Australia’s most underrated medical modernism

It’s a home-grown innovation that should be helping masses of Australians freely follow their medical results, but instead patient portal ‘Wedgetail’ is shrouded in obscurity.

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Since 2010, there’s been a remedial revolution down under, borne from New South Wales’ Northern Rivers General Practice Network.

It’s called Wedgetail; an Individual Electronic Health Record Service, or patient portal if you like.

The premise of the service is simple; doctors post test results for patients-including comments and recommendations- on the Wedgetail site. The patients log in under a unique username and password to access this information, then choose whether or not they follow-up further.

According to the site,

“Wedgetail securely stores and shares important information about your health, such as the medications you take, any allergies you have and a summary of your health history. It also contains information that is collected when one visits participating health care providers such as specialists, nurses, and allied health professionals such as physiotherapists, dieticians and diabetic educators.”

Importantly, Wedgetail’s not a replacement of hard-copy medical records held by a GP, it’s a service designed to complement rather than substitute.

Above: An example of the patient message interface.

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Why Wedgetail is important

German-born American physician and author Dr. Martin Henry Fischer has been dead for 50 years, but  remains one of the world’s most quoted medics to this day.

Like a medical incarnation of Hemingway, Fischer was renowned for being frank and forthright, and speaking a lot of truth.

Aside from this tongue-in-cheek gem; “A doctor whose breath smells has no right to medical opinion,” Dr. Fischer also imparted these pearls of wisdom:

“A doctor must work eighteen hours a day and seven days a week.  If you cannot console yourself to this, get out of the profession.”

“Diagnosis is not the end, but the beginning of practice.”

“You must learn to talk clearly. The jargon of scientific terminology which rolls off your tongues is mental garbage.”

This trio of quotes highlight why Wedgetail is so important. Firstly, Doctors’ workloads are excessive; anything which makes them more time-efficient should be welcomed. Second, diagnoses are crucial; it’s essential patients are informed of them. And lastly, the online blog-like medium of Wedgetial encourages doctors to use non-scientific understandable language, and the fact they can insert links/images/video means patients could theoretically receive more complete explanations.

As Dr. Oliver Frank explains, the widespread use of Wedgetial seems like a no-brainer for increasingly overworked GPs.

“It’s a service which I think is brilliant; it’s going to save a lot of time for medical practitioners, and it’s so easy for patients to navigate. I’ve been a GP for more than thirty years, and it’s a job which gets busier and busier-population growth being a big factor with that. So anything which saves doctors time should be welcomed.”

Above: Dr. Frank is a Senior Research Fellow at the University of Adelaide.

Click here to listen to my full interview with Dr. Oliver Frank.

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Overlooked by experts

On September 25 ABC radio’s PM program ran this interview with  Dr. Joanne Callen, about the worryingly high number of test results being missed by doctors.

A team at the University of New South Wales reviewed 19 international studies and found doctors missed up to two-thirds of laboratory test results and up to one-third of radiology reports. That meant that diagnoses were missed, and treatment options delayed.

Dr. Callen was adamant the results were pertinent to Australia too, saying “test management practices are similar worldwide in the developed countries,” but she also conducted several surveys of Sydney hospitals as well, finding 21.1% of doctors thought they’d missed test results in the past years, and 47.4% indicated they thought a colleague had.

Missed test results are a large issue worldwide and domestically, and Dr.Callen went on to offer a solution.

“Patients are interested in having access to their own test results and they could be seen as a safety net. For instance, in the US some of the larger private hospital groups, Kaiser Permanente for example, have a patient portal where patients can actually access, securely access their results.”

Arguably the country’s biggest expert on patient results testing is oblivious to the fact there’s already a home-grown version of the exact securely-accessed portal she refers to.

But Dr. Callen isn’t the only high-profile GP who’s living under a remedial rock; former AMAQ President Dr. Gino Pecararo said he had “no idea such a thing existed” when I spoke to him last week.

Above: Dr. Gino Pecoraro and Dr. Joanne Callen

Click here to listen to my full interview with Dr. Gino Pecoraro

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Changes need to be made

Wedgetail appears an unequivocally useful tool for health professionals and patients alike, so why does it  wallow in such deep anonymity?

Dr. Frank says it’s due to a combination of three factors.

1. Accessibility. Wedgetail only works on the two largest available clinical software programs-as there’s no software regulations many practices- including Dr. Franks’-use other non-compatible programs. Many GPs simply cannot access Wedgetail.

2. Money, funding specifically. Wedgetail is not a government-supported initiative, and receives no private financial support. It was created, and is maintained, by a group of volunteer GPs.

3. Money, again. Doctors, despite their crowded schedules, prefer patients to come in personally to collect test results, so they can collect the fees for the visit-even if it’s only a five minute consultation to advise of an innocuous outcome.

With society becoming increasingly technology-savvy, and myriad services gravitating online, we need to embrace Wedgetail. If we don’t find a way to overcome the difficulties afflicting its implementation and can’t effectively promote it, Australia will blow an all-too-rare opportunity to foster a genuinely useful innovation.

Click here to listen to my report on patient results and Wedgetail.

All sources (including images) referenced via links in text, including interviews with Dr.Oliver Frank, Dr. Gino Pecoraro, Dr. Joanne Callen. Quotes and Bio of Dr. Henry Fischer, websites of Wedgetail, Northern Rivers General Practice Network etc.

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