The story of Marjorie Irene Aston, an 86 year old woman from South Australia who died after a fall—hitting her head on her bed, has caused frustration for a number of reasons. The article by Australian Doctor, 20 July 2015 “Delayed hospital letter to GP led to patient death”, reveals avoidable factors that contributed to Mrs Aston’s death.
Professor John Horowitz, Director of Cardiology at the Queen Elizabeth Hospital was Mrs Aston’s heart specialist. He had “arbitrarily” prescribed Mrs Aston warfarin and used snail mail to inform her GP of her potentially dangerous medication. Her GP received Professor Horowitz’s letter two weeks later, but four days after Mrs Aston’s death.
In an inquest, the SA Coroners Court was told that although Professor Horowitz had referred Mrs Aston for an urgent INR test following his consultation (a test that was carried out) he had made no provision for Mrs Aston’s GP to be copied in on the results. Professor Horowitz told the court that it was common practice for a specialist to communicate with a GP by letter.
In this day and age, it’s irresponsible for healthcare providers to not have appropriate processes and technologies in place to assist them in performing their role better.
Dr Michael Levick, the chairman of the Australian Medical Association Victoria’s section of general practice, said communication methods between GPs and hospitals had not changed much in the past two decades.
“Some hospitals do have the ability to send secure messages, which is like an email which arrives at the doctor’s surgery immediately, but that is few and far between.
“This leads to patients not getting adequately treated or monitored when they come out of the hospital.”
Secure messaging is becoming the new standard of communication between healthcare providers, but the uptake has been quite slow despite Doctors seeing the advantages in using secure messaging. The healthcare sector is way behind on the times with some hospitals still using DOS-based Patient Administration Systems.
Primary care physicians need to have adequate and timely information about patient conditions. This is not only about quality of care but also accountability. Delays lead to patient harm, a continuation of incorrect treatment, increased length of stay and increased costs.
Without effective, timely communication between physicians, both the quality of care and the patient experience can suffer.