GPs are bearing the brunt of a disconnected health system. In the words of Little Britain’s Carol Beer, ‘the computer says no’.
If GPs are meant to be keeping patients out of hospital, they need the information to do it, says a prominent professor of general practice.
Speaking at yesterday’s Connect Care Confidence 2025 Summit, run by the Australian Digital Health Agency, GP and head of general practice at the Sydney School of Medicine, University of Notre Dame Professor Charlotte Hespe said that interoperability in primary care was the “bottomless pit question”.
“If I’m going to provide true patient-centred care, I need to be able to understand and coordinate everything … I need [the system] to be connected,” she told delegates of the interoperability in action session.
“The computer says no … that’s the GP experience of trying to access the public health system.
“It seems crazy when we’re there to do the same thing. We’re there to deliver really good, patient-centred, quality care.
“I get told all the time why GPs should be keeping patients out of hospital.
“Yep we should, I 100% agree. So, give me the data, give me access to the information so we can actually try and make sure that we are on the same page.”
Professor Hespe said she hoped for a future without siloed care which allowed her to provide safe, quality healthcare.
“We work in a very, very fragmented system at the moment, everybody is the boss of their own little system and they don’t really want to give up the power,” she said.
“I dream of the day when I can have a new patient turn up [and] we can seamlessly set up a medical record that actually has access to accurate data, so that both I and the patient don’t feel like we’re wasting time going over old business, so we can actually spend time sharing the story rather than chasing the data.
“My dream is that my patient and I don’t know that it was once hard, because it’s all there.
“I can open up my patient electronic record, and I’ve got little notifications that let me know that things have happened.
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“I can go and find the results of the tests that were done at the hospital 100km away as easily as the hospital that’s only a kilometre away, as easily as the non-GP specialist that they saw two weeks ago.
“And I also know the medicines that were dispensed by their community pharmacy a week ago.”
Chief medical information officer for Western Sydney Local Health District, Associate Professor Naren Gunja said public hospital clinicians also spent a lot of time chasing private data, like pathology and radiology, which are often stored in different systems.
“It’s not just about getting the right information but getting it at the right place.”
The interface is not just between primary care and the hospital system, but also jurisdictionally, he said.
Professor Hespe added that information boundaries existed at all scales.
“It’s not just the boundaries with states, because within my own state of New South Wales each LHD has a system that doesn’t talk to the system next door,” she said.
“So where my practice is located, we are on the boundary of four different LHDs, and it makes it incredibly difficult.
“Why should my patients understand that they’ve accessed part of NSW Health that happens to have a completely different health record and system because they’ve happened to move to a different hospital.
“We’ve got to get rid of all of those nonsenses.”
The session’s facilitator, chief digital officer of the ADHA Peter O’Halloran was concerned by the labour required of clinicians and patients to access information.
“I think if consumers knew how fragmented the health system was, they’d be horrified,” he said.
“As a technologist, can I say I’m horrified with what we put clinicians and consumers through every day.
“It is it is not ideal, but it is getting better.”
Board director for the not-for-profit data-sharing standards development organisation Health Level Seven International Reuben Daniels said the challenge with interoperability was people, not technology.
“I see interoperability really as a pursuit,” he said.
“It’s not really getting from A to B … [it’s] a culture or state of mind that the health system really needs to adopt.
“It is a key enabler for any healthcare system.”
