Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, June 23, 2021

It Looks Like There Are Problems With A Telstra Health EHR Implementation In The Deep North!

The first inklings of ‘trouble at mill’ appeared mid-last week:

Doctors refusing to use $35m electronic medical record system because of ‘safety risks’

Matthew Newton, The Cairns Post

June 16, 2021 5:00am

A NEW $35m electronic record system intended to make life easier for health workers in rural and remote sites across Far North Queensland is so bad that some clinicians are refusing to use it.

The intention of the RIVeR program was to create a single electronic patient medical record system accessible in 58 primary, community and hospital settings from the Torres Strait to the Cassowary Coast. (Regional Information via Electronic Records (RIVeR).

Now eight months into the rollout across 28 sites, Together Queensland senior vice president Dr Sandy Donald said some doctors had stopped using RIVeR because it created “substantial safety risks”.

Both the Queensland Nurses and Midwives Union and the Together Queensland union have written to Queensland Health outlining their concerns with the program, which took five years to develop.

Dr Donald said there had been “lots of reassurances” about how good RIVeR would be.

But those assurances do not appear to have translated into reality.

“It turns out that it’s intrusive … it slows the doctors down enormously,” he said.

“There have been problems with prescribing, which involves in particular whether prescriptions are accurately filled and whether everyone knows what prescriptions have been written.

“With test results, there have been major problems with the person who ordered the test not seeing the result.

“And then there is what is essentially, what the members say is that there is often an incomplete or inadequate record.”

Dr Donald said the Together Union had invited clinicians who were affected by the rollout to put their name to an open letter saying “we would like (a program) that actually works, works well, and improves the care of patients”.

“Cape York is one of those areas where we’ve got remote, vulnerable populations and we desperately need the clinicians who are there to stay,” Dr Donald said.

“And we don’t need something that makes their life more difficult or intrudes on their service delivery.”

QNMU Cairns Acting Organiser David Beckham said the QNMU had written to the Torres and Cape Hospital and Health Service outlining their concerns about the program and requesting the system be “paused” while their concerns are addressed.

Mr Beckham said the QNMU had received a response from the TCHHS detailing their plan to address issues linked to RIVeR.

But he said the union was worried about reports doctors were no longer using the system due to safety concerns.

“This action has led to multiple patient records being used. The use of multiple records increases concerns for patient safety and significantly increased nurse workloads,” Mr Beckham said.

“The QNMU maintains the system should be paused until all issues are addressed. We also want to see all staff using a uniform alternative system while this occurring.”

The development of RIVeR was a five-year, federally funded joint initiative of the Cairns and Hinterland Hospital and Health Service and the TCHHS.

TCHHS chief executive Beverley Hamerton said the health service was confident RIVeR was fit for purpose as a multidisciplinary primary health care record system.

More here:

https://www.cairnspost.com.au/news/cairns/doctors-refusing-to-use-35m-electronic-medical-record-system-because-of-safety-risks/news-story/546c116c72d3dd3cfc10bd3d8577395b

This article was followed by a second two days later:

FNQ doc says they are resigning over rollout of $35m eHealth medical record project

Matthew Newton, The Cairns Post

June 18, 2021 5:00am

A FAR North doctor with 10 years under their belt at a health care clinic said they were resigning because of the “distressing” impact of a new Queensland Health electronic medical record that cost $35m.

The Cairns Post has obtained a copy of an internal Queensland Health survey of 27 medical officers using RIVeR, the multimillion-dollar taxpayer-funded program designed to provide a single electronic medical record across primary, community and hospital health care settings from the Torres Strait to the Cassowary Coast.

Responses to all questions in the April survey included more than 20 comments voicing concerns regarding “patient harm, and clinical/medico-legal risk”.

The program, which took five years to develop, has been slammed by the Together Union and the Queensland Nurses and Midwives Union.

Union officials have written to Queensland Health outlining their concerns.

Torres and Cape Hospital and Health Service chief executive Beverley Hamerton on Wednesday said the health service was confident RIVeR was fit for purpose as a multidisciplinary primary health care record system.

She said patient safety was not being compromised by the implementation of the new system, and that it was typical during the introduction of new IT systems for there to be a “bedding down” process.

But people on the ground are extremely unhappy, according to the survey.

“I cannot continue to work at the (Primary Health Care Clinic) I have been at for 10 years,” wrote one doctor, responding to a question about the overall impact of RIVeR.

“I am finishing there because of RIVeR and ONLY because of RIVeR. I have found the whole experience very distressing.

“We have waited for three years for a promised (electronic medical record), we looked forward to it, we engaged with enthusiasm and optimism – very disappointed.”

The doctor also took aim at the memo which was posted on the wall of their clinic advising staff not to discuss frustrations related to the program with patients.

“I don’t have words for it – but I find it Orwellian,” they said.

The survey also revealed no doctors believed there had been an increase in efficiency as a result of RIVeR’s introduction, 15 per cent thought there had been “no change”, 18.5 per cent believed it was “slightly worse” and 66.6 per cent believed it was “much worse”.

More here:

https://www.cairnspost.com.au/news/cairns/fnq-doc-says-they-are-resigning-over-rollout-of-35m-ehealth-medical-record-project/news-story/28d74a4aab59b052bd7c770254ee63dd

There is also coverage here:

https://www.pulseitmagazine.com.au/australian-ehealth/6112-clinicians-health-unions-call-for-river-fix-in-far-north-queensland

I have to say it is hard to tell just where the problem(s) and issues lie but it seems a little odd that various unions are involved given they are hardly the intended system users. It does sound pretty serious as people seem to be resigning etc.

The project seems to have been going for a long time and I wonder if part of the problem is scope creep or similar – as it sounds like this is a development not installing purchased software project.

The complaints we are seeing are pretty typical for most IT implementations I have to say.

Does anyone closer to the action know what is actually going on?

David.

3 comments:

Anonymous said...

Oh dear:

Dr Donald said there had been "lots of reassurances" about how good RIVeR would be.

But those assurances do not appear to have translated into reality.

"It turns out that it’s intrusive … it slows the doctors down enormously," he said.

It all sounds so familiar.

And we've got the ACT's system due later this year.

Anonymous said...

I have seen no media coverage indicating that this is a Telstra Health EMR Project although I accept your assertion that it is.

Anonymous said...

Check out the Pulse+IT link:

Clinicians, health unions call for RIVeR fix in Far North Queensland

RIVeR, which is part of the $35 million Regional eHealth Project (ReHP) first funded in 2012, is a shared electronic health record based on Telstra Health’s Communicare primary and community care software and has been rolled out to 28 rural and remote sites in the Cairns and Hinterland Hospital and Health Service (CHHHS) and Torres and Cape HHS (TCHHS) catchments.