GP to chase results no more?

There's a lot about working at the pointy end of the healthcare system that annoys GPs, but “GP to chase” test results ordered while the patient was in hospital has to be up there with the worst of them. Even when prefaced with the word “kindly”, reading a discharge summary written by a junior medical officer with a demand that the GP do the work the hospital doctors should be doing is enough to drive many of them to distraction.

While no one is saying that the My Health Record will put an end to this, the ability to see a patient's results with the click of a button or two and not have to spend time on the phone with the hospital is one of the system's selling points for GPs. Last month, SA Health joined most of the other jurisdictions in beginning to upload pathology and diagnostic imaging reports to the My Health Record from its hospitals, but in a new move SA Pathology is also doing so for tests that GPs themselves have requested from the public provider.

This is a bit of a coup for SA Health and the public pathology sector, and it has been warmly welcomed by one GP at least. While many others are still skeptical about the system, Chandlers Hill Surgery GP Danny Byrne makes no bones about the fact that he believes the My Health Record is a game-changer for the way he practises medicine. “I like having correct up to date information when I see a patient,” he says. “I am a bit pedantic that way.”

Considering the volume of pathology and radiology that is done in the community sector, when the private providers connect and begin contributing reports in bulk, there may finally be a reason for GPs to try it out. Most results will still be sent directly to the requesting doctor as is the case now, but for anyone with a patient who has been in hospital recently or if they are seeing a new patient, the My Health Record might just turn out to be useful. Glory be.

In other news, hospitals are finally moving away from sending discharge summaries by fax and are now using more secure channels. It would be nice if they returned the favour and stopped asking for faxed referrals but progress is progress. My Aged Care, which still has fax or phone referral as an option, has at least improved its webform offering and now lets GPs save the referral in PDF form to their systems. A glory be again, if you send the referral by that route, you even get an acknowledgement it has been received.

One of our other top stories this week was about some extra funding for Queensland Health's specialist outpatients strategy. It too has seen the value in investing in eReferral technology and giving GPs access to more information electronically, although we were amused somewhat to see that one of the big ticket items was money to permanently employ 400 nurse navigators for patients with chronic conditions. It seems we have made the healthcare system so complex we have to employ people to navigate it for us.

And finally, on a very sad note for the software vendor community, we heard that Bridget Kirkham, who ran the Medical Software Industry Association for seven years, passed away in Sydney last week aged just 65. Bridget was a fierce advocate for the industry and for the healthcare system in general, having also spent some time as CEO of Arthritis Australia, CEO of Repromed, director of Research Australia and eight years as assistant secretary of the Medical Defence Union in the UK.

She was incredibly knowledgeable not just about healthcare but the healthcare system and its strange permutations, and was innately suspicious of its bureaucracy. She also had an acerbic wit, a flair for writing and painting, and a great, abiding love for the All Blacks. She will be missed.

Our poll question this week is: will access to test results on the My Health Record be a game-changer for GPs?

Sign up to our weekend edition or Pulse+IT Chat to vote, or leave your thoughts below.

Last week we asked: Should ACT Health buy an off-the-shelf EMR? While the majority said yes, a substantial 32 per cent said the ACT should not go down that path.

Comments  

# Oliver Frank 2019-06-15 16:55
Thanks for your many great articles. I would like to check whether the word "most" in: "Most results will still be sent directly to the requesting doctor as is the case now" means that from now on doctors who request tests will not receive the results of some of the tests that they request.
# Duncan Priest 2019-06-17 10:21
Hi Oliver, the existing distribution of results by SA Pathology to the ordering GP is not affected and continues to operate as before. This is an additional distribution of reports (note the subtle distinction from results) to the My Health Record.
As you correctly note below, the My Health Record does not yet accept atomised results, only an overall report in the form of a PDF attachment to the CDA document. This was a design decision made by industry representatives together with the then NEHTA (now replaced by ADHA). My understanding is that this was in large part due to a lack of standardised notation across the industry. Hopefully we'll see atomised results being accepted into the My Health Record in the near future. (Duncan Priest, DWS)
# Oliver Frank 2019-06-15 17:38
While it is better than nothing that GPs will be able to view and download pathology reports of tests performed by SA Pathology, I believe that the downloaded reports will be PDFs and not HL7 data. I tried to test this in my practice's Zedmed system, but I get an error message that says that there us an access violation.
# Mark Santamaria 2019-06-16 09:11
The bottom line is that there is one patient with many healthcare providers responsible for their care and investigation results are one of the biggest problems in primary and acute care settings.

Currently there is a disconnect between the results from private pathology / medical imaging and public hospital ones. Yet they are both funded by the same pot of money in the end. The monetary cost to the community is enormous as there is significant duplication of tests due to lack of available results.

The SA solution is one step in the right direction but needs to extend to private pathology and medical imaging companies. Remembering that they all receive public monies for the services they provide and the public expects more than what is currently happening.

The other issue of whose responsibility is it to check results is simple. All care providers need to check the results of any test they request and then ensure the appropriate management is in place.

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