Closing the Communication Gap Between Hospitals and Primary Health Care Providers

Abstract

Most of the technological attention in health care communications has been given to hospital systems. We perceive a gap in communications between different layers of the health care hierarchy, which often means that relevant information does not accompany patients as they move into or out of hospitals. In this paper we first review some systems, such as HealthLink in New Zealand and Health.On.Net in South Australia, which have been or are being established to rectify this situation. We review systems being developed and installed in our own regions. Planning has involved local hospitals, general practitioners, government, and allied health professionals. Funding has been a major problem, partly due to a lack of defined responsibility for this area. On the technical side, we have opted for the World Wide Web (WWW) communications protocols as the most general and widely accepted; also, the standards for text-based messages (HL7) and for images (DICOM 3.0) are lagging the WWW in capabilities. The communications medium must include normal telephone lines (PSTN or POTS), as these are the connections which most private healthcare providers have. Various forms of security, encryption and access control have been employed. Possibly least important nowadays is the selection of a 'hardware or operating platform'.