Island Health has paid “shadow” doctors $1,850 a day to cover for those at Nanaimo Regional General Hospital who refused to use an electronic health records system that they said put patients at risk, the Times Colonist has learned.
A May 4 letter advertising the position to internal medicine doctors on Vancouver Island and the Lower Mainland said doctors would receive the fee for being available — plus travel, accommodation and meal allowances and more money if they were called into action.
“As you might be aware, a cadre of General Internal Medicine physicians in Nanaimo has declared an intention not to use the [order-entry] component of the electronic health record, in contravention of Island Health policy. This is a letter to appeal to you for urgent coverage,” the letter said.
“The ‘shadow’ role is merely one of presence, without the need for patient services, and would be paid at a rate of $1,850.00 per day plus travel, accommodation and meal allowance.”
If called into action, a doctor would be paid a standard fee-for-service, in addition to the shadow-role amount.
Island Health has paid a total of $57,350 for 31 days of coverage at the $1,850 daily rate, the health authority told the Times Colonist Tuesday.
To date, $3,800 has been paid in travel, accommodation and meal costs. There is about $1,000 in outstanding travel costs the health authority has not yet been invoiced for, Island Health estimated.
The fees for service are billed through the provincial Medical Services Plan, not Island Health.
IHealth electronic records system launched in March 2016 at Nanaimo Regional General Hospital, Dufferin Place residential care centre in Nanaimo and Oceanside Health Centre in Parksville.
The system was scheduled to roll out to other Island health facilities this year, including in Greater Victoria, but was delayed after some doctors said its “order entry” component caused dangerous dosage errors and took time away from patient care.
Some refused to use it, reverting to handwritten orders for medication and lab tests.
The $174-million IHealth system started with a $50-million deal for software and professional services signed in 2013 with Cerner Corp., an American health information technology company.
In Nanaimo, the shadow-doctor costs have been covered through Island Health’s approved budget, separate from its Cerner contract, according to Island Health.
“The purpose of the additional physicians was to provide additional support and education to physicians to ensure high quality, safe patient care and to fill gaps in the internal medicine physician on-call schedule,” spokeswoman Val Wilson said in an email.
“Island Health will continue to recruit additional physicians to assist with [order-entry] education and support as needed.”
This month, Health Minister Adrian Dix said he has ordered professional-services firm Ernst & Young to conduct an independent review of IHealth this fall and make recommendations. It will assess the system’s challenges, financial status and plans for improvement, and identify whether it’s likely to achieve intended benefits.
By July, $72 million of the province’s $100-million budget for the project had already been spent, according to the provincial budget update.
The project completion date has been extended to 2020 from 2017.
“We’ve spent a significant amount of money and we’re just in Nanaimo,” Dix said when announcing the review. “That’s one question I want to see answered: Where do we stand and how much will it cost to achieve what we need to achieve here?”
IHealth will remain in use during the review.
