Hi My name is Ewen McPhee
I am a rural GP Obstetrician from a small country town in Queensland.
I am here to talk about my journey to being en eGP and to share a couple of insights with you along the way.
Recently I received a text message from one of my bosses (lately I have more and more the more I get involved). The CEO wanted to talk to me about some strategy that he had been working on.
The Company has a fantastic secure videoconference system with data pipes the size of fire hoses, with password protection and digital encryption all the bells and whistles.
Unfortunately, the CEO was in China… And he actually hadn’t installed it or used it before. So his IT guy installed it for him. When I finally found and downloaded the app I asked “where’s the password?” …… Um the IT guy forgot to give us that key information.
So here am I in Emerald, wanting to please my CEO, in China, by connecting with him to hear his latest epiphany… I looked down and I have been texting him using iMessage and we both have iPhones. My next question was “Can we do FaceTime?
Here we were each trying to connect and missing the most obvious tool that we both had available to us, technology that we have come to take for granted, technology that we had subconsciously assumed wasn’t fit for purpose.
Yet Apple has spent a long time building their IP and their apps to the point where it is natural to use them (or overlook them when were thinking we need to do something special, different, industry specific)
This presentation isn’t about my iPhone or Apple.
I have two key messages.
If we are going to success from our endeavors, we need understand where we are going. To shift our focus from doing stuff that meets our sectorial needs. We need to understand the Big Picture, the Why, the end we have in mind…
And If we are to see the value that IT solutions in health can bring, we need to create solutions that support and connect clinicians and consumers in natural practical and easy to use ways…
My profession is general practice, what I do every day is connect with people. I see people from cradle to grave though the highs and lows of life. I was to deliver the eulogy at my mother in law’s funeral a couple of weeks ago. true to form my son gave that eulogy because I was delivering a healthy baby girl at the Hospital.
Successful GPs are people who deal with uncertainty, who know its OK to say I don’t know because they understand how to navigate the best care they can for their patient
In our country, at least, General practice is the lynch pin to the health system, for most people it is their first and last contact with the Health system. General practice is also a small business, a cottage industry where IT still is in many ways in its infancy regardless of GPs being the most enabled with respect of electronic records.
In the last few years I have participated in a number of eHealth initiatives state and federal that relate to my profession of General Practice. Each of those has been struck by certain challenges.
Queensland Health has one of the largest distributed Telehealth networks in Australia if not the World. Yet at present it cannot talk to anyone outside of the Cisco Network without special software or systems. Telehealth has a lot to offer especially rural and remote Australians yet remains constrained by technology and bandwidth, not enabled by it.
The National eHealth Transition Authority has seen the implementation of an Australia Wide secure backbone for information transfer. Through the Practice Improvements Program over 5000 General practices have registered to be able to send secure files yet only 900 GPs out of over 32,000 have uploaded a file. There are over 2 million Australians registered but a mere fraction has an online health summary. The potential for a real time medication list to reduce avoidable harm is still a bridge too far.
More recently I have been involved in the Queensland Health Clinical Prioritization Criteria consultation process. The CPC aims to create a set of clinical criteria that GPS will have to tick off before a hospital will accept their referral. The CPC has enlisted a large number of specialists in defining their specialist spheres, the priorities, needs and requirements that would increase efficiency in the system. Numerous large documents have been produced, the expectation being that eventually GPs will use them to refer patients.
These are but a few of the examples of the application of IT in Healthcare, yet unlike FaceTime on my iPhone haven’t yet become embedded in the toolkit of clinicians and patients.
Coming back to my key messages.
Skype has security issues and has been deemed unsuitable by many IT administrators, yet many of the consultations that are enabled in my practice every day use this tool. We can see who is online and we can easily connect with them.
One kangaroo through the windscreen makes a compelling case for robust easy to use Videoconference systems.
The secure backbone developed by NEHTA is complex, it requires various certificates, health identifiers, and aggressive punishments for infringing privacy legislation.
However, people are only too happy to share their most intimate details on Facebook it seems, not that I am suggesting we do that of course.
Finally, the issue of intelligent design must be embedded into our projects. There must be some value add to empowering clinicians in using systems. Clinicians will find value when systems offer them decision support, information “just in time” that is relevant to their patient care.
There are so many guidelines, maps of medicine, referral pathways out there already but few support the clinician and their patient to navigate the health system.
Ease of use, intuitive and natural design must underpin what we do if it is to succeed in Primary care
Yet why do we innovate and invent? Why do we invest large sums in IT (like my CEO) when perhaps a simple universal tool is already out there that can get the job done?
Why isn’t it about saving money, why isn’t it about quality or safety, why isn’t it about efficiencies.
When we are thinking about the reason why we develop our projects we need to keep front of mind that it will always be about human touch, voice and caring. IT solutions, especially as they relate to my profession should be seen but not heard, they should be as simple as an iPhone app to use, their power hidden, but present.
Health care is about connection, it’s about shepherding people through a complex system safely.
In summary the eGP of the future needs powerful systems that are easy to use, that support good decisions, connect the right people with their patients and ease the health journey that we all at some time will make.
At the end of the day the IT isn’t the means to an end, its part of the toolbox that enable effective safe clinical care.