IHealth records system still putting patients at risk at Nanaimo hospital, doctors say

More than a year after an electronic health records system was introduced at Nanaimo Regional General Hospital, doctors say patient safety is still at risk.

Physicians and other medical staff have been raising concerns about IHealth since it was rolled out 14 months ago.

Island Health planned to temporarily suspend the use of IHealth's electronic tool for ordering medications in February, following an external review that was ordered by B.C.'s health minister.

But the health authority later decided it would be too difficult to safely go back to pen and paper orders. Instead, it decided it would be best to work on improvements while continuing to use the system.

• Island Health temporarily suspends troubled IHealth system
• Review urges changes to Nanaimo hospital records system​
• Nanaimo hospital replaces paper charts with electronic health records

The situation has put Nanaimo doctors in a difficult position, said Doctors of B.C. president Dr. Alan Ruddiman, during a visit to the hospital on Thursday.

"The system in place at this hospital remains absolutely fraught with serious problems ... and this simply cannot continue," he said.

"Doctors cannot be asked to abandon either their ethics or abandon their patients. It's simply a choice they are having to face and they are caught in the middle."

Some doctors at the hospital have gone back to using a pen and paper to make medication orders. One specialist was disciplined and given a 24-hour suspension for the move, Ruddiman said.

"This is totally unconscionable on behalf of the health authority," he said.

Benefit outweighs risk

Island Health maintains the benefits of using IHealth outweigh any risks to patients, and it still plans to roll out the system at its hospitals and health-care facilities across Vancouver Island.

"I don't agree that there is greater patient risk at all," said Dr. Brendan Carr, Island Health's president and CEO.

"The problems in the system are actually not so much with the system but with our ability to support people in using the tools in their day-to-day practice."

Carr said the majority of physicians at the hospital in Nanaimo are successfully using IHealth and thousands of potential drug interactions have already been flagged by the system.

The health authority also says there have been situations where IHealth has prevented medications from going to the wrong patient. 

Medication orders are being tracked to provide data to address lingering concerns, Carr said, adding the work also continues to address more than 20 recommendations from the external review.

In the meantime, he said the health authority expects all doctors at the hospital to use the system.

But that approach could have a long-term impact on Nanaimo, Ruddiman said, adding that other health authorities have had more success moving to electronic tools.

"How can you possibly recruit new physicians and nurses into a community where the environment is not being characterized as being healthy and a responsive and happy place to work?"