NWT ready to replace its aging EHR

YELLOWKNIFE – The Northwest Territories’ electronic medical records system needs replacing, with parts of the platform being 15 to 20 years old. In the NWT legislature, health minister Lesa Semmler said a request for proposals is expected to go out in September for the first phase of the work.

The estimated cost to replace the system is $20 million to $30 million, according to Range Lake MLA Kieron Testart.

Testart is personally familiar with the system’s flaws. He’s been trying to figure out a lung infection and, at his most recent appointment, the system was down and the terminal in the exam room wasn’t working.

“The technology infrastructure really is in desperate need of replacement,” Testart told NWT’s Cabin Radio.

The new electronic health record system will be designed to enable access to patient records, by clinicians, across the north, said Michele Herriot, the Department of Health and Social Services’ chief information officer.

“If you start off in Inuvik and then you end up in Yellowknife or Hay River, any one of our communities, they’re all charting in the same system,” Herriot said.

Dr Ewan Affleck, a past chief medical information officer for the NWT’s health authority, has lived and worked in northern Canada for 30 years. Affleck was instrumental in bringing the EMR system to the NWT, receiving the Order of Canada in 2013 for his work improving healthcare in remote areas through the use of electronic medical records.

While the NWT started rolling out EMR in 2001, Affleck said, it wasn’t fully implemented in all the territory’s communities until 2018.

As to why it took 17 years to implement, “it’s just a very slow deployment,” Affleck said. “It was a complex endeavour with a small staff.”

Now, the EMR software is at the end of its life. “Some of these systems we purchased 20 years ago, 15 years ago, so it’s just a natural life cycle of technology,” said Herriot.

“Our electronic medical record system as well as a bunch of our systems are ageing, and we need to replace them.”

Herriot notes it’s not just the age of the systems that’s the problem, but also that these systems are not necessarily meeting current clinical needs.

“As programs and services advance and change in how the care delivery model looks and functions, the technology needs to change alongside that,” Herriot said.

Though primary care providers are charting in the same digitized system, different care systems remain compartmentalized. Hospitals, for example, have digitized lab results and appointments, but charting is still done on paper.

“Even though it seems like when you walk in the front doors of a hospital, it looks like they’re checking you in on a computer… if somebody is laying in a bed in the hospital, like as an inpatient, that charting is still all done on paper,” Herriot said.

More modern systems would be able to exchange information between care teams so that it’s less compartmentalized, while maintaining security and respecting privacy rules.

Implementing electronic health records is a pan-Canadian priority, Herriot said. “This is something that across Canada, everybody is moving towards, being able to exchange that information so it’s available to the right practitioner at the right time to support care delivery for clients.”

In the meantime, there’s a risk that the technology could stop working altogether.

“If we don’t replace them soon enough, then the technology could fail,” Herriot said. “And then where we have digitized, we could end up having to go back to paper.”