After torturing health-care staff for almost a year, Island Health has paused its electronic health-record system at Nanaimo Regional General Hospital to fix continuing problems.
Electronic health records are the way of the future because they are safer and more efficient for patients and staff than paper, but the rollout of the IHealth system was badly flawed.
Island Health has agreed to suspend use of the part of the software that orders medications, lab tests and diagnostic images on the IHealth system until improvements are made.
“Despite everybody trying really, really hard, there’s a level of exhaustion on the site,” said Dr. Brendan Carr, Island Health president and chief executive officer. “When I go up there and talk to my colleagues, they’re tired and they’re really uncertain. I think we kind of just need to take a pause to give everybody a little space and then, from that, be able to go forward.”
A steep learning curve is normal with many new computer systems, but if staff have reached the stage of exhaustion, that has to be laid at the door of Island Health.
The $174-million IHealth system was launched March 19 at Nanaimo Regional General Hospital, Dufferin Place residential care centre in Nanaimo, and Oceanside Health Centre in Parksville.
Nine weeks later, physicians in the Nanaimo hospital’s intensive care and emergency departments went back to pen and paper “out of concern for patient safety.”
One of the major causes for concern was the way the system handled drug orders. Doctors said the software was cancelling, overriding, changing or doubling some drug orders.
Health Minister Terry Lake ordered a review of the system by Dr. Doug Cochrane, the province’s patient safety and quality officer. In his report, Cochrane agreed there was a potential for errors without diligent staff oversight, and the system resulted in decreased productivity.
He said the more complex care components of the system needed to be reviewed and improved.
Not surprisingly, Cochrane’s report found Island Health should have spent more time tailoring the software to the needs of front-line workers before introducing it. That seems to happen far too often with computer systems that incorporate many different kinds of work across large organizations.
The goals are laudable, but if the people at the pointy end aren’t consulted enough, the system creates more work for them. In areas such as health care, that means front-line staff spend more time feeding the computerized beast and less time doing what we want them to do: Helping patients.
Cochrane said that until it was modified and fully functional, it should not be rolled out to hospitals in Greater Victoria and the rest of the Island. However, Carr said the health authority still plans to expand it to other hospitals over the long term.
After the report came out, Lake said there is no intention to give up on providing British Columbians with an electronic health records system.
“We live in a digital age, and the health system needs to take advantage of the benefits that this technology can give us,” he said.
He’s right. Carr pointed out that the system delivered more than 2,000 alerts to staff that they were going to give a patient the wrong medication. Those are the kinds of benefits over paper records that should be a major selling point for staff and patients.
Strong leaders make a new system work for everyone, stand beside staff as they learn and evangelize effectively from the beginning, so everyone buys in. That kind of leadership was lacking in Island Health.
