Is Anyone Out There Clear Abut The Reasons Bendigo Health Is Moving Away From Use Of Secure Clinical Messaging While ADHA etc. Are Encouraging It?

I had this e-mail from a GP Tech Support Consultant a few days ago.

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I'd like to give you a heads up on a recent development by Bendigo Health regarding the secure delivery of discharge summaries to GP clinics in the region.

I understand that these were sent by Argus, 6 months or more ago and have since been sent by a variety of other methods. The default method is now snail mail with them moving to an email-based method. As far as I have been able to determine, they are emailing GP clinics with a link to the discharge summary held on a secure site. There is some method of ensuring that the information cannot be downloaded by unauthorised persons but Bendigo Health has been scant in detail.

I am assuming, that from a security perspective, the information is safe. However, Bendigo Health has been less than forthcoming in providing this level of detail. Despite repeated requests. The information I have received from them is somewhat limited.

My main concerns are around the workflow impacts on GP clinics in the region and the unnecessary additional work imposed on these businesses. From discussions with my GP clinic clients, the time taken to access the discharge summary in this way, download it, remove any blank or unnecessary pages, upload it into the clinical software and apply the necessary metadata could take say 2 minutes per document. This would be performed by a GP clinic staff member. This is 2 minutes more than what would be required if the message was sent via HL7 messaging. In this case, Argus.

Discharge summaries are bad enough at 50000+ per year. If this approach is taken with specialist letters and ED presentations then the total number of messages could be in excess of 200000 per year. That will translate into a lot of additional unnecessary work imposed on GP clinics which could be easily avoided.

I have based these possible message volumes on information published in the Bendigo Health annual report.

It seems clear to me that the people who think it is acceptable to impose unnecessary costs on a business have never had to run a business.

Without appearing alarmist, some of the communication I have had with Bendigo Health personnel imply that similar approaches are being adopted by other similar organisations across Victoria. If this is true then we have a huge problem developing.

I believe that the widespread adoption of the Bendigo Health proposed approach has the potential to put clinical messaging back 20 years in Victoria - at least as far as the state-funded health services are concerned. In my view, this is unconscionable conduct by those involved.

I am happy to share with you all of the information I have collated on this issue so far.

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I have had a look at a range of the associated materials and e-mails and it does indeed seem Bendigo Health wants to move to a system of e-mailing links to GPs for them to download and process into their systems the Discharge Summaries (and other clinical documents) from a central secure server.

On the face of it, compared with the access provided by the use of Argus (or other SMD solutions), this does rather seem like a step backwards.

Can anyone reading here let us all know just what is going on and is this some sort of policy change at Bendigo Health or Victoria more widely?

Anyone want to comment on how SMD is working for GPs more broadly and what, if anything, is needed,  to improve things?

Root causes of any problems seen always welcome!

David.