Island Health presses ahead with CPOE, despite complaints

VICTORIA, BC – Island Health will not delay the implementation of a $174-million electronic health-record system in a Nanaimo hospital, but will add extra resources as physicians continue to sound warnings about fatigue and a possible catastrophic incident.

“Moving to an electronic system should enhance the care we provide, rather than jeopardize it,” says a report by the newly formed Medical Staff Association, representing about 250 physicians with privileges at Nanaimo Regional General Hospital.

“We do not want a catastrophic event to occur in order to have our concerns heard,” says the report, obtained by the Times Colonist newspaper, in Victoria.

Sixty-one Medical Staff Association members voted unanimously to back a “no confidence” motion on the system’s electronic ordering system, which allows physicians to order diagnostic tests or drugs and to enter patient instructions electronically.

They are calling for a return to paper orders while the system is independently reviewed.

Physicians claim the software is cancelling, overriding, changing or doubling up some drug orders and critical physician instructions.

Island Health CEO Brendan Carr (pictured) said the health authority’s board members “quite seriously” considered the request to remove the ordering module, but decided against it.

The board, which is appointed by the province, has directed the health authority to “persevere” through the implementation of the iHealth system, Carr said.

But it also wants several changes, he said, including the addition of resources and ongoing refinements, based on physician concerns and recommendations from a recent internal investigation.

“We are very confident the system is doing what it was designed to do,” Carr said.

“Equally we understand, though, if physicians are not really confident in the use of the system, that can lead to concerns the system could do things that are not the best for our patients – not because the system doesn’t work, but because they are not using the system perfectly.”

Island Health has a 10-year, $50-million deal with software developer Cerner Corp. of Kansas City, Missouri, for an electronic health record software system. Island Health will spend an additional $124 million for hardware and training.

The CPOE component has been implemented successfully in other hospitals, including North York General Hospital, in Toronto.

The Island Health system launched March 19 at the Nanaimo hospital, Dufferin Place residential care centre in Nanaimo and Oceanside Health Centre in Parksville.

It is the first in B.C. to connect most of a patient’s acute-care and diagnostic healthcare services through one computerized medical record.

Nine weeks into the launch, emergency room and intensive care unit doctors reverted to paper orders and instructions out of concern for patient safety. Internists and others want to do the same.

Once the system is stabilized at the three Nanaimo and Parksville sites, Island Health plans to implement it across the Island, the health authority has said.