NSHA axing 90 health-record keeping jobs
Dozens of people working in health record management at the Nova Scotia Health Authority could soon be out of these jobs and replaced with a U.s.-owned company.
That’s part of a plan that NSHA has to improve the quality of record keeping in the province.
The company, called Iron Mountain, will be entrusted with scanning patients’ records to create digital versions. The work is now being done by 91 NSHA employees at 24 hospitals across the province. They also store and retrieve the documents as needed by physicians and clinicians.
CONSULTATIONS INADEQUATE
In late November, these employees first heard that their positions would disappear through conference calls with NSHA managers. Most of them work outside the Halifax Regional Municipality.
“What I was hearing from them, it just didn’t sound that it was real,” said Jason Maclean, president of the Nova Scotia Government and General Employees Union (NSGEU).
“They’re just looking to fluff off the work on someone else and eliminate jobs.”
Maclean said the Canadian Union of Public Employees (CUPE) and NSGEU were not consulted before November. The issue was brought up in December 2019, but there was no opportunity to give feedback and specific details were not provided.
Andrew Nemirovsky, senior director IM/IT and chief information officer at NSHA, said there was no consultation in 2019, but verbal and written communication was provided to employees in September and October 2020.
“We’ve made an honest effort to engage the union as much as possible and we’ve made sure we’ve been in line with the collective agreement,” he said.
He added that NSHA is committed to finding comparable opportunities for the employees, whether in existing or new roles.
“If there is any job loss, it’ll be very minimal. Ideally zero.”
CLEARING A BACKLOG
Nemirovsky said the plan to contract Iron Mountain is the most cost-effective method to improve the quality of health records “so that when clinicians read them, they can actually read what’s scanned in properly.”
He said there have been significant scanning errors in the past and “boxes and boxes of unscanned charts sitting in various locations across the province.”
The issues are attributed in part to the scanning equipment available to NSHA. Nemirovsky said they couldn’t afford to buy the high-quality and high-capacity scanners required to do the job. If NSHA signs the contract with Iron Mountain, the company would buy the scanners and keep them at the company’s facilities.
“That’s why it’s really impossible to meet the same kind of quality that they can because we just can’t afford the equipment. It would sink our budget.”
With the new scanners, NSHA could finally get on top of the backlogs they’ve been trying to clear for years.
“Sometimes we get on top of it with overtime and extra staff coming in,” he said. “It just continues to backlog.”
NO ACCOUNTABILITY
NSHA has also never had enough funding to hire auditors to ensure quality of the scanned records, he said.
The authority oversees an annual $2.3 billion budget but Nemirovsky said most of it goes to patient care.
“The intention of this shift was to take some of the funding that’s in the health information portfolio and put it towards those auditors.”
Maclean said the inability of NSHA to hire these auditors or purchase the scanners reflects “the mismanagement of the Nova Scotia Health Authority.”
“(The health authority) was meant to have everything to be easier to access, more streamlined, cheaper to run. It’s been proven that that isn’t the case,” said Maclean. “We’re just stuck with a monster that has no accountability to anybody.”
When Maclean heard of NSHA’S plan, he took it to the government, but politicians told him they weren’t aware of it.
“Here is a contracting out piece where (NSHA) were going to take millions and millions of dollars ... but there’s no accountability to Nova Scotians in spending their money, especially during a pandemic,” he said.
Nemirovsky said the government is not consulted in “day-to-day operational work” within the health authority, such as contracting or eliminating jobs.
“We don’t usually go to them for permission around these things, but we do inform them and listen to feedback,” he said.
“We may modify plans based on concerns raised by them, but there were no concerns raised.”
RECORDS INACCESSIBLE DURING TRANSIT
Maclean also said he was also worried that the contract with Iron Mountain wasn’t tendered. Nemirovsky said Iron Mountain has been in charge of health records in the central health zone for decades, with “zero concerns.”
“They’re a well-trusted partner at this point,” he said. “If we have a historical chart request, they pull them out and send them back to us.”
With the new contract with Iron Mountain, the company will also be in charge of records of Nova Scotians in all health zones. Records will be transported from across the province to the Dickson Building at the QEII, and from there will be transported to Iron Mountain’s facilities in Burnside.
Nemirovsky said physicians wouldn’t be able to access the documents while in transit from the hospital to the Dickson Building and vice versa. He said that amount of time is “very minimal,” especially when it’s common to misplace charts at hospitals. Clinicians may not send it back to the records department immediately or they may be on a desk waiting for a signature.
Maclean said the NSGEU and CUPE will continue to ask NSHA to reconsider their business plan.
“We will not stop with this just being swept under the rug ... especially for those that you call health-care heroes during the pandemic.”