Newfoundland revises approach to EHR deployment

ST. JOHN’S, NL – After doctors raised concerns, Newfoundland and Labrador Health Services (NLHS) is backtracking on some aspects of an agreement that previously made a new health information system mandatory for all physicians.

“We’ve changed our stance. The system will not be mandatory,” interim NLHS CEO Ron Johnson (pictured) told CBC Radio. “If they choose not to come, we’ll have systems in place to be able to deal with paper requisitions or the way that they currently send them.”

“So, we’re not forcing people to join. We’ve listened to the physicians’ concerns and we’ve adjusted,” he said.

The agreement also made them liable for any costs associated with breaches of health information. Physicians feared they would be on the hook for costs associated with potential cyberattacks.

Johnson said adjustments have also been made to those clauses.

“The original version of the contract … was protecting the Newfoundland and Labrador Health Services a little more than the people we were partnering with,” said Johnson.

The new system, called CorCare, is based on Epic and will replace the collection of electronic health record systems with a single, province-wide digital record. It is to be launched on April 25.

But last month, hundreds of N.L. physicians signed a petition raising concern about the system launch and its 35-page agreement.

Physicians feared launching the system across the province all at once would create potential risk to patients, like missed or delayed testing.

Physicians had also raised concern about a temporary reduction in “patient access,” when the new system launches.

Johnson confirmed that services will be reduced.

“It’s gonna take a little period of time for people to get used to the system and learn the system. And in that time frame, while people are learning, we’ve reduced our services a little bit, not a lot … like 20 percent in some areas,” said Johnson. “But in a couple of weeks they’ll come back up.”

However, emergency rooms services will “remain uninterrupted,” added NLHS medical services vice-president Dr. Gena Bugden.

Meanwhile, Johnson said they have been preparing for the system’s launch for three years.

He said computer systems have been replaced and upgraded and over 30,000 individual training sessions have taken place since February, with over 13,000 staff having already received training on the new system.

After launching, Johnson said there will also be command centers providing 24/7 support for a month.

“We have phone lines set up especially for physicians where they can call in and get help. And we have, I think, 2,700 super users that will be available to help people learn and onboard the system,” he said.

In the meantime, Johnson said the new system will have some benefits for patients too.

Bugden said it will mean healthcare providers across the province will now be able to see a patient’s entire records, which will help avoid duplicate testing.

She also said the system will allow patients to see appointments across the province, which could help reduce wait times.

“Let’s say the wait time for a CAT scan was two months in one area of the province, but I could see it was one month in another area of the province. Then I could choose, if I was willing to do so, to go to the other area of the province to get my imaging quicker,” she said.

While there may be some learning curves at launch, Johnson said the new system will create many benefits for the province’s healthcare system in the long run.

“This is a transformational change for the healthcare system in the province. And there’s huge benefits for the patients. So just be patient with us as we’re learning the system.”