Kelly.Manning@ncf.ca
Date: Sat, 13 Jan 2018 13:25:57 -0500 (EST)
A new Ernst & Young report has been prepared about the failed iHealth
Electronic Records project at Nanaimo General Hospital. Direction of the
project has been taken away from the Hospital and roll out to other
Hospitals on Vancouver Island has been suspended until existing problems are
fixed, if possible.
http://www.timescolonist.com/news/local/nanaimo-electronic-health-records-mismanaged-report-says-1.23143541 https://news.gov.bc.ca/releases/2018HLTH0003-000038 https://vancouverisland.ctvnews.ca/nanaimo-electronic-health-records-system-over-budget-mismanaged-report-1.3757733
"It confirmed that it wasn't only a small group of physicians, but the majority of healthcare workers who were concerned about the technology. It also showed those feelings haven't changed since a 2016 independent report by Dr. Doug Cochrane, who identified potential for errors, decreased productivity and other problems with the system."
"The report found less than half of staff and physicians surveyed agreed it would be possible to work collaboratively to make IHealth a success"
One innovation to be implemented is that staff who report problems with iHealth should no longer expect workplace reprisals. The earlier Cochrane reported identified a "blame the user" response to problem reports as a root cause of failure to address the issues.
http://ihealth.islandhealth.ca/the-cochrane-report/
A report from the Vector Group had identified Nanaimo General as having a
"toxic" top down bullying culture . That may have played a role in the
iHealth project getting it so wrong and failing to correct problems reported
by users.
https://vancouverisland.ctvnews.ca/toxic-culture-of-fear-bullying-tearing-apart-nanaimo-hospital-report-1.3670885 https://www.cheknews.ca/culture-report-says-nanaimo-hospital-is-leading-to-self-destruction-385673/
One man had to have heart surgery after notes about an infection were not visible to Physicians. He was sent home with an inappropriate prescription and readmitted when his heart problem became more grave.
A similar electronic Health Record project in the Vancouver Coastal Health
Authority is also over budget, behind schedule and nowhere near as effective
as expected.
http://vancouversun.com/news/politics/more-delays-cost-overruns-hit-vancouver-electronic-health-project
A common assumptions failure in these projects, and in the Federal
Government's failed Phoenix system, is that improved efficiency would
quickly be realised. That led to an assumption that all 3 projects could be
funded out of operational budgets, because of the assumed payback. It also
led to a rush to roll out flawed systems, to realise the anticipated
"savings". Instead the systems require more staff time than the previous
applications they were supposed to replace, have gone far over budget, and
show no hope of realising operational savings by making staff more
efficient. They also have operational errors and user interface issues.
It reminds me of the repeating mistake of assuming that Data Base Systems
would be less expensive to operate that the sorted Master File Systems they
replaced. Systems Analysts had a hard time understanding the difference
between a sequential tape or disk file read and a non sequential Data Base
record retrieval. In some cases they justified DB projects by a proposal to
"eliminate the operational cost of sorting". My experience with CODASYL,
Hierarchical, and Relational DBs is that Sorting is often a method of
reducing the overhead of Direct Access I/O.
With both Phoenix and the Electronic Patient Records systems the current BC and Canadian Federal governments are dealing with the legacy of projects initiated under previous Right Wing Administrations.
There are of echoes of the project management failures of the
various attempts to develop a Case Management System for the
FBI in the USA.
https://www.computer.org/cms/Computer.org/ComputingNow/homepage/2012/0712/rW_CO_WhytheFBI.pdf
https://spectrum.ieee.org/riskfactor/computing/it/fbis-500-million-sentinel-case-management-system-still-has-major-operational-kinks-ig-reports