Health Minister Adrian Dix has released a report on the review of Island Health’s IHealth system.
The Ernst & Young (EY) report, Review of Island Health’s IHealth Electronic Health Record System, makes nine recommendations and outlines findings in the areas of system planning, implementation, governance, leadership and budget.
The report found that the implementation of IHealth has been one of the most significant changes of practice for many hospital staff members and physicians. It is clear that there was deep mismanagement of the project: it was not properly planned or implemented, with some issues thought to be preventable if the health authority had leveraged advice from other Canadian experiences. This coupled with the pre-existing and long-standing contentious relationship at Nanaimo Regional General Hospital (NRGH) created an extremely challenging situation. As a result, the project is significantly delayed and facing serious financial pressures. Island Health will not be able to complete the full project scope within its initial $173.5-million budget. Island Health estimates an additional $54.1 million is required to complete the project. However, EY suggest that more will likely be needed.
“I have read the report and I accept its recommendations,” Dix said. “Ultimately, this decision is about doing what is best for patients, as well as those who provide care for them. Patients deserve access to timely, integrated quality care, and successfully implemented electronic health-record systems can support that by delivering the most current health and medication information when and where it is needed.”
Dix also announced that a mediator will be put in place to support stakeholders moving forward together.
“I am deeply troubled by some of the findings and believe that it is not good enough to merely continue forward. We must do this together,” Dix said. “In support of that, I will be appointing a mediator in the coming days to help all stakeholders work together to address the recommendations as they are applicable to Nanaimo Regional General Hospital.”
At a minimum, the mediator will:
- Meet with all stakeholders to ensure agreement that the report accurately describes the situation that has developed at NRGH;
- Help stakeholders produce an accord on how everyone will work together to identify and resolve issues, make decisions, communicate with each other and report progress;
- Assist stakeholders in developing a work plan to implement the actions required to address the recommendations as they are applicable to IHealth at NRGH; and
- Monitor adherence to the terms of the accord and progress against the work plan, until no longer required by the Minister of Health.
“Over the past decade, hundreds of millions of dollars have been spent on IT projects that have failed to deliver the outcomes promised,” Dix said. “By taking this action today, this government is making sure that we take a more thoughtful approach to these projects by slowing down, properly planning and engaging the right people in the right way.”
While the issues at NRGH are addressed, Island Health has been directed to apply the learnings from this report, and from the work at NRGH, to plan future acute-care electronic health-record implementations and map out a measured and realistic plan that is funded appropriately.
Health-care systems across Canada and globally are adopting electronic health systems to deliver health and medication information where and when it is needed. They make a patient’s health information easily transferable, giving each care provider access to a complete medical record, including any diagnoses, tests and examinations recorded by other providers, helping ensure accurate diagnosis and appropriate care. Electronic health-record systems can also give patients access to their own health information and support their active participation in their care.
The EY report is available at: www.health.gov.bc.ca/library/publications/year/2017/review-of-Island-Health-IHealth-electronic-health-record-system.pdf
Two backgrounders follow.