Representatives from two Quebec health-care unions say community-level medical workers are struggling to adapt to the province’s new digital health record system due to a lack of technical support staff in CLSCs and CHSLDs.
The digital health record network (DSN) officially launched last week in two pilot regions — the CIUSSS du Nord-de-l’Île-de-Montréal and the CIUSSS Mauricie-Centre-du-Québec — as part of Quebec’s broader push to modernize its paper-heavy health-care system.
“We’re sort of, like, building the plane while in flight,” said Teresa Muccari, spokesperson for the Alliance du personnel professionnel et technique de la santé et des services sociaux (APTS) in Montreal’s north-end regional health authority.
“What we’re hearing now in the social services is really a cry for help,” she added.
During an April technical briefing, CIUSSS du Nord-de-l’Île-de-Montréal president Adélaïde de Melo said Santé Québec was following a staffing ratio recommended by software provider Epic systems — roughly one “super-user” for every 10 employees.
Super-users are health-care workers who received advanced training in the DSN and are tasked with helping colleagues navigate the new system during deployment.
But according to union representatives, many community care teams do not have enough of them.
“A lot of the people who started as a super user decided to let go because it was more than what they anticipated,” Muccari said.
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Muccari said that super-users in CLSCs and CHSLDs are overloaded with a high volume of support requests due to the fact the DSN doesn’t account for certain features specific to Quebec’s local front-line care.
“They’re saying, ‘Hey, you know what? The forms that I was using beforehand does not have a good interface with the DSN,’” Muccari explained.
Part of the concern involves the OCCI system — an already digitized platform used to manage assessments and documents related to home care and long-term care services.
“It might mean additional work for the next two years,” said Marc-André Paquette, the union delegate for APTS.
Meanwhile, the Fédération interprofessionnelle de la santé du Québec (FIQ), which represents Quebec’s nurses, says some staff are submitting between 15 and 20 support requests per day.
“We also see in certain activity centres, even in hospitals, that the super-user must take patients in charge,” said Isabelle Roy, the president of FIQ-CIUSSS du Nord-de-l’Île-de-Montréal. “In that moment, obviously, they’re not available to respond to the team.”
Roy said support levels appear to be uneven between hospitals and community-level services.
“In hospital centres, we really feel that there are a lot more super-users,” she said. “On the other hand, in CHSLDs, we have reported that we sometimes have a super-user for all departments in a centre.”
In a statement to CityNews, Santé Québec did not specify how many of its roughly 4,000 support staff were assigned to CLSCs and CHSLDs, but said additional on-site technical support can be requested when needed.
Health facilities are currently reducing non-urgent services to 50 to 75 per cent during the transition period as staff adapt to the new system, with regular activity to gradually come back by May 25.
But unions warn the adjustment period could take longer.
“If we re-establish services too quickly, we may have big bottlenecks in certain services,” Roy explained.
Paquette added, “It will definitely take more than two weeks.”
