[LINK] Hospital use of SMS for Appointment Reminders

Richard Chirgwin rchirgwin at ozemail.com.au
Fri Aug 20 08:55:59 AEST 2010

Tom Worthington wrote:
> Birch, Jim wrote:
>> Tom Worthington wrote:
>>> Perhaps something as simple as authorised staff being able to
>>> access the other hospital's records using a secure web interface would be sufficient.
>> Even this is problematic. ...
> Yes, but keep in mind that there are only two major public hospitals in 
> Canberra, funded by the same ACT government, operating under the same 
> ACT legislation. It should not be difficult to have their staff share 
> records.
> However, if you want an even simpler system, what about e-referrals? 
> This would emulate the current paper system with an electronic letter, 
> plus medical record attachments, secured by a code carried by the 
> patient. 
> When I was being referred from one medical centre to another 
> the doctor would type a letter on their computer as usual and attach any 
> needed records. As well as a printed copy an electronic version would be 
> created. The electronic version would be secured with a code on the 
> printed letter. The patient would hand the printed letter to the 
> referred doctor, who would enter the code into their computer to access 
> the electronic records. A e-referral would not be as efficient as full 
> e-health records, but far more efficient, secure and safer than the 
> current paper system.
What is the genuine security / safety issue with a paper referral? To 
put this another way, is there a safety / security problem that's so 
broad it demands the introduction of an electronic referral?

Too many of the e-health proposals I see look like a solution in search 
of a problem, while quite obvious and immediate issues are missed.

Example: When my wife was in RPA, she required a CT scan with a 
particular dye, which was only available at an attached private clinic. 
Connectivity wasn't even remotely an issue - RPA is fibred to the max, 
the clinic was on the network, all should be well and good. But the CT 
system in question can't transmit pictures: its proporietary transfer 
mechanism demands that the images are embedded in the application.

The upshot was that the only way to get the images from the clinic to 
the specialist was on a DVD containing the images and a runtime reader 
(not installable on the target machine, it runs from the DVD). So we had 
the stupid situation where the scan was available pretty much the 
instant my wife left the room, but had to be burned onto a DVD and 
collected in person by someone.

In a case such as this, mandated interoperability would do more than an 
e-health record.


>> Would you require authorisation from the patient? ...
> The consent could be included in the boilerplate form which patients
> have to sign to be treated in hospital. In the case of doctors 
> referrals, the patient handing over the referral letter would indicate 
> consent.
>> For the full (online) eHealth record you will need authorisation for
>> patient/provider pairs. ...
> If the patient is considered to own their medical records, then you 
> would only need their permission to release the information.

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