Expert brought in to fix BC ehealth project

VICTORIA – To help with the troubled Clinical Systems Transformation Project in the Vancouver area, Health Minister Adrian Dix has called in the former London Drugs CEO, Wynne Powell (pictured), who helped the Fraser Health Authority during a leadership crisis in 2014.

Powell was named the project’s new board chair and will report directly to Dix on how to get things under control.

The Clinical Systems Transformation Project is the largest I.T. project in B.C. government history, and is intended to handle the records of more than one million Vancouver-area medical patients However, it is beset by delays, and has ballooned massively over-budget.

“We’ve got to take action,” Dix told the Vancouver Sun. “And today we’ve got the right person to do that. That’s not to say it will be easy.”

The project is supposed to give doctors and nurses better access to shared electronic health records at hospitals and health care centres in Vancouver Coastal Health, the Provincial Health Services Authority and Providence Health Care. It also includes updated clinical standards for care, new workflow guidelines, and a drug system with automated packaging and bar codes that ensure patients get the right kind and quantity of medication.

The original $842-million budget has jumped to $972 million, said Dix, who began reviewing the Liberal-created project when he became health minister this year. The approximately $130-million overrun is mostly coming out of the operating budgets of the health authorities as they struggle to keep their antiquated IT systems running to compensate for the delays, said Dix.

“We’re talking about operating funds,” he said. “You could argue that these are being done within the budgets of the health authorities, but that’s money that can’t be spent on other services.

“To say that is displeasing as an idea is to greatly understate it,” he added.

The first phase of the project was supposed to go live at Lions Gate Hospital in spring of 2017, but it was pushed to spring of 2018, and even that is uncertain given the problems so far, said Dix.

“We’re not a year late; we hope we’re a year late, which is a different question,” he said.

That’s on top of an 18-month delay and additional cost overruns in 2015 when the province fired technology giant IBM from the project, amid concerns from doctors, nurses and health care workers than an early draft of the system couldn’t do what they wanted.

“I would describe that decision as catastrophic,” Dix said of the IBM reset. The government hired another IT firm, Cerner, to take over.

The health workers were supposed to begin validating the new work last year, but that progress appears to have been slow. “What was proposed by the government clearly dramatically underestimated the difficulty and costs of the project,” said Dix.

Before the IBM firing in 2015, the project was set to be completed in 2017-18. Previous Liberal health minister Terry Lake said at one point he “read the riot act” to the health authorities and the project team over continued failures.

Dix blamed the previous Liberal government for numerous bungled IT projects, such as a combination social/child welfare system whose features had to be gutted to achieve completion, and the $174-million Vancouver Island iHealth paperless records project (also by Cerner) that has undergone two independent reviews after doctors refused to use it.

“They consistently failed to learn,” Dix said of the Liberals.

“I think at its core, these IT projects are too big, and not gated enough,” said Dix. “What we need are smaller spends. And if the smaller spend doesn’t work, sure you have to write off some money and it doesn’t look good, but it’s a smaller spend. When you start and approve projects with these $500-600-800 million in costs, and go ahead and spend a couple million you are stuck into those systems before you know that they work.”

The Clinical Systems Transformation Project’s new automated pharmacy production centre did go live in late 2016 at Vancouver General Hospital. But the bulk of the project remains delayed.

Dix said he expects Powell to assess the project’s management, identify its remaining risks, review its completion costs and find ways to meet the original objective of electronic health records without more delays and overruns.

“The worst possible thing that could happen now is not to do it well, and continue to spend money beyond what we have because we need that money in other areas of government.”