title: The impact of extensive loss of telecommunications on general practice: A case study in rural Victoria.
abstract: OBJECTIVE
  To describe the impact of major loss of telecommunications on general practice in a rural region of Australia.
  
  
  METHODS
  A multi-stage qualitative study. Purposively selected participants were invited to contribute to initial data collection using an online survey, followed by interviews with selected participants. Thematic analysis of the data was performed by both research team members.
  
  
  METHODS
  South-western Victoria, Australia.
  
  
  METHODS
  Individuals from organisations involved in Telstra recovery efforts, disaster management, health care and general practice staff.
  
  
  METHODS
  The survey collected freeform responses from participants. Semi-structured interviews further explored a variety of experiences from purposively selected participants.
  
  
  RESULTS
  Organisations and practices in the region were prepared for major disasters, but not for the unusual and 'limited' disaster of losing telecommunications, including lack of Internet access and loss of telephone services. Although alternative measures were found for telecommunications, there was still a significant impact on many health-care-related activities and general practice functionality during the outage period. In particular, there was an increase in duties for administrative staff to compensate for loss of telecommunications. Patient traffic for many services decreased due to uncertainty about availability and continuation of business.
  
  
  CONCLUSIONS
  The Warrnambool outage could be used as a case study illustrating the dramatic impact of communication loss. Major impacts include changes in patient traffic, increased administrative duties and slowing of patient care. When developing or assessing disaster management plans, general practices should consider the impact of telecommunication loss on functionality and prepare appropriate alternative, accessible and reliable measures.
authors.affiliation: Department of Rural General Practice, School of Medicine, Deakin University, Warrnambool, Victoria, Australia.
authors.forename: Nancy H
authors.initials: NH
authors.lastname: Tran
authors.affiliation: Department of Rural General Practice, School of Medicine, Deakin University, Warrnambool, Victoria, Australia.
authors.forename: Daryl
authors.initials: D
authors.lastname: Pedler
mesh_terms: D058006:General Practice; D019982:Organizational Case Studies; D036301:Qualitative Research; D012424:Rural Population; D011795:Surveys and Questionnaires; D013685:Telecommunications; D014739:Victoria
keywords: business resilience; disaster planning; emergency management; preparedness; rural health