Nanaimo doctors defy IHealth, dump software; MD suspended

Some doctors at Nanaimo Regional General Hospital are abandoning an Island Health computer system in defiance of the health authority.

The doctors say the IHealth system could cause dangerous drug dosage errors. They reverted to ordering medicine and lab work using pens and paper on Thursday, after using the IHealth system for more than a year.

One doctor has been suspended and another is facing disciplinary action, said Dr. David Forrest, president of the Nanaimo Medical Staff Association.

“Physicians have taken action to prevent patient harm. And their careers are jeopardized for it.”

About 15 internal medicine doctors are at the hospital, almost all of whom have expressed an interest in suspending the system until problems are fixed, Forrest said.

The IHealth system, introduced in March 2016, aims to digitize and centralize patient records. One component involves ordering medicine and tests such as X-rays and blood work.

The doctors support the use of an electronic health system, but want a safer one, says an April 24 letter from the hospital’s internal medicine representative to Island Health’s chief medical officer, Dr. Jeremy Etherington.

The order-entry system’s cumbersome nature affects patient safety by reducing access to care, the letter says.

“We cannot ethically and in good conscience continue to use a system that poses these risks for Internal Medicine patients,” J. P. Wallach wrote.

Responding to complaints, Island Health had announced that it would suspend use of IHealth while it makes improvements.

But it reversed that decision last month, saying the system must continue to be used.

Island Health said that it found that the order entry component is entrenched in other parts of the electronic health records system, and can’t be shelved. The system offers safety benefits, such as warning about allergy problems when medications are prescribed, it said.

Dr. Ben Williams, who has helped lead Island Health’s transition to IHealth as medical director for Oceanside Health Centre, said patients continue to get the care they need.

“Some physicians are writing paper orders. We cannot support paper orders, but for the orders that have been received on paper, other physicians have entered those in the electronic health record,” Williams said.

It’s a process that cannot be replicated, if many more doctors revert to paper orders in the hospital, he said.

He could not comment on the suspension, he said.

“Island Health can’t and will not discuss personnel matters. Island Health expects all members of the medical staff to follow Island Health policies and rules,” he said.

The IHealth system got off to a rocky start after it was unveiled in March 2016. Nine weeks later, doctors in the intensive care and emergency departments voiced concerns about patient safety and reverted to pen and paper orders.

In July, Health Minister Terry Lake ordered a review of the system by Dr. Doug Cochrane, the province’s patient safety and quality officer.

He found potential for errors and said Island Health should have spent more time tailoring the software to the needs of front-line workers before introducing it.

Cochrane said the system needs to be modified and cannot be rolled out to hospitals in Greater Victoria and the rest of the Island before it’s fully functional.

In February, Island Health agreed to suspend the order-entry system, after 75 per cent of Nanaimo Medical Staff Association members voted to suspend it until fixes were made.

It reversed the decision in March.

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