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This month’s edition of Healthcare Review – OnlineTM is the third in a three-part series examining rural health in New Zealand and Australia.
The first edition in the series considered the rural health scene in New Zealand. Papers considered issues faced in rural general practice and the components of a "quality" rural health service [Janes R, Ross J, Taylor J. Healthcare Review – OnlineTM. 3(10); October 1999], the various elements required to overcome the difficulties faced in rural health from a political perspective [Farry P. Healthcare Review – OnlineTM. 3(10); October 1999] and a "Total Package" approach to rural health issues [Harris A. Healthcare Review – OnlineTM. 3(10); October 1999].
The second edition in the series expanded on these papers, reviewing approaches to improving health services in rural Australia. Papers reviewed various strategies for building the rural health workforce and the unique features of rural practice that place rural health professionals in a strong position to respond to the changing nature of rural health practice [Durham G, Durham J. Healthcare Review – OnlineTM. 4(1); December 1999 / January 2000], and the role of teams in rural practice and the importance of a collaborative approach [Strasser R. Healthcare Review – OnlineTM. 4(1); December 1999 / January 2000].
In this edition, Dr David Rosenthal, General Practitioner in the rural setting of Renmark, South Australia considers the development of emergency medicine curricula and regulation for intending and practising rural doctors. Rosenthal is the past president of the Rural Doctors Association of Australia and the current Chair of the Rural Health Education Foundation. He has an active interest in the delineation of clinical privileges and educational support for rural doctors.
Dr Rosenthal explores some of the infrastructure issues that underlie the practice of emergency medicine in rural areas in Australia. Particular emphasis is placed on the preparation and continuing medical education of emergency medicine practitioners in rural areas.
The paper covers a range of issues relating to the practice of emergency medicine, especially in rural hospitals. There has been some progress in developing national uniformity in the teaching and assessment of emergency medicine skills of intending rural practitioners. It is hoped that the future rural training mechanisms will be able to deal consistently with emergency medicine under national guidelines.
A paper from Dr Tom Mulholland, Director Doctor Global, New Zealand, considers the impact of the electronic health record on rural health practice. Coming from a different approach to all other papers in this series, Mulholland highlights how the availability of an electronic health record can provide urban quality of care in a rural setting. Rural consumers do not have the same level of access to health services as their urban counterparts. Rural health professionals are also disadvantaged through long hours and limited peer support and educational opportunities.
Doctor Global is an Australasian health services and clinical software provider, which supplies web-based health records. The organisation’s philosophy is based on the belief that online consultations and a web-based electronic health record (EHR) can increase access to health care, reduce errors, and create efficiency. Potential benefits of shared EHRs include improved outcomes for patients and increased patient knowledge of their own condition(s), and improved clinical decision-making processes, safety and accuracy for health professionals through ready access to timely, reliable, accurate, comprehensive and relevant patient information.
The opportunity exists via EHRs and the internet to enhance the quality of patient care in rural and remote locations and for transient population groups by:
- empowering consumers through greater access to their own information
- providing health care providers with an effective way of carrying out on-line patient consultations in a highly secure and private environment
- increasing consumer safety through availability of a complete medical record with reduced legibility problems and risk of transcription errors.
Rural communities are already online and trading and adding health care to the services available is a logical and necessary addition. Numerous people perceive rural life as having many advantages over city dwelling and the internet and EHRs may ensure that the quality of health care available to rural dwellers matches that of their urban counterparts.
