Quebec moves to a single, province-wide EHR

QUEBEC CITY – Health Minister Gaétan Barrette (pictured) announced that Quebec will move toward the use of a single electronic health record system in hospitals across the province. The solution decided upon by the province is called Cristal-Net, and it has been in use at the Centre hospitalier universitaire de Québec – Université Laval since 2003.

“The decision to deploy a single solution for Electronic Medical Record is part of our efforts to standardize practices within our health and social services, clinically and financially and administratively,” said Barrette. “This will benefit clinicians and all users.”

The Cristal-Net solution will be implemented in all 34 hospital institutions in Quebec, starting with those who do not have an electronic record system.

Institutions using another solution will have to establish a transition strategy in order to comply with the directive, taking into account the end dates of contracts with current suppliers.

This process will be overseen by a governance structure composed of CEOs of the network and health and social services deputy ministers who will have to set development priorities, approve deployment strategies and endorse the clinical and administrative practices that result.

According to an article in Le Soleil, Barrette called the decision a “master stroke” for Quebec economically and functionally.

“You end up with a product developed here, which is provincially owned and for which we do not have to pay huge licencing fees,” said Dr. Barrette, noting that the costs of IT products are generally quite high.

Cristal-Net was co-developed by CHUQ, in Quebec City, with the CHU de Grenoble, in France. The director of information technology University of Quebec-Laval University Hospital, Jean Boulanger, has led the development team in Quebec since 2000, when they signed a co-development agreement with the centre in France.

Boulanger said Cristal-Net is useful and effective: “Doctors find it easy to use, the software is very user friendly.”

Institutions using another solution – five different software solutions are currently used in Quebec hospitals – will be required to establish a transition strategy in order to comply with the new directive, taking into account the end-of-contract dates with current suppliers.

For the Minister of Health, the money invested in other electronic health records systems is not considered to be wasted. “The work that has been done is useful work,” said Dr. Barrette. He observed that existing EHRs have enabled hospitals to collect patient information, which will be transferred to the new Cristal-Net system.

“This is just the container, the destination of the data that changes. And it will be a complete vehicle, analyzable and searchable, something we do not have at this time,” said Dr. Barrette.

Deployment of Cristal-Net across Quebec will lead to the completion of the 2019 Quebec Health Record (EHR), a database that will allow physicians and other healthcare professionals to access the results of examinations and laboratory tests, prescription drugs, vaccines received in Quebec, a summary of hospitalization and information on allergies.

Barrette believes that the government will have spent around $ 2 billion to complete the integrated, provincial electronic health record.

Le Journal de Montreal reported that the government announced the expansion of Cristal-Net in late December, when MPs and ministers had already left the National Assembly for their constituencies and the holiday season.

Before the announcement, Quebec hospitals could select their own software solutions from a list of approved products.

In Montreal, the chosen solution was Oacis (now owned by Telus) and its development began in 2004. The system is not fully implemented and will be completed in 2019 at an estimated cost of $130 million, the Journal de Montreal said.

After the completion of the Oacis contract in 2019, however, the Montreal hospitals will be required to shutter the system and start over again by implementing Cristal-Net.

The Journal de Montreal asked the minister, “Will the hundreds of millions spent on systems other than Cristal-Net be put in the garbage?”

The minister’s office answered that “It is not true that everything that has been done will be wasted. There will be database transfers. And ultimately, there will be less money wasted.”