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Private specialists shun e-health

by Michael Woodhead  

Specialist physicians are e-health luddites, with as few as one in ten using computers in their private practice, a new survey suggests.

While virtually all GPs are using computers in their clinical work, only 12.6% of specialist physicians were using computers in private hospitals and 27% used computers in their consulting rooms, a study published in Internal Medicine Journal (39:655) this week shows.

The survey of more than 2300 fellows of the RACP found that computers were used by two out of three specialists working in public hospitals, who used them primarily for looking up information, receiving test results electronically and for educational activities.

But in private practice the picture was one of limited access and infrequent use of computers. Despite the fact that about 40% of specialists spent most of their time working in consulting rooms, only a small number used computers in these locations.

Only 15% used computers to access to patient medical records and 11% used computers for prescribing.

The study authors said the findings were in marked contrast to general practice, where virtually all GPs used computers for prescribing, and computers were widely used for recall systems and to record notes.

Their study found that most specialists expressed a positive attitude toward electronic applications, but it was not clear why so few had access to computers or used them in the private practice.

“One reason may be that physicians work in multiple locations whereas GPs are more likely to work from one location,” the study authors say.    


19 October 2009
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Latest Comments

  • The working from multiple worksites is a problem, but one that is soluble by providing specialists with mobile broadband for a laptop to get remote access. This is also a popular solution for GPs who are working from multiple locations. There have been earlier attempts at mobility solutions, but these required a costly and time consuming unload and reload of data without real time access.

    Posted by Jim Cocks 19/10/2009 4:05:12 PM

  • I am a GP who has recently specialised. Specialists are meant to be the "smart" doctors. I feel their lack of use of technology is an indication, they are not so smart. GPs and the RACGP should be proud of how they have supported computerisation and modernised while so many of the "specialists" have been left behind. I feel like I have almost taken a step backwards because the hospital systems are so far behind the private General Practices. I have done a number of locums in hospitals. The hospitals I have worked in recently, the notes are still hand-written and there is no electronic script writing. I worry about my handwriting and I feel less safe if I am not using a computer for script writing. In comparison all the GP surgeries I have locumed in are computerised. I understand the difficulties as the private and public hospital systems are slow to change. As you are trained in those systems there is a tendency to adopt the same ones in your practice. I believe the specialists college should be supporting and promoting computerisation, and working with the government to ensure that this process is accelerated in the hospitals. I believe we should all embrace the new technology and incorporate it into our practice for the benefit of all.

    Dr Andrew Jeremijenko

    MBBS, MAE, CertHEd, FRACGP, FAFOEM RACP.

    CMO TeleDr

    Posted by Dr Andrew Jeremijenko 20/10/2009 8:48:36 AM

  • As will all superficial comparisons, this is not really helpful.

    Historically, the GPs had money thrown at them to buy computers a long time ago, not relevant now but a kick start then. They have a purpose built software environment also with several products to choose from. They work predominantly for themselves, and manage their own practices.

    Specialists have been given no IT assistance. There is no available software package for my area that costs less than $100K! (not like the $2-6K/year for GP software), other specialists are similar and so we are left to try to bend GP software to our purposes. Specialist who work in private hospitals do not use electronic solutions, but might that be due to the lack of software and terminals in private hospitals? The large proportion of specialists in hospitals are at the mercy of IT departments and managerial whims in providing any software. The large HIS solutions are not proving to be the clinical panacea (perhaps spelt as 'pain-as..sea' if the end users are to be believed .... click go the tests, boys, click, click, click .... click, click, click, etc (repeat for another 20 times to order a test in some systems!). So getting clinically acceptable software in to use is a problem.

    These problems are not soluble with a laptop and broadband connection.

    Shame that the reporting doesn't go and look for some answers.

    Posted by Dr Andrew Miller 21/10/2009 11:54:10 PM

  • First, it is unwise to generalise as the 27% of specialists who have actually invested in IT often have very elaborate IT setups. Second, apart from the HealthConnect program in SA there has never been an incentive program directed at specialists (or allied health providers for that matter), whereas GPs have benefited from multiple targed incentive programs over the years. From my experience it seems to be obstetricians & surgeons who have invested the least in IT, perhaps because of the episodic nature of their work. On the other hand, medical physicians, often have long and continuing relationships with patients with complex & chronic conditions have a corresponding greater interest in eHealth & electronic health records.

    Posted by Andrew 22/10/2009 7:34:29 AM

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