BC takes charge of Nanaimo EMR project

VICTORIA – B.C.’s health minister has stripped Vancouver Island’s health authority of decision-making power over a troubled electronic health records project in Nanaimo, after an external report was sharply critical of the authority’s management of the project.

Adrian Dix (pictured) said he will appoint a mediator to handle the future of the iHealth project, a contentious paperless records system at Nanaimo Regional General Hospital. The Vancouver Sun reported that doctors, nurses and other healthcare staff will be at the same table as Island Health officials, with the health authority now reduced to one voice on the project’s future.

Disputes that can’t be resolved will be decided directly by the government, through the deputy minister of health or Dix himself.

“There will be no Island Health taking input and deciding,” said Dix. “Everybody will be working on issues together.”

The move comes after an external report by consulting firm Ernst & Young, obtained by Postmedia News, concluded the iHealth project in Nanaimo should not expand to other healthcare facilities on Vancouver Island until its many problems are fixed and a dispute between doctors and administrators over the technology is resolved.

“The report is devastating for the health authority in my view,” Dix said in an interview. “It shows that the project is obviously delayed, substantially over-budget, and that initially they budgeted only 80 percent of the capital costs of the project, which is an extraordinary way to do business.”

The $174-million iHealth system was launched in 2016 but has come under intense criticism in Nanaimo by a group of physicians who have refused to use it, arguing it has compromised patient safety due to errors in which medication and laboratory test orders are sometimes changed, dropped or duplicated incorrectly.

Dix said Island Health estimates the project will now cost $227.6 million to complete, but the Ernst & Young report indicates even that estimate could be low. Much of the overrun is from the operating budget, meaning money that would otherwise be going to front line medical services, said Dix.

The report concluded that the iHealth paperless records system at Nanaimo Regional General Hospital should not be broadened to four new Island facilities in 2018 as had been planned, and should instead be refocused to fix its budget, technical issues and leadership problems.

“Given the continuing challenges and uncertainty with the existing activation, we would suggest Island Health should attain a more certain level of readiness before activating new sites,” read the study by consulting firm Ernst & Young.

“At a minimum, Island Health should strongly reconsider any planned ‘big bang’ rollouts. Future plans should be realistically phased and reflect the lessons learned from peer Canadian organizations.”

It is the second major eHealth project in B.C. to face problems, after the government admitted last month the province’s largest IT project, the Clinical Systems Transformation Project in Vancouver, is behind schedule and has ballooned over budget to $972-million.

Dix has ordered outside help for the Vancouver area eHealth project. He also ordered the review into the Vancouver Island iHealth project in September. It’s the second outside technical report into iHealth, the first having been ordered last year by the previous Liberal government, which concluded the system had problems but did not need to be shut down.

The new Ernst & Young report, dated Dec. 12, also recommended that iHealth should remain operational because “the outstanding technical challenges can be successfully addressed” and “reversing the iHealth system would be significantly disruptive.” Dix agreed, saying the project still has merit and can be fixed despite its implementation problems.