October 6, 2022

The Australian Medical Association has claimed that “chronically poor” communication between general practitioners and hospitals is putting patient safety at risk, and called for the Victorian Government to fix the problem in the state’s health system.

In its submission before the state budget to be delivered on Tuesday, the AMA said it is “scarcely believable” that many of Victoria’s public hospitals continue to use fax machines, contributing to concerns over quality of care.

“This chronically poor interaction results in significant problems in many areas including safety, equity and access, gaps and duplication. With respect to referrals, it is scarcely believable that many public hospitals continue to rely on facsimile (fax) as a mode of communication. This results in both clinical governance problems (lost referrals, lack of accountability and audit trails) and efficiency issues (hundreds of pages printed, faxed and refaxed).”

The doctors’ group recommends the government mandate that “all public hospitals develop a single point of contact to receive electronic referrals sent by GPs” and ensure that “electronic referrals are able to be received directly from GP software”.

WHY IT MATTERS

The submission said general practice “shoulders over 90 per cent of the healthcare burden in Victoria” but is “regularly and profoundly neglected by [the] state government, to every Victorian’s detriment”.

The AMA urges the government to invest in improving “the interface between general practice and our hospitals, both public and private”.

In the Melbourne suburb of Melton, GP Alastair Stark told The Age that at times hospital discharge summaries for their patients “just never arrive and it always causes trouble”.

“They change the patient’s medication and we don’t know what’s been changed and we can’t, therefore, manage the patient’s medication properly, so there are major risks for that patient,” Dr Stark said.

He said hospitals had even failed to inform him when his patients had died: “I am being phoned up and informed by the families that they have died when I should have been given this knowledge from the hospital.”

THE LARGER CONTEXT

The state’s health system is currently dealing with the consequences of the pandemic, including deferred care and treatment of other conditions. More than 80,000 Victorians are also waiting for elective surgery. There are over 52,000 known active COVID-19 cases, with 445 cases in hospital and 32 in ICU.

The AMA claims the state’s public hospitals are “in crisis”, with an ageing infrastructure unable to meet new models of care.

“Many older public hospital buildings are at end-of-life and are severely constrained in their ability to meet the standards expected in the delivery of health care in 2022 and beyond. Buildings need to be flexible and need to be built to evolve as technology develops, delivery of care models change and community expectations shift. Similarly, the management of public hospital assets and equipment requires huge investment to ensure end-of-life infrastructure does not fail,” the submission says.

Within its recommendations, the AMA urges the government to ensure “new hospital developments are built with consideration given to digital technology requirements”, and to fund ‘hospital-in-the-home’ services, mobile diagnostics, telehealth and virtual care “to reduce the strain on hospitals and presentations to emergency departments – for example, Northern Health’s virtual ED”.