1. Please introduce self-help counters in Emergency, specialist clinic, GP
office and public hospitals: In every day life, we are used to the concept of
self help. We follow the traffic lighting system and does not need human
police. We use petrol stations honestly. All the major shopping malls
(Coles, Woolworth) are using self-help check out counters. We self-check
in at the airport. Its time to bring the computer based (tablet based) self
help counter to our hospital system. National eHealth Strategy talks about
web based self-help portal. Making this self help counters visible in the
hospital system would bring in the attitudinal changes. This would also
encourage the patients to use web-based government run portal for the
self-help. There is always a role for a nurse assistant to help the waiting
patient in interacting with the computers. We could use cognitive
computing to help the community. At the same time, we can improve our
emergency department performances.
2. Make it mandatory that the discharge summary to be given to the
patient at the time of discharge from the hospital. As much as doctor has
to sign the document and patient also need to sign the document. This
would force significant attitudinal changes in the health care sector. This
would also enforce more collaborative approach. This should challenge
the current power difference in the doctor and patient relationship.
3. There should be free and automatic access to professional background of
the treating doctors. The Doctors photos and their professional
qualifications should be displayed for the patients to see.
4. The culture of daily feedback system between the patient and health
care providers should be encouraged. Recently I noticed a tablet based
(computer based) feedback system in a airport toilet about it’s
cleanliness. I am sure hospitals are much more important. At the time of
discharge from the hospital, there should be easy and anonymous way of
seeking feedback. We should use tablets more readily in this domain.
5. Centerlink forms and e-health records should be integrated in much
greater depth than what it exists currently. Integrating mental health
records and Centerlink is highly important. At one level, inappropriate
claims can be reduced. At another level, we will have more accurate data
around the level of disability that exists in the community.
6. Non medical, social care aspect of health should be formally recognized
and accepted as a legitimate aspect of the health care. In the hospitals,
there is a perennial debate and the stigma around “social admissions”.
There are several patients who are staying in the hospital for long time
due to lack of appropriate community based social support systems. We
should invest more in the community care and less in the hospital care.
7. Age care facility: Now days, several states have taken up the bed flow
management in the hospital system very seriously. This system should be
adopted for the age care facility also. There should be a central web based
access to nursing home vacancy. This would reduce the lengthy stay of
elderly patients in the hospitals.
8. There is growing need to build residential facilities for the mentally ill and
intellectually challenged. They also need to be regularly monitored and
integrated into the larger electronic system. NGO also need to be given
some access to the electronic health records. This would validate their
role in holistic health care.
9. Private and public integration: It’s hard to get any discharge summary
or notes from the private psychiatric hospitals. I am not sure about the
medical and surgical private hospitals. Hopefully with better engagement
of Private system with the PCEHR, this should change. I hope insurance
company demand the same level of openness from the private hospitals.
10. I hope with the role out of PCEHR, government will have more data on the
level of psychotropics prescribed. There is urgent need for national level
strategy to address the problem of over diagnosis and over medication in
the field of psychiatry.
Healthcare recipient