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Specialists paid for “shadow” coverage at NRGH

Doctors’ reluctance to use key component of IHealth causes additional expenses for health authority
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Island Health has paid doctors more than $50,000 for “shadow” coverage at Nanaimo Regional General Hospital since May. FILE PHOTO

A move by internal medicine doctors not to use part of the electronic record system has cost the health authority more than $60,000.

The health authority put out a call to internal medicine specialists in May after a “cadre” of physicians in Nanaimo declared they wouldn’t use a key part of the electronic health record.

A letter by Dr. Jennifer Grace, executive medical director, shows it was an appeal for urgent coverage at Nanaimo Regional General Hospital to provide shadow service, where the doctors would be present in case they’re needed for $1,850 a day, plus travel, accommodation and meal allowance.

Doctors would be paid an additional fee if they were required to actually provide patient care.

“The purpose of the additional physicians was to provide additional support and education to physicians to ensure high-quality, safe patient care and to fill gaps in the internal medicine physician on-call schedule,” said Val Wilson, Island Health spokeswoman in an e-mail.

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The letter from Grace came after the health authority reversed its decision to suspend its order entry component of IHealth, a $178-million paperless system that rolled out at NRGH, Dufferin and Oceanside last year.

A group in internal medicine returned to writing paper orders in April, no longer willing to support IHealth’s computer order management process, which allows for electronic orders of tests and medicine.

Dr. David Forrest, an internal medicine specialist and president of Nanaimo Medical Staff Association, previously told the News Bulletin among issues are problems with the order process that lead to medications being dropped off the medication record and orders being altered in the system, which can lead to error.

One internist has since returned to the use of the computer order management process upon legal advice, two internists went on medical leave and another couple were dropped from the call schedule and no longer provide on-call services for internal medicine, according to Forrest.

“That has had an impact on internal medicine manpower, which has been a struggle in order to ensure that there’s continuous coverage for internal medicine,” he said.

The shadow coverage has cost Island Health $57,350 with 31 days covered and to date $3,800 has been paid in travel, accommodation and meal costs. The health authority hasn’t been invoiced for an estimated $1,000 in outstanding travel costs, and the fee for service is billed to the provincial medical services plan.

All the work is captured within the approved budget for IHealth and Wilson said Island Health will continue to recruit additional physicians to assist with computer order-entry education and support as needed.

The province has announced a review of the IHealth system, expected to be completed later this fall.



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