$258M SYSTEM FAILING DOCTORS
Electronic medical records plagued by file-sharing problems
A Vancouver doctor has spoken out against a dysfunctional, $258-million, information-sharing system that’s failing doctors.
“I have a patient who has a very serious heart condition and because of that he went to Eagle Ridge Hospital (in Port Moody),” said general practitioner Etela Neumann. “Most of his records, if not all, are kept at St. Paul’s (Hospital in Vancouver), but because the (ER) physician had no access to them, he ordered several tests that were already done a few weeks before and the patient was very frustrated.”
At the heart of Neumann’s complaint is B.C.’s electronic medicalrecords system that’s been under development since the mid-2000s and has so far cost $258 million.
On top of that cost is the Physician Information Technology Office, which has a budget of $108 million to roll out technology and support doctors using the doctor’s informationsharing system — dubbed EMR. The Health Ministry has acknowledged that the implementation of EMR has been a costly challenge.
“Each health authority introduced computer systems and programs more than 10, 15 or even 20 years ago, ”the ministry explained in a statement. “... The focus at the time was often not on sharing records or discharging information between the other health authorities.”
EMR was also subject to a scathing review by departing Auditor General John Doyle, who in 2010 stated “significant implementation challenges remain” within the system. EMR is part of the government’s much larger electronic health record — or EHR — system that’s supposed to integrate patient health records from multiple community health sources, as part of the eHealth initiative. Doyle’s audit looked at both the EMR and EHR systems.
Doyle’s audit found EMR was poorly managed from the start, there were duplications and a lack of support from health-care workers. He added: “The Ministry of Health did not start the EHR initiative with a well-formulated strategic plan or effective planning processes.”
Health Ministry spokesman Ryan Jabs said Tuesday that the program was still working out issues of “cross-jurisdictional sharing.”
“It’s a major change in the system. The systems are so much better than they were, but there is still much to do,” Jabs said.
Steven Hales, a former manager of Information Management Planning for Fraser Health, says the EMR problems are signs of underlying issues created by the health authority’s patchwork of clinical information systems.
“Many, if not all, of the province’s health authorities have purchased and continue to support different core clinical information systems,” Hales said. “This not only leads to inefficiency but, despite the claims of inter-operability among the systems, proprietary packages are not 100-per-cent integrated or integratable provincewide and, thus, health-care delivery can be impeded and patient health itself may be suffering.”
Hales said a move to standardize systems ,perhaps to open-source software, could help address the issue. EMR is one of several eHealth initiatives, including an electronic lab result system, an electronic drug/ pharmacy system, an electronic diagnostic imaging project, a public-health information project and the Telehealth initiative.
Ultimately, the records will become part of a Canada-wide health-information system: the Canada Health Infoway, which was established in 2001. This network of electronic health records will include information from public-health units, pharmacies, hospitals, long-term care facilities, labs and other community health agencies.