Painful birth for paperless health care

Island Health's new digital diagnosis, treatment and medical history recording system on a difficult learning curve in Nanaimo test rollout

Island Health remains firmly committed to iHealth.

But two months into its initial rollout in Nanaimo, the health of Vancouver Island’s groundbreaking $178-million paperless system is proving difficult to diagnose.

On one hand, you’ve got administrators saying more than 400 errors that would have slipped through under previous paper-based methods have already been caught by the new electronic record-keeping system.

On the other, you hear talk of frustrated doctors considering defying their bosses and reverting to the old system in the emergency room of Nanaimo Regional General Hospital in order to speed up diagnosis and treatment.

Ten years in the making, iHealth went live in the Nanaimo area March 19 as the first phase of a multi-step process to see it fully implemented in every facility in the Island Health region by 2018.

For the past eight weeks, each NRGH nurse has been trundling through hospital hallways with a wheeled touch-screen computer console, voice-recognition dictation software and a bar code scanner designed to track and record each patient’s diagnosis, treatment and history at the touch of a button.

Ultimately, the system is aimed at improving patient safety by bringing clarity, consistency and easy access to their records, with built-in safeguards designed to ensure they are getting the right doses of the right treatments at the right times.

But while iHealth appears to be largely delivering on those promises, its implementation has also slowed the work flow enough that some are questioning whether the gains are worth the losses.

While procedures for things like lab and diagnostic orders have reportedly been improved, that hasn’t necessarily been the case in some of the more intense areas of the hospital, like the ER and the intensive care unit.

“The overwhelming concern I am hearing is the effect on patient care,” Nanaimo Division of Family Practice Chairwoman Dr. Melissa Oberholster said. “Are there less procedures? Are waiting lists getting longer?”

Oberholster was very cautious not to be seen as passing judgment on the system, adding she has heard both positive and negative reports, but only on an ad hoc basis. She said Nanaimo area doctors are meeting next week to discuss the situation more fully.

“It’s difficult to speak about it because we have only heard anecdotes,” she said. “We have certainly heard the morale has been low. We will get the family doctors together to get a better idea of the impact.

“The other piece is that we haven’t had the doctors and the nurses together; how is it affecting working relationships and our collegiality?”

Rachel Kimler, the B.C. Nurses Union spokeswoman for Nanaimo said the nurses are in a similar place.

“There is not a lot I can say. The union supports and will continue to support electronic records,” Kimler said. “Some of it is growing pains, some of it may be system-related.”

Island Health’s chief information officer Catherine Claiter Larsen acknowledged the process has been painful, but said growing pains were expected as people switch to an entirely new way of doing things.

“It looks like a very normal distribution of the learning curve: some people already running down the other side; a few are not willing to start the climb; most are around the top of the hill,” she said. “It’s still going as expected with a change of this magnitude. It will take a good six months for everyone to return to their levels.”

Claiter Larsen said that while doctors are frustrated about the increased time it takes them to log information into the system, they are overlooking the time saved on the other end of the process. Nurses and pharmacists are no longer struggling to decipher hand-scrawled messages. The iHealth system has drastically reduced the number of follow-up calls and rewritten prescriptions.

“It was easy to scribble. They forget the amount of time it took for pharmacists to track them down.”

Oberholster said the experiences of other jurisdictions — Island Health is the second largest and seventh overall in North America to go completely digital — is reason to be skeptical.

“We will make some gains. If you read most of the information you get, you do not ever recover that productivity back to the baseline.”

Claiter Larsen said there is a payoff.

“We will never achieve perfect comfort, but people will begin to notice it less as time goes by. I’d like to acknowledge the perseverance of our Nanaimo partners,” she said. “The first activation is the hardest one. Patient care will be more safe and of a higher quality.”

Dufferin Place residential care centre in Nanaimo and Oceanside Health Centre in Parksville joined NRGH as the iHealth Guinea pigs. Next up is Campbell River and the Comox Valley, with the aim of getting staff acclimated to the new system before the new hospitals open in those communities in 2017.

At the end of the process iHealth will be in place across the entire Island Health system, not just hospitals.

“What our board has asked of us is to make sure we do it right,” Craiter Larsen said. “Other industries are so far ahead of us. This is the future of health care. This is what the next generation uses every day.”

Follow me on Twitter @JohnMcKinleyBP

Just Posted

Cute but fierce! Timber moonlights as an attack kitty. (Sarah Simpson/Citizen)
Sarah Simpson Column: Beware of Mr. Bite, the midnight attacker

Last week, in the middle of the night, I was awoken by… Continue reading

The province has come through with funding for Duncan Manor’s renewal project. (File photo)
Funding comes through for Duncan Manor’s renewal project

Money will come from the province’s Community Housing Fund

The former St. Joseph’s School site will remain an art studio at least into early next year. It will take some time before being converted to an addictions recovery community. (Photo by Don Bodger)
Addiction recovery facility will be all about building community together

Society on a clear path with members’ experiences to provide valuable help

Seniors in the Cowichan Valley are being moved into the new Hamlets. (Sarah Simpson/Citizen)
New Hamlets in Duncan admitting seniors

Residential-care facility has 88 beds

t
How to tell if a call from ‘CRA’ is legitimate or a scam

Expert says it’s important to verify you really are dealing with the CRA before you give out any info

Unofficial holidays: Here’s what people are celebrating for the week of June 13 to 19

Flag Day, Garbage Man Day, International Panic Day all coming up this week

Terry Mazzei next to a truck after it was struck by lightning, with him inside, on Wednesday afternoon, June 9. He walked away from the incident without injury and the truck sustained only mild damage; a blown front tire and newly broken gas gauge. (Wendy Mazzei photo)
Vancouver Island man walks away unscathed after lightning strike

VIDEO: ‘We like to think that his dad was watching over him’

Cannabis bought in British Columbia (Ashley Wadhwani/Black Press Media)
Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

The courthouse in Nanaimo. (News Bulletin file)
Nanaimo man, already in jail, found guilty of sexual abuse of sons

Man previously sentenced for sexual interference involving girl in Nanaimo

British Columbia-Yukon Community News Association’s 2021 Ma Murray Awards were handed out during a virtual ceremony on Friday, June 10. (Screen grab)
Black Press Media winners take gold at B.C. and Yukon journalism awards

Publications received nods in dozens of categories

Prime Minister Justin Trudeau greets campers while visiting McDougall, Ont. on Thursday, July 19, 2018. THE CANADIAN PRESS/Frank Gunn
71% of B.C. men say they’d prefer to go camping with Trudeau: survey

Most British Columbians with plans to go camping outdoors say they’d prefer to go with Trudeau or Shania Twain

Members of the Department of Fisheries and Oceans’ Marine Mammal Response Program rescued an adult humpback what that was entangled in commercial fishing gear in the waters off of Entrance Island on Thursday, June 10. (Photo courtesy Marine Mammal Response Program)
Rescuers free humpback ‘anchored’ down by prawn traps off Vancouver Island

Department of Fisheries and Oceans responders spend hours untangling whale

Chilliwack cocaine trafficker Clayton Eheler seen with a tiger somewhere in Asia in 2014. Eheler was sentenced to nine years jail in 2018, but was released on bail in October 2020 pending his appeal of conviction.(Facebook)
Director of civil forfeiture seeks $140,000 from Fraser Valley drug dealer’s father-in-law

Clayton Eheler’s father-in-law Ray Morrissey caught with money in Fort St. John by B.C.’s gang unit

Most Read