Plan to digitize medical files stalled
THREE YEARS after provincial medical records were supposed to be digitized, fewer than a dozen Montreal clinics are part of the network. Aaron Derfel reports that one of the companies helping family medicine groups set up electronic records is CGI, the lo
Three years after Quebec was supposed to make all medical records digital, only four out of Montreal’s 39 CLSC clinics and seven out of 80 family medicine groups are hooked up to a centralized online network, shows the latest provincial government data, made public Tuesday.
Who and what are to blame for the delays in a system that Quebec’s auditor general described two years ago as a “failure”?
Health Minister Réjean Hébert insists that the program, called Dossier Santé Québec (DSQ), is progressing well, despite the fact that the vast majority of Montreal’s health-care institutions have yet to connect to the system.
Making medical records electronic or digital is an extremely complicated process, since it involves many doc- tors and specialists, as well as updating test results and including every last detail in a patient’s file.
One of the informationtechnology firms assisting family medicine groups in setting up electronic medical records is CGI, the same company that has come under sharp criticism for its handling of the Obamacare website.
On Monday, U.S. President Barack Obama said there is “no excuse” for the delays and computer glitches that have stalled the healthcare insurance exchange at HealthCare.gov. A subsidiary of Montreal-based CGI is the federal IT contractor that has engineered most of the U.S. website.
CGI has also come under scrutiny in Ontario after the provincial government cancelled a contract with the firm to build an electronic registry of diabetes patients. Ontario spent $24.4 million on the registry before scrapping it in September, insisting there were no cancellation penalties.
In Quebec, Telus Health is mainly responsible for the DSQ. But CGI states on its website that it is responsible for implementing electronic medical records for family medicine groups and medical clinics. A family medicine group is like a super clinic, with some diagnostic imaging capabilities and is supposed to be open on weeknights and weekends.
The CGI website notes that the total investment for its Quebec family medicine initiative is $60 million over four years and that implementation “packages are granted by the MSSS (Ministère de la santé et des services sociaux du Québec).”
The Quebec Medical Association, on its website, highlights for family doctors the “Quebec program for the adoption of electronic medical records,” a service “offered by CGI.”
The Gazette left phone and email messages with CGI for comment on the Quebec program. In a one-sentence email reply late Wednesday, the company said it is “not involved in Dossier Santé Québec.” It did not provide any more details.
Ariane Lareau, the health minister’s press attaché, was also asked to comment on CGI’s involvement in the DSQ, but she was unable to return a reporter’s phone call.
However, Lareau added that “for the moment, every-
Only four out of Montreal’s 39 CLSC clinics are hooked up to a centralized
online network.
thing is going well and we’re on track toward achieving our goals.”
In 2011, Quebec’s auditorgeneral called the centralized DSQ “a failure,” observing that it was supposed to be completed in 2010, but that the target date is now 2016.
The DSQ was also supposed to cut health costs by 20 per cent, yet no savings have been realized. Launched in 2006, the program was supposed to cost $563 million, but the latest estimate has ballooned to $1.6 billion.
There has been some modest progress, though. In the autumn of 2011, the Centre de santé et des services sociaux de la Montagne — the health network includes a number of CLSC clinics and family medicine groups in central Montreal — succeeded in digitizing its medical records.
The CSSS Sud-Ouest-Verdun also managed to link all computerized medical records between its CLSCs and long-term-care centres with its acute-care hospital.
In May, Hébert announced that the government would make regular updates on its website of the latest “deployments” of the Dossier Santé Québec.
As of Oct. 22, the website shows that on the island of Montreal, nine out of 20 labs are hooked up to the system, all 34 medical-imaging sites are connected, 255 out of 438 pharmacies and one out of six university-affiliated family medicine departments.
Ultimately, the city’s 20 emergency rooms and 320 private family-medicine clinics will also be connected.
The DSQ is intended not only to integrate medical records, but also lab results, prescriptions for drugs that are filled, as well as medicalimaging scans. Robyn Tamblyn, of McGill’s clinical and health informatics group, has been an outspoken critic of the program.
Tamblyn was unavailable for comment, but in a 2011 interview, she lay part of the blame on failing to get familymedicine clinics involved right from the start — something that is now CGI’s focus.
“What got us bogged down is that we didn’t invest in the users at the front lines — meaning the private clinics, the CLSC clinics, the hospital emergency rooms — so that these people could connect to the software,” Tamblyn said at the time.