The president of Doctors of B.C. appealed to Island Health to work with physicians on appropriate and meaningful solutions around IHealth during a visit to Nanaimo this week.
Dr. Alan Ruddiman, whose organization represents 12,000 doctors, is encouraging collaboration between Nanaimo Medical Staff Association and Island Health on solutions that serve patients well and suggests a mediator in the event of an impasse.
Members of the medical staff association have felt the order entry system of IHealth, where doctors place electronic orders for tests and medication, should be put on hold until it’s redesigned, with concerns about the safety of the system. Island Health had agreed to suspend the system, but later reversed the decision because of its connection to the rest of the electronic health record.
Ruddiman said his organization understands there’s a significant risk to patients and his visit was to stand up for physicians, nurses and allied health professionals, “who’ve tried raising this through the appropriate channels.”
The health authority is not allowing the “legitimate voice of clinicians” to have the system suspended to reduce risk, fix problems and re-initiate the program when ready, according to Ruddiman, who also said there’s a broken culture at the hospital and one where physicians’ leadership, guidance and advice in protecting patient safety isn’t embraced. To him, that’s a vulnerability for Island Health, patients and residents and doesn’t serve doctors well, he said, claiming physicians are burning out, disconnecting from the hospital and giving up and resigning their privileges.
“If the medical personnel are hurting and they are uncoupling from this hospital then it’s only a matter of time where this gets known as a community that’s not an attractive place to live and work and that hurts everybody, every citizen in this community,” he said, pointing to an inability to recruit.
A staff association meeting was held Wednesday during Ruddiman’s visit.
Dr. David Forrest, Nanaimo Medical Staff Association president, said there was a strong feeling of no confidence in the health authority to act ethically and fairly in their dealings with health care workers and in its ability to address safety issues raised for the past 14 months. He’s not sure where things go from here but said staff are in a “very difficult position.”
In May, Island Health stopped processing paper orders for internal specialists, who Forrest said have been put in a position of abandoning their ethical principles or abandoning patients. He said they’ve been effectively suspended from their ability to provide service and Forrest sees internal medicine being in jeopardy because of potential gaps in the call schedule that if filled will be with locums, often from out of town, impacting continuity of care.
Dr. Ben Williams, medical director for Oceanside, said it’s never been about discipline, rules or regulations, but keeping patients safe and part of that involves using the electronic health record. When doctors decide not to use the electronic health record, the health authority finds alternate arrangements to get patients internal medicine coverage. He also said there’s a strong relationship between Island Health and members of the medical staff and ongoing relationships with the medical staff association are welcome.
Williams said the association has been invited to make improvements and have representation on the electronic health record quality council.
“There are some physicians out there who feel very strongly about this issue and that it’s hard in that context of having such hard feelings to engage day to day on making improvements on a system that I think they feel shouldn’t be used at all. But we are very open to begin to work with all of our colleagues, including those physicians, to make improvements that they do feel that level of confidence,” he said.
He confirmed a breakdown of relationships between some physicians and the health authority around the electronic health record and said those relationships and trust will take time to rebuild.
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