I was at a meeting last night and the subject was the Future of General Practice. Funny thing about Crystal Balls is that they're just as likely to be wrong as they are to be right. Never-the-less, after having been in the GP craft for about 40 years, I was excited about what might be presented. I was also acutely aware that after having traveled all around Australia in my position as a Locum GP, that what most patients are crying out for is for a Doctor to listen to them and someone who can talk back to them in words they can understand. But no! The first hour was clinically presented by an obviously zealous GP - who also appears to be on so many committees that I seriously can't fathom how he finds time to sit in his surgery - who talked to a slide show of flow charts and graphs. His talk was interspersed with little vignettes about individual patients aimed to tug at heartstrings. And of course there was the modern Tech Speak of Big Data and Silo's of Information as well as numerous acronyms relating to general practice.
So here's the thing:
1. This new experiment in sharing data is going to cost multiples of millions 2.It depends of GP's uploading accurate information to be shared with patients and hospitals. 3. It's going to be encrypted to make it safe.
And the benefits?
Hospitals are probably the most dangerous places in Australia! There are multiple opportunities of making simple mistakes which can have catastrophic consequences for serious sick patients - drug interactions, wrong dose of medications, allergies, unnecessary doubling up of investigations ..... the list is worryingly long. So where does the family Doctor fit into this?
By uploading current health information onto the patients "cloud based" file, Hospital Docs will have all the baseline information they need!
Sounds fantastic. But .....
1. Those that use the Health system wisely and provide regularly updated, accurate medical information will be OK. But then they were going to be OK in the first place. 2. Those who are not involved with their health care (which happens for a plethora of personal, social and familial reasons) are not great historians, often don't hear what their Doctors tell them or translate it into their own version of the truth - and that goes for Docs too when recording medical histories - and it isn't uncommon for them to blatantly lie to their treating Docs (how much do you drink? etc) 3. Then there are those who actively cheat the system - and again, the Doc's are not immune to "bending the rules" if it suits their aims.
I love it when people say the information is safe! Anyone fill in their census details online in Australia on Census night? Was that a software company related to the CIA that was hacked by villains just yesterday? Why is the CBA projected to spend over $1 Billion on cyber-security next year?
Then there's the fact that other people with less altruistic aims who might be interested in the information gleaned from such a sharing of Big Data - I'm sure marketers and Life Insurance companies might have more than a passing interest in it.
By the way, anyone remember Motorola? Kodak? Iridium? These were great initiatives that couldn't stand the test of time ... or ran out of ideas. So when the money runs out for this massive IT plan, who picks up the pieces? Some benevolent white night or perhaps a foreign national?
Whilst sounding negative about what seems at first face to be a "great idea guys," why not focus on letting Doctors doctor? Over the past twenty years the GP has moved from being patient orientated to computer orientated. Yes, lets use IT as an adjunct, but first we must focus on the patient. Use Nurses to oversee immunizations, check INRs, care for wounds etc., but let the Doctor Diagnose. The most important person is the person in front of them and that includes the community they come from - so we need to encourage more Home Visits.
The alternative is for a Committee to re-invent how medicine is practice. But then, look what they did when they were asked to re-invent the horse .... they came up with a camel!
Categories Patients,Big data, GPs, Family Medicine, Home Visits, Cyber-security, Encryption, Practice Nurses, General Practice