On June 1 St. Francis Memorial Hospital (SFMH) went live with its new health information system (“EPIC”). Click HERE for more information. However, according to local doctor Ray Dawes, it has not gone according to plan and he has gone public with his concerns.
The June 26 issue of the Valley Gazette contained a strongly worded letter by Dr. Dawes complaining that the “system has not gone smoothly either here in Barry’s Bay or any of the five hospitals in Eastern Ontario that are using it.” This he says has caused him to advise his patients that if they have to go to the ER at SFMH “find out what the wait time is and consider whether a trip to another hospital in Pembroke or Bancroft which is not using this new system would be sensible.” Although noting that “the jury is out as to whether this change will turn out to be a benefit or a mistake,” he concluded his letter by noting that “a new small hospital could have been built with the money spent on it” and then issuing a stark warning by saying “much more could be written about other concerns such as the loss of experienced staff, the possibility of privacy breaches, and computer hacking with demands for ransom payments.”
The Current reached out to the CEO of SFMH, Randy Penney, as well as Dr. Jack Kitts, President and CEO at The Ottawa Hospital, for a response to Dr. Dawes’ criticisms. Penney told The Current that Dr. Dawes “is entitled to his opinion.” He went on to congratulate the staff, physicians and Board for the work that they have completed implementing the new electronic health record. “This has been a major undertaking and has demonstrated once again that our small, rural hospital can partner with world class organizations like The Ottawa Hospital and the Ottawa Heart Institute.” He shared with The Current what he said was one of the many positive stories that have been told since EPIC started on June 1. This involved a local retired RN whose husband is in the cancer program and who has been trying for years to gain access to his treatment plans, his health vitals and to be an active participant in the care that he has and will be receiving. Requests in the past were met with no success. Now, with EPIC, he has MyChart and he and his wife have instant access to his health record. “This is the future of healthcare.” Penney points out that across the sites implementing EPIC, 18,400 patients have now signed up for MyChart in just three weeks.
The Ottawa Hospital replied saying:
“Digital health information systems are foundational to 21st-century health care. However, getting there is difficult as it requires our health-care professionals to adapt to a new digital system that standardizes how we care for our patients. We knew from those who have gone before us that the transition would be difficult. We also knew that once we adapted: our patients would become active partners in their care, because they have immediate access to their own health record; health-care professionals will provide safer care with better health outcomes, because they have immediate access to vital health information; and we will create better health-care systems, because decisions will be informed by better data, leading to greater accountability. Because of digital technology, our hospitals will provide safer, more effective care for our patients.”
The Current also reached out to Dr. Dawes requesting further comment including whether he had discussed his concerns with SFMH management before going public but at the time of publication had not received a response.
Shown at top: Kim Stewart, Megan Mask, Jose Pinto and Shayna Perry demonstrate some of the equipment that replaced paper charts on June 1st to allow for improved coordination of care across multiple sites. (Photo Pappin Communications)
As a patient using the Ottawa Hospital system since 2017… I can attest that the old “MyChart” system was concise, easy to use and very user friendly. The new Epic system is difficult to manoeuvre and information is never timely. It seems more effective with appointment reminders than posting important pathology and clinical reports (all of which are simply emailed vs posted on the app!?) From a medical staff position… input is typically a drop-down menu on-screen form that is time consuming and limits the ability to add specific /individual comments. The potential universality of the system may be impressive but what’s the point if the content is mediocre and inputting takes too much valuable time away from hands-on patient care.
Regarding my recent editorial about the new computerized charting system at SFMH and the resonse to it.
I would like to point out that unlike the letter writers who responded to my article, I am in a position to actually see real people in my office who have been through a very difficult time in the ER. I see the people who left the ER because, ironically, they felt too sick to wait any longer. I also am privileged to be able to talk off the record with other doctors and hospital staff, and so, feel that I have a very good understanding of the situation.
Some of the people responding to my editorial feel that the benefits of the program outweight the dangers – and perhaps they are right.
This is a classical and never-ending debate – What is a reasonable price for progress?
At the very least, those in control must find a way to mitigate the effect on fragile patients during the initial stages and there are now signs of this happening. During this past weekend, when the ER was overflowing, Dr Atfield who was the back up ER physician came in and a good spent part of the holiday weekend helping out. I have also suggested the establishment of a walk-in type clinic to handle the less serious problems, but financial and staffing concerns have made this difficult.
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I fully realize that digitalization of health care is inevitable and am quite familiar with this as I have learned and used two different electronic record systems in my office. I support the overall process.
But the fact remains – the role out of this complex system – designed for large American hospitals,- has not gone well.
What is a reasonable wait time to be seen (not just waiting for results) for a rural emergency department? Is it 2 hours, 5 hours, or 10 hours? And please remember that these are not healthy people for the most part – many are elderly and all are unwell in some form or another.
What is a reasonable price to pay for this, particularly in an era of huge government deficits? Could that money have been better spent on research, capital upgrades for hospitals and nursing homes, or other forms of clinical care?. There is no definitive research showing a savings to the health care system nor confirming an overall improvement in health care from this system. For every benefit there is a disadvantage – in our case the main one being inefficiency and slowing down of an already overwhelmed (in the summer months) emerg deparatment, not to mention the incredible stress placed on staff.
One writer smugly suggested that I get “out of the kitchen”. In fact one of the main problems of Epic, not just here but elsewhere is the decision by many senior staff to do just that. Any successful team must have a combination of experience and young energy, and we have lost a great deal of experience. At least two if not more of our reliable ER doctors have also decided to work elsewhere to avoid the extensive training and hassle of the new system. New doctors coming in will take time to learn the system, assuming we can find new doctors. For myself, I am not directly affected since I gave up my ER work several years ago due to semi-retirement..
I am certain that things will improve as time goes by, but I am also certain that this will be a slow process and many problems remain to be solved. I am not convinced that there will ever be a savings in time or efficiency due to the complexity of the system.
Computerization also brings more risks in the forms of computer hacking, privacy concerns, and ransomwear – all of which have happened in very serious ways in the US, Britain and Canada.
But my biggest concern at present continues to be our patients and how they being treated in our ER.
Dr Ray Dawes, Rural Family Physician
I commend SFMH for being proactive and part of the new digital health information system. I see all sorts of advantages, and also concerns. We live in a world of progressive innovative technology, whether it be hybrid cars, genomics, or smartphones. Do we forge ahead or get left behind? We know no system is infallible and glitches along the way is part of rolling out a new system. I sincerely hope the software does not work against our small community financially and I hope the benefits to patient care are notable. It is very disheartening to think that patient care could be directly affected by the time used for data entry, although I remember spending hours documenting that was repetitive and unnecessary but part of protocol at the time during my years of nursing. I think the question needs to be asked: Are health professionals providing care better or less after the investment? I also think we need to remember anyone speaking out with concerns from a health professional view speaks out in advocacy for the patient/client they provide care for.
We all have heard of tests and lab results being lost. I believe the system will allow for health professionals to be more accountable to patients. It allows patients to take more responsibility for their personal health care and have access to it. Information can be passed along between SFMH and tertiary hospitals in emergency situations quicker and with easier access. It leaves very little room for miscommunication between health professionals. I, for one am grateful for the epic, my chart.
How can you condemn a system before it has barely had time to get up and become operational. I have had a wonderful experience with “My Chart“ as I am a patient at the Ottawa Hospital. I was excited when I saw that SFMH would be switching to this system and that all my information would now be available to my Dr.at Saint Francis. This is an updated version of the one I had before. Believe me it is amazing. The change over to the new system was so easy and I am happy that everything will now be linked together, as it should be.
I do not understand Dr Dawes going public on this in such a negative way before the system has even had a chance to prove itself. Times change and progress sometimes has its challenges but this system is great. Let’s keep moving forward. Thank you to everyone who worked so hard to make this system a reality and please be patient while the inevitable glitches are worked out.
Thanks Mark, for sharing your first hand experience with this new system. I agree with your comments – the transition period for a complicated change such as this one is always painful and often slows things down initially, but that doesn’t mean it shouldn’t happen, and we need to give it time for everyone to get over the hump before slamming it.
There’s too many benefits to this new system to not get on board with it. From the accounts I’ve heard from you and other patients who have had experience with it, I’m confident that once users get fully familiar with the processes around this new system, the benefits will be clear. We all tend to hate change, but most times it brings benefits – change is good, embrace the change!
The Ottawa hospital has been using My Chart for quite some time now. Last year when I was being treated for cancer all of my reports, test results including PET scan were available to me through My Chart quicker than my Doctor received them. I was able to print out different reports and give them to him for my file here. Any treatment I have had at the Ottawa Hospital is available to me through this system. People will learn to appreciate this new system with time. I was quite surprised by Dr. Dawes negativity.
I have had 2 negative experience with the new system, both involved specialist appointments in Renfrew. In two instances the system changed my appointment and I was not informed. I just wonder how many glitches will happen. I bet the Ottawa Hospitals are struggling under the crush of this transition. I think, as with many technical advances, there are not enough professionals who are actually needing to use the system that are involved in development