost savings
compared to normal hard copy records.  I believe that Royal Hobart
Hospital has just implemented this EHR, and there are plans to roll out
to other Tasmanian hospitals. 

I agree that the politics are the greatest hurdle to all this.  This
means that
it's time to start being political, by targetting the right movers and
shakers
with information using the right syntax, viz:

1) a proper hospital EHR will save huge $'s (several million per year for
larger hospitals), improve patient care and safety, and help alleviate the
rural doctor crisis. 

2) the quickest a best way to a proper hospital EHR (sql databased,
cross platform, and open source) would be to fund this software
development, and to stop wasting time and money on talkfests.

John Mac
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