You鈥檙e a Vancouver Islander on holiday in the Interior. A pre-existing medical condition flares up, and you get an ambulance ride to the nearest hospital.
It鈥檚 a life-threatening situation, the emergency staff needs your clinical history fast and you鈥檙e in no state to tell them. What do they do?
Ideally, they contact your hospital back home and ask for your record of treatment 鈥� X-rays, lab tests and so on.
There鈥檚 only one problem. The two hospitals almost certainly use different software to store electronic records, and they can鈥檛 talk to each other.
The problem goes back to the days before health services were regionalized. Well into the 1990s, sa国际传媒 had 700 different agencies delivering medical care. Each facility was free to choose its own software.
Unfortunately, these choices were made without thought for the future. The result was a maze of incompatible systems 鈥� digital silos that made inter-agency communication nearly impossible.
There was a dramatic illustration of the problem in 2011. It was feared a radiologist at Abbotsford Regional Hospital had misinterpreted some medical images. The Fraser Health Authority asked experts in the region to double-check. It turned out there had indeed been mistakes.
But it took months to transmit the images from one site to another, because each used different software. That led to a serious delay in completing the review.
The solution, it would seem, is simple. Get every hospital and general practitioner in the province to install the same software and adopt the same data-coding system.
But simple it is not. Every year, British Columbians on average visit a family physician four to five times, fill 16 prescriptions and have at least one diagnostic test. Across the province, those interactions alone generate about 120 million file entries.
Add records from hospitals, long-term care homes, community-care agencies, etc., and the total soars.
Moreover, some of these file components are huge. Two or three megabytes of computer space are required to store a digital-camera photograph. An MRI image needs at least 1,400 megabytes, and often more.
Then there鈥檚 an additional problem. It will take years to unify record-keeping across the entire health sector. But the computers can鈥檛 be shut off while the work is done. So any changes must be merged, step by step, without blowing up the existing system.
After the medical-imaging debacle in 2011, a temporary fix was adopted. A central depository was set up where each hospital could file laboratory and imaging records. And a translation system was built in that converted the data to a common format.
Now, if you have a life-threatening event far from home, the emergency staff will have access to some of your treatment records. But while that was an important step forward, it left a lot undone.
A significant chunk of patient files, in hospitals, some GP offices and walk-in clinics, exist only on paper. Doctors鈥� orders, nurses鈥� observations, patient requests, dietary needs, etc., might not be part of the electronic record.
And here things get really expensive. Vancouver Island鈥檚 health authority is spending $100 million to computerize all of these handwritten files. The goal is to have a completely paperless system, on uniform software, across the Island.
Nanaimo Regional General hospital will roll out the first phase of the new system later this year.
That鈥檚 a huge bill for correcting the shortcomings of earlier decades. And we鈥檙e talking only Vancouver Island. The price tag for a provincewide conversion is more than $1 billion.
Yet modern medicine is increasingly complex. If that鈥檚 what it takes to keep up, there鈥檚 really no choice. The longer we wait, the higher the cost.
