B.C. Health Minister says electronic health record system use will continue during review

NANAIMO – Island Health and the B.C. Ministry of Health have agreed to a third-party review of IHealth, currently used in Nanaimo.

Island Health’s new electronic record system will continue during a third-party review, according to B.C. Health Minister Terry Lake.

The B.C. Ministry of Health announced last week a joint agreement with Island Health to undertake a third-party review of IHealth, which will be led by Dr. Doug Cochrane, provincial safety and quality officer for B.C. and chairman of the B.C. Patient Safety and Quality Council.

The $178-million electronic health record system went online at Nanaimo Regional General Hospital and Dufferin Place March 19. Last week, there was a call for an expedited, external and independent review of the system by three New Democrat MLAs, including health critic for the Opposition Judy Darcy, as well as Dr. David Forrest, president of Nanaimo’s medical staff association, and Sheryl Armstrong, chairwoman of the Dufferin Place family council. Forrest claimed the system is difficult to use, inefficient and that there’s concern about patient safety.

The review will assess and make recommendations to address workflow and patient-care quality concerns identified, as well as the implementation of IHealth at NRGH, Oceanside Health Centre and Dufferin Place. It will also make recommendations on how to improve implementation of electronic health records at other Island Health sites.

A review was agreed to following a meeting that included Lake, Island Health CEO Brendan Carr and Nanaimo hospital physicians and staff on Wednesday. Lake said he met with the medical staff association, clinicians and other health care providers for close to two hours and afterwards it was clear to him someone needed to come in and give a good assessment. A written statement by Lake said he and Carr heard concerns expressed, but also support for the health record which is why they feel Cochrane’s work will be helpful in charting a path forward.

Lake confirmed IHealth will not be suspended during the review and said he understands Cochrane will be on site after the August long weekend.

“I don’t want to cause any more concern on the part of health-care providers, and Dr. Cochrane can come in while the system is working and see it in real time and make recommendations either immediately or short term or longterm once he’s had a chance to assess the situation,” he said.

Carr could not be reached for an interview, but in an e-mailed statement he said Island Health continues to work closely with the Ministry of Health, physicians and staff on the implementation of IHealth and fully supports the review.

“The outcomes of the review will allow us to assess the strengths of the system and identify areas that require refinement,” he said.

Forrest, with the medical staff association and a physician at the Nanaimo hospital, said the commitment to a review is viewed positively and they look forward to working collaboratively with Cochrane, the patient safety and quality council review process, Ministry of Health and Island Health to develop an electronic health record system that’s safe, efficient and improves care. The review process through the patient safety and quality council is at arm’s length, arguably not entirely independent, he said, but there’s recognition and trust the appropriate expertise will be brought in.

Forrest expressed concerns about documentation in the record system. He claims it is possible to alter physicians’ notes and that somebody might delete a paragraph accidentally or deliberately and there’s no ability to identify what exactly was done. He also said inefficiency of the work system increases workload.

“An internist who could see 15 consults in a 24-hour period can only see 10 because everything is taking so much longer, which means patients are getting reduced access to care,” he said.

The review is expected to be substantially complete by Sept. 30.