Linda Mann, a Sydney GP, proposes ways of potentially enhancing patient care and reducing hospital stays, without increasing overall healthcare costs. Her suggested solutions include making it simpler for all healthcare practitioners involved in caring for the same patient to share (rather than not share) all patient information by applying the information technology of today (rather than tomorrow). Also, pooling some funding from state and federal sources could allow for further “seamless care” at areas of reasonable overlap between the current “silos” of hospital-based and community-based care.
The type of scenario described in Box 1 is not uncommon. Contemporary healthcare cuts patient care into separate events by erecting barriers at the boundaries of what we have come to see as “hospital practice” and “general practice”. As a result, Mr A and his doctors face several barriers to optimal care:
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- 1. Campos-Outcalt D, Fernandez R, Hollow W, et al. Providing quality health care to vulnerable populations. US Public Health Service Primary Care Policy Fellowship, 1994. Available at: www.primarycaresociety.org/1994d.htm (accessed Sep 2004).
- 2. Smith BJ, Weekley JS, Pilotto L, et al. Cost comparison of at-home treatment of deep venous thrombosis with low molecular weight heparin to inpatient treatment with unfractionated heparin. Intern Med J 2002; 32: 29-34.
- 3. Scott IA, Greenberg PB. General internal medicine. Med J Aust 2002; 176: 16. <MJA full text>
- 4. Chew M, Van Der Weyden MB. Chronic illness: the burden and the dream. Med J Aust 2003; 179: 229-230. <MJA full text>
- 5. Goldsmith J. How will the Internet change our health system? Health Aff (Millwood) 2000; 19: 148-156.
- 6. Thomas AN, Pilkington CE, Greer R. Critical incident reporting in UK intensive care units: a postal survey. J Eval Clin Pract 2003; 9: 59-68.
- 7. Delnoij D, Glasgow IK, Klazinga N. Financial and organisational barriers to integrated care: an international comparison. 2002. Available at: www.academyhealth.org/2002/presentations/delnoij.pdf (accessed Sep 2004).
- 8. Zorbas H, Barraclough B, Rainbird K, et al. Multidisciplinary care for women with early breast cancer in the Australian context: what does it mean? Med J Aust 2003; 179: 528-531. <MJA full text>
- 9. Swan N. Reforming the health care system. The Health Report [radio program], ABC Radio National, 27 November 1995. Available at: www.abc.net.au/rn/talks/8.30/helthrpt/hstories/hr271102.htm (accessed Sep 2004).
- 10. Cunningham FC. Medicare: diagnosis and prognosis. Med J Aust 2000; 173: 52-55. Available at: (accessed Sep 2004). <MJA full text>
- 11. Knowledge Management Research Center. Hind P. Earnest seekers after knowledge. Available at: www.cio.com/research/knowledge (accessed Jul 2004).
- 12. Smart Health Solutions. Case study: Brisbane Waters Private Hospital. 2003. Available at: www.smarthealth.com.au/PDF%20BWPH%20Case% 20Study.pdf (accessed Jul 2004).
- 13. Australian Government Department of Communications, Information Technology and the Arts. Information technology online (ITOL) program. Available at: www2.dcita.gov.au/ie/ebusiness/developing/about/previous_itol_rounds/round_11 (accessed Sep 2004).
- 14. Australian Department of Health and Ageing. Primary care initiatives. Further coordinated care trials. About the trials. 2000. Available at: www.health.gov.au/hsdd/primcare/acoorcar/abtrials.htm (accessed Jul 2004).
- 15. Australian Department of Health and Ageing. Primary care initiatives. Further coordinated care trials. Information technology and management — guidelines. 2000. Available at: www.health.gov.au/hsdd/primcare/it/guideline.htm (accessed Jul 2004).
- 16. Dearne K. NET takes lead for health industry. The Australian 2004: Jan 20; IT [online]. Available at: www.australianit.com.au/common/print/0,7208,8433127%5E15841%5E%5Enbv%5E,00.html (accessed Sep 2004).
- 17. Australian Government Department of Health and Ageing. Electronic health measures under MedicarePlus. Media release (21 Apr 2004) by Tony Abbott, Minister for Health and Ageing. Cited 10 April 2004. Available at: http://www.health.gov.au/internet/wcms/publishing.nsf/Content/health-mediarel-yr2004-ta-abb044.htm (accessed Sep 2004).
- 18. Zajac JD. The public hospital of the future. Med J Aust 2003; 179: 250-252. <MJA full text>
- 19. Queensland Health. Australian Health Care Agreement 2003 to 2008. Facing the future: opportunities for a better health deal. 2003. Available at: www.health.qld.gov.au/publications/aust_hlth_care_agreement/Facing_the_Future_AHCA.pdf (accessed Sep 2004).
- 20. Maleny Enterprise Network Association. Maleny LETS. Cited 29 March 2004. Available at: www.mena.org.au/lets(accessed November 2004).
- 21. UTS Shopfront Projects. Leung L. NSW Community Options Project. Cited 9 April 2004. Available at: www.shopfront.uts.edu.au/projects/in_progress/client220.html (accessed Sep 2004).
I am a director of Ozdocsonline, which provides a secure Internet-based communication tool for doctors and their patients. Ozdocsonline is currently involved in a cross-sectoral, federally funded trial of complex care. My involvement provided current knowledge without influence.