People wait outside the entrance of the emergency room at Nanaimo Regional General Hospital

UPDATED: Island Health rejects doctors’ plea to suspend iHealth at ‘hospital in crisis’

Use of electronic record-keeping system to continue in Nanaimo while health authority looks for ways to build trust, reduce fatigue

Island Health listened to doctors deliver a formal non-confidence vote Wednesday in a new system that has created a “hospital in crisis.”

It decided to go with a second opinion.

Vancouver Island’s health authority has rejected a last-ditch plea from Nanaimo doctors to suspend use of the controversial $178-million iHealth paperless record-keeping system until its issues are rectified.

Instead, the system will continue operating while immediate steps are taken to address staff fatigue and boost staff trust.

The decision comes at the recommendation of the Health Authority Medical Advisory Committee, a team of medical professionals that determined current staff distress and fatigue was due to “resource gaps.”

HAMAC advised urgent action to alleviate the workload and find ways to improve how iHealth is being utilized, as well as reviews at least monthly of the effectiveness of those steps.

Ultimately, Island Health decided the issues being experienced are tied to inadequate staff support, rather than the system itself.

That’s not what Nanaimo doctors wanted to hear.

“Our request was to remove the ordering system while they work on it and reintroduce it when certain goals are met,” said Nanaimo Medical Staff Association treasurer Dr. Alison Croome.

“We feel it’s a reasonable request and that the safety concerns are sufficient. They are confident in their safety data and they feel our concerns are unfounded.”

The NMSA stated its case in a June 29 presentation to the board, led by vice-president Dr. Tony Booth. Booth said the implementation of iHealth has created a crisis at NRGH that has gone unrecognized by an Island Health report that concluded the system was working as intended.

“This report lacks face validity, meaning there are inconsistencies in this report compared with the real-life experiences of the physicians using the system,” he said. “Since the iHealth launch (there has) been a multitude of physician-reported major safety issues from every department that deals with acute patient care.

“We do not want a catastrophic event to occur in order to have our concerns heard. We do not feel that it is ethical to put patient at risk using a system that makes it difficult to ‘do the right thing’ and much easier to make a significant error.”

Implemented in March at Nanaimo Regional General Hospital, Nanaimo’s Dufferin extended care facility and the Oceanside Health Centre in Parksville, iHealth is design to eliminate the use of paper in the recording of medical diagnosis and treatment. Island Health plans to implement it Island-wide after any kinks are worked out.

Medical staff concerns have centred on how the system has slowed the pace of treatment in critical areas like the hospital’s emergency room and intensive care unit and resulted in missing or misplaced orders, putting patient health at risk.

Staff at the NRGH ER and ICU have been using paper orders — which are then copied into iHealth — for about a month now as a precautionary measure and a means to expedite treatment.

Booth said doctors are concerned that the administration’s pride in the system is getting in the way of a solution.

“We ask you the board what price is willing to be paid to continue a system whose benefits are as yet theoretical but whose side effects are very real?”

According to Croome the doctors will regroup to discuss what, if any, further steps should be taken.

“We have not decided to take any action, as of yet,” she said. “There are no other steps we can take with the health authority.”

Island Health CEO Dr. Brendan Carr responds to this issue here.

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