RACGP election interview: Dr Danny Byrne
Danny Byrne is a GP in Happy Valley, Adelaide, who has declared his passion for eHealth, which he says is a no-brainer when it comes to changing healthcare for the better. He has recently acted as a clinical adviser to NEHTA.
In what areas do you feel IT could most improve general practice, either clinically, administratively or both?
IT will continue to help improve general practice in both areas. I remember in 2004 when Vioxx was banned overnight we had a list of patients to call generated by a software search within minutes. My rheumatology colleagues had no idea who they had prescribed to or how to contact any patients. They had to rely on GPs and pharmacists. That one experience was enough to convince me that using IT for data collection, analysis and interpretation is clinical gold. Since then I have used IT tools for quality improvement on a regular basis, such as PEN CAT. The clinical benefits are numerous – would anyone really go back to pen and paper notes now? I really enjoy not writing out the patient's name and address over and over again! Admin wise we are miles ahead – online appointments are the latest advance. We have data to generate reports on waiting times, income per patient, costs and income – the list is endless. With the help of IT we have moved from a cottage industry to well-run enterprises.
Have you used the PCEHR, and if so in what capacity? (e.g. to review patient information, upload a shared health summary etc).
I have used the PCEHR. I have uploaded around 30 Shared Health Summaries. These have mostly been for patients travelling to WA and Queensland to escape the southern winter. These "grey nomads" are IT savvy and see the benefits. Quite a few are surprised that we have not been able to do this already. Personally I experienced the frustration of being a parent of a sick child (parietal AVM) having tests, scans, angiograms and MRIs in various facilities with no coordination, then interstate surgery with no seamless communication back to our home state. The stress of being a parent in this situation and then dealing with missing results was beyond a joke. That personal experience was enough to convince me we have to do better – and we can. (All turned out really well by the way – thank you Australia for a great health system).
What do you think about the PCEHR in its current form?
The current PCEHR is a cousin of what the final product will be. The Shared Health Summaries I uploaded in May are already out of date once a few medication changes are made. Patients with chronic illnesses are not stable. Ideally we would have real time feed of data into the PCEHR. The discharge summaries going in are good. There is plenty to build on.
Do you agree with the college’s position that future functionality should be put on hold until existing functionality is improved and adopted by doctors and other health professionals and organisations?
If that is the current RACGP position then that is what I will be supporting as President. In the long run sensible approaches will win out and if it takes a bit more time to get it right then so be it.
What future role do you see for the National E-Health Transition Authority?
NEHTA – or its suggested replacement – has a crucial role because that is where the corporate governance and knowledge reside. The behind the scenes work we GPs don't see in the legal, technical and standards area is huge. We just want to see something that works.
Medicare Locals are to be collapsed to a lesser number of Primary Healthcare Networks with funding for Medicare Local eHealth officers concluding. From an eHealth perspective, what material impact do you think these realignments will have on your own practice, and the practices of other RACGP members?
In the short term, because of the cuts, eHealth support will depend on each individual Medicare Local deciding how much money they will allocate from core funding towards eHealth. It could vary from zero to full support.
Do you see a future role in eHealth for PHNs, and if so in what capacity?
From July 2015 the new Primary Health Networks will surely have to take on eHealth support – the tools required to bring about the integration of primary health are IT based.
Have you conducted any telehealth consultations, and how do you think the regulatory/remuneration structures for the provision of such services could be improved?
No I have not used telehealth but I have tried to keep up to date with what is happening. As with all IT programs the most important aspects are standards, enablers and incentives. I worry that "just use Skype" is a bit too simplistic.
What clinical software do you use in your own practice?
Best Practice – very happy user.
If you had to pick one area for improvement in this software package, what would it be?
I would like to see the Care Planning module become more sophisticated to produce a genuine living document with meaningful use rather than the current one that ticks the boxes for claiming Medicare item numbers but is not best practice.
Lastly I have to declare my passion for eHealth. To me it is a no brainer that eHealth is going to change our health care for the better. I can make this statement – I want it to be user friendly, intuitive and indispensable. I want GPs to be saying, “How did I practice without this before”. I just won’t promise that the printer will work every time.
Declared interest: Dr Byrne has worked for NEHTA as a clinical adviser contractor over the last six months, earning $3000.
Posted in Australian eHealth