The use of secure electronic communication within the health care system

1. Position

The systems should communicate via or integrate with general practices’ electronic clinical and administrative systems. These electronic communications should be usable by and satisfactory to general practitioners and general practice staff. The RACGP advocates that services communicating with general practice work towards implementing two-way secure electronic communication within the next three years. The implementation and evolution of the National Health Services Directory now makes this achievable.

This position is consistent with the Australian Government Digital Transformation Office agenda. This agenda is focused on creating a user centered digital approach to ensure all government services are easy to use and communication can be completed entirely electronically.

Slow communication between hospitals and general practice via ordinary mail has been identified as one of the contributory factors resulting in a patient’s death.1 This position statement addresses safety issues where the lack of timely communication between healthcare services and general practice can result in medical errors that can cause severe injury or unexpected death.

2. Background

The provision of modern day healthcare often involves patients interacting with multiple healthcare professionals or organisations in different physical locations. The provision of high quality, effective and safe healthcare depends on efficient communication between all parties involved in a patient’s care. Secure electronic communication is currently one of the most efficient methods of communication.

General practice has been an early adopter of electronic clinical, administrative and communication systems. This has enabled general practice to increase the quality, safety and efficiency of care provided.2 A national priority now exists for the rest of the healthcare sector to move away from paper based healthcare communication systems towards electronic systems.

The majority of health services and government agencies communicating with general practice do not currently use electronic communication systems which are compatible with those existing in general practice. As a result, general practices are often required to manually transfer information from their clinical or administrative systems into paper based or online forms. This information is then sent to the relevant agency via an online upload, by post, fax, or via standard and unsecured email. Information leaving general practice through these methods requires significant manual processing.

Hardcopy or image formats of letters, reports and requests received by general practice from other health services must be manually scanned and added to the patient’s clinical record. Most organisations fail to consider the implications and costs for General Practice’s to manage information transfers safely, reliably and efficiently. The inefficiencies of current processes creates a heavy burden on GPs, diverting their time away from providing essential medical care for patients.

Documents received by general practice provide the most clinical value when they can be searched and interrogated by general practice clinical software. Faxed reports which are scanned into clinical records and saved as an image are not easily searchable. Standard and unsecured email is not considered suitable for routine communication between healthcare providers and patients due to inadequate privacy and security features, and because the content of these messages has to be copied and manually transferred. Information manually obtained from web portals presents similar issues.

3. The principles of electronic communication

The RACGP supports the following principles for electronic communication between general practice and other healthcare agencies:

  • all electronic communications templates and systems should use existing data and information from general practice clinical information systems to pre-populate documents and forms
  • all communications should be
    • created and sent from within the general practice’s electronic clinical software system and
    • automatically received into the local patient electronic health record via the clinical software system inbox
  • all electronic communications to external healthcare providers and agencies should be sent securely using secure messaging to align with best practice data privacy handling principles to protect patient privacy and confidentiality.

4. Conclusion

GPs are often the “information managers” for patients and rely on other healthcare organisations to reliably provide additional details regarding diagnosis, treatments, management plans and outcomes.3 The adoption of secure electronic communications should be a priority for the entire healthcare sector to ensure improved efficiencies and provision of safe quality care.

  1. South Australia Coroner’s report: Finding of inquest into the case of Marjorie Irene Aston: 2015
  2. van der Kam WJ, Moorman PW, Koppejan-Mulder MJ. Effects of electronic communication in general practice. Int J Med Inform 2000; 60(1):59-70
  3. McInnes DK, Saltman DC, Kidd MR. General practitioners’ use of computers for prescribing and electronic health records: results from a national survey. Med J Aust 2006; 185(2):88-91.

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The use of secure electronic communication within the health care system (PDF 394 KB)