Tony Lembke wrote:
On 07/04/2007, at 8:00 AM, Peter MacIsaac wrote:
So if GPs are concerned that communication is happening in an ad hoc and
uncoordinated way at their regional level - then asking the local
Division
of GPs to start a round table discussion with other health services
may be a
place to start. There are emerging models and systems for this.
Peter,
I agree that a bottom -> top approach to local communication is likely
to achieve more short term progress -
as long as the systems that are chosen have the capacity to use emerging
standards of interoperability.
Tony,
That's a very big and important caveat. While some local areas have more
capacity and scale for bottom up projects, there desperately needs to be
some rules/standards/legislation about interoperability. There are
commercial players wanting to lock-in providers for sure.
Most of the recent Managed Health Network grants have gone to rural,
regional and special purpose organisations. Getting anything in place in
the metropolis is much harder, owing to scale and much higher thresholds
before enough business partners come on board to make adoption
worthwhile. The small size of these grants basically precluded a project
aiming to cover a large population.
Otherwise, it is hard to imagine anything worse than 100 different
divisions adopting different solutions, locking their regions into
proprietary solutions that can't speak with each other.
Fortunately there is nothing like 100 different solutions, and division
attitude varies enormously, ranging from indifference, to wondering how
to resource such an endeavour, to actively committing to one solution or
another. Some love the big players, some want low-level, open-source and
member and business-partner collaborations. Very few have the necessary
funds to do much and MHN has funded mostly small seeding grants and a
very few bigger projects, three of which, out of about ten, are in
Queensland interestingly
I am aware that the call for standards-based solutions is a
long-standing plea from many on this list, but, given some of the
choices made, I wonder how many divisions and GPs can give 'informed
consent' to schemes that are proposed to them.
A very good point. About half the NSW Divisions are without any IM
support capacity, according to a recent SBO survey. One possible answer
lies in Division amalgamation, currently being incentivised by DoHA,
which may lead to mega-Divisions in town with further loss of face to
face relationships with members. Hence a push to beef-up Division CRM
capacity.
Constant staff turnover is already a big resource drain for many
Divisions. Little wonder with all the uncertainty, rising expectations
and responsibilities and clouding of role. Division staff all live on
one-year contracts, without many of the perks of AHS staff or public
servants.
How any of this will help the many small rural Divisions with far-flung
memberships and huge logistic and resource problems I fail to see.
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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