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Doctors petition for halt to health-record-system rollout

More than 100 doctors have signed a petition asking Island Health to suspend the introduction of its $174-million electronic health record system at Nanaimo Regional General Hospital.
An IHealth computer terminal cart at Nanaimo Regional General Hospital.

More than 100 doctors have signed a petition asking Island Health to suspend the introduction of its $174-million electronic health record system at Nanaimo Regional General Hospital.

The petition asks that Island Health suspend the system’s implementation until software that they say is canceling, overriding, changing or doubling up some drug orders is fixed or replaced.

“Otherwise it’s inevitable something horrible is going to happen,” said one physician, on the condition of anonymity because of fear of repercussions.

Island Health, which has declined to suspend the rollout, has a 10-year, $50-million deal with software-developer Cerner Corp. of Kansas City, Missouri, for the system. Island Health will spend an additional $124 million for hardware and training.

It’s intended to be the first system in B.C. where all of a patient’s acute-care and diagnostic health care services across the health authority are connected through one computerized medical record.

The system was launched on March 19 at the Nanaimo hospital, Dufferin Place residential care centre in Nanaimo and Oceanside Health Centre in Parksville.

Nine weeks later, physicians in the hospital’s intensive-care and emergency departments reverted to pen and paper orders — entered into computers by support staff — citing concern for patient safety. Doctors have said the system generates wrong drug dosages and cancels or overrides critical instructions.

Cerner said in a statement: “We understand this can be a difficult transition for some and we’re collaborating with Island Health to optimize the physician workflow.”

Antoinette O’Keeffe, health authority spokeswoman, said once the system is “stabilized” at the three sites, implementation will begin at other Island Health sites. “Our goal is to have IHealth implemented across the Island over the next 18 months. Our time line has not changed,” O’Keeffe said.

Island Health said it has found no evidence the system is changing or deleting medication orders and that resources are on site to assist intensive care unit and emergency room physicians and staff to enter medication orders into the system.

Nonetheless, more specialists at Nanaimo General — including internists — say they plan to return to pen and paper orders this week.

Medical staff warned the Health Authority Medical Advisory Committee, which provides advice to the Island Health board of directors and CEO, on May 31 of their concerns.

Last week, B.C. Health Minister Terry Lake and Island Health president Brendan Carr discussed modifications made to the system based on staff and physician feedback, O’Keeffe said.

The minister said he is confident patient safety is not at risk.

But nurses’ concerns prompted B.C. Nurses’ Union president Gayle Duteil to meet with the health authority last week.

One complaint from nurses is that so-called “tick boxes” on computer forms don’t allow nurses to relay a patient complaint without opening a series of time-consuming pull-down menus. Nurses also complained computer infrastructure was not adequately upgraded to handle the complex system.

Nurses, like doctors, say any problems are blamed on the users, not the system.

Sheryl Armstrong, whose mother is at Dufferin Place, said the computer system crashed several weeks ago and no one could access patient records.

“They didn’t know who needed what meds because the system was down,” said Armstrong, chairwoman of the Dufferin Family Council.

O’Keeffe said a special computer takes “snapshots” of information in the electronic health record —medications and allergies, for example — so that it can be accessed if the system is down.

At other times, Armstrong said, doctors’ orders that in the past would have been written down or verbally communicated are being lost in the system.

Armstrong said she visits her mother every day and has seen the staff’s difficulties with the system firsthand.

“We can see staff struggling, saying: ‘We don’t know how to do this and that and we don’t know where to find this and that,’ ” she said.

The Dufferin Family Council has requested a meeting with Island Health to discuss its concerns.