Island Health to 'persevere' through rocky Cerner EHR rollout

A month after physicians at a Canadian health system returned to using pen and paper to submit orders in the midst of an EHR roll out, health system officials have decided to move forward with the implementation, according to a Times Colonist report.

Vancouver Island Health Authority in British Columbia, Canada, is in the middle of implementing Cerner's EHR, a $174 million project. Three sites went live on the EHR March 19, including Nanaimo Regional General Hospital. But physicians at Nanaimo's intensive care unit and emergency department reverted to submitting orders via pen and paper out of patient safety concerns. Specifically, physicians report the EHR is changing medication orders and physician instructions, sometimes canceling, overriding or doubling orders.

The physicians petitioned for hospital officials to suspend the implementation. Sixty-one members of Nanaimo Regional's Medical Staff Association voted on a "no confidence" motion on the EHR's electronic ordering system.

"Moving to an electronic system should enhance the care we provide rather than jeopardize it," reads a report by the Medical Staff Association obtained by Times Colonist. "We do not feel that it is ethical to put patients at risk using a system that makes it difficult to 'do the right thing' and much easier to make a significant error."

Island Health officials met to discuss the request but ultimately decided to "persevere" through the implementation, Brendan Carr, Island Health CEO, told Times Colonist.

Mr. Carr said officials are confident the system is doing what it is supposed to. "We understand, though, if physicians are not really confident in the use of the system, that can lead to concerns the system could do things that are not the best for our patients — not because the system doesn't work, but because they are not using the system perfectly," he told Times Colonist.

Officials have called for several changes to the implementation project, including additional resources to address fatigue in clinical staff, alleviate workload burden, work to improve trust in the EHR and work with clinicians to evaluate further improvements in the EHR, according to the report.

Mr. Carr said the new system does take more time to use, thereby limiting how many patients physicians can see. "We understand that's not good for patient care and it's not good for physicians," he told Times Colonist. "We're very motivated to do what we can to support the physicians and try to change that either by adding more resources or looking at other mechanisms."

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