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Lessons can be learned from B.C. health-record woes, says new Nova Scotia Health Authority boss

Dr. Brendan Carr, the new CEO of the Nova Scotia Health Authority, spoke to media Tuesday in Halifax.
Dr. Brendan Carr, the new CEO of the Nova Scotia Health Authority, spoke to media Tuesday in Halifax. - John McPhee
HALIFAX, N.S. —

The Nova Scotia Health Authority’s new boss says lessons can be learned from the glitch-plagued health record project in the Vancouver Island health district where he was CEO.

Plans for a “one person, one record” system have been in the works for years in Nova Scotia.

The province’s procurement department allowed two companies to bid on the contract in what turned out to be a controversial process in 2017.

A company that didn't make the shortlist said the process was biased toward Cerner and Allscripts. The province has denied this.

Dr. Brendan Carr, the NSHA’s new CEO and president, filled the same roles at Vancouver Island Health during the 2016-17 failed rollout of a multimilliondollar computerized health record software provided by Cerner.

Doctors complained about the system from the get-go, saying iHealth increased the risk of errors and decreased productivity. An investigation by the provincial patient safety officer confirmed these problems.

"There is a lot of work that needs to be done to ensure that when you turn on the technology, that the people that are using the technology are really ready to use it in their day-today practice and in their workflows.”

In November 2016, Carr apologized for the health authority’s response to the doctors’ concerns, telling the Victoria Times-Colonist “the health authority had underestimated the impact moving to a fully automated electronic health record would have on clinicians both individually and as team members. This placed tremendous strain on what is already a very challenging work environment.”

In response to a question at a news conference Tuesday in Halifax on Nova Scotia’s OPOR project, Carr said, “I have some very specific learnings from our experience there (in Vancouver). There is a lot of work that needs to be done to ensure that when you turn on the technology, that the people that are using the technology are really ready to use it in their day-today practice and in their workflows.”

Carr noted there are many different electronic record systems being used in Nova Scotia. On its website, Doctors Nova Scotia lists several used by its members including Med Access, Practimax and Nightingale.

The provincial Health Department uses an e-health system called SHARE, which includes information about "admissions, discharges, and transfers from provincial hospital systems. It also includes results for lab tests and diagnostic imaging, such as X-rays or MRIs, as well as access to the images," according to the department's webpage on the system. "And it includes many important clinical reports for patients, such as discharge summaries " 

Over time, the department says, information will be added from other parts of the health system, including pharmacies, public health services, primary healthcare, cancer care and addiction services.

“We're spending a lot of time and energy trying to keep them (different record systems) operating,” Carr said Tuesday. “They cost a lot of money, they're not particularly well connected and therefore they're not serving patients very well. We still have a lot of safety risks in our system today because of the way that system is constructed.

“So there are a lot of reasons why moving to a single system makes a lot of sense. And it is the right thing for us to do as a province. And we are going to need to be very diligent about making sure that we've done the work that we need to do to be prepared for the implementation.”

The province has yet to choose between Cerner and Allscripts for the OPOR contract. Carr couldn’t say when the authority expects the new system will be up and running.

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