Santé Québec is preparing for the first large-scale test of the digital health records (DSN) following a launch weekend in the two CIUSSS—Mauricie-Centre-du-Québec and Nord-de-l’île-de-Montréal—which are serving as pilot sites for the implementation of this major transformation of health-care practices.
Those responsible for the rollout received 2,168 “tickets” over the weekend—that is, reports of all kinds of issues—but the overwhelming majority of these were requests for support and information related to the new system.
The most significant problem encountered—and one that remains to be resolved—is latency, meaning when the system becomes overloaded and stops functioning for certain operations. This issue led officials to increase bandwidth capacity from 2 gigabits to 10 gigabits, but the problem was still occurring intermittently as of Monday morning.
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However, the entire system was paralyzed for about two hours on Monday morning at the CIUSSS Mauricie-Centre-du-Québec due to “an issue with network equipment,” Santé Québec explained in a statement to La Presse Canadienne. “Since 9:25 a.m., no new incidents have been reported regarding this issue, and connections have now been restored,” the statement noted. “A thorough analysis is currently underway to identify the exact cause and implement appropriate corrective measures.”
During Monday’s update, Santé Québec’s vice president of IT, Erika Bially, described the latency issue as a priority and said she expected a busy day. “We have several services that weren’t performed over the weekend, so we’re really seeing a massive influx of employees today and we expect an increase in tickets. (…) We’re going to have more activity, we’re going to have more users, and we’re going to have more clinicians and professionals working across multiple facilities.”
Bially did, however, point out that the Epic Systems provider had warned Santé Québec to expect around 6,000 tickets per day at the start of implementation and that the actual figure of 2,000 was well below what had been feared. It remains to be seen what Monday will bring in terms of service requests.
However, the CEOs of both CIUSSs report that their operations ran smoothly over the weekend; Nathalie Petitclerc, from Mauricie-Centre-du-Québec, even noted a 29 per cent increase in the number of ambulances arriving at the emergency room compared to usual, without this causing any problems.
Santé Québec also said despite higher volume of ER visits on the day of the deployment, the teams in Mauricie “have maintained care and services while appropriating the new tools.”
Among the reported benefits was rapid and comprehensive access to the medical record of a person struggling with mental health issues who was in crisis. “What this means is that the responders were better positioned to manage the risk, knowing the person’s history, and were thus able to better tailor their interventions to that patient’s needs,” said Petitclerc.
Her counterpart from Montreal North, Adélaïde De Melo, reported some difficulties regarding access to the DSN, specifically how to log in. “That remains one of the issues, though it’s being resolved fairly quickly.” She also said she expects a very busy Monday. “Today, there are other new factors, such as the entire outpatient component and the start of elective procedures for the week.”
Santé Québec said that its home care workers on the go also reported improvements in productivity.
“The (mobile-based tool) provides easy access to file notes, which is perfect for teams on the road meeting with users. Visits are therefore faster thanks to this new tool,” the agency said.
While in Montreal for a public health announcement, Health Minister Sonia Bélanger said she was very satisfied after spending the weekend on the ground to see how the rollout was going. She acknowledged, however, that there were still issues to be resolved, but that this was to be expected. “Listen, this is a massive transformation that is currently being implemented with an information system that is truly extremely extensive. We’re not just talking about a system in hospitals, but in long-term care facilities and community health centers as well. I’ve said this a few times: it’s normal that we’ll encounter glitches. Not all of them are computer bugs. Sometimes they’re user errors. Sometimes, yes, they’re technical issues.”
“Regarding latency,” she continued, “the issues that occurred with bandwidth also happened this weekend. They were able to restore service quickly. This morning, it happened for about two hours; I’m told it’s been fixed.”
While the vast majority of messages relate to requests for information, support, and assistance with using the system, it goes without saying that frontline staff—particularly those known as “super-users,” among others—are under heavy strain.
In a press release issued Monday morning, the Fédération interprofessionnelle de la santé du Québec (FIQ) expressed concern about a “significant overload on support teams and super-users,” “connection issues with the Epic Systems,” “glitches with certain devices,” and “a return to paper-based systems in many healthcare settings.”
–This report by La Presse Canadienne was translated by CityNews
