Nunavut falling 'behind the times'

Nunavut's health department plans to dump paper health records in favour of electronic health records by 2012.

When the four-year, $14 million move away from paper is completed, Nunavummiut who are medevaced south won't have to travel with their medical records strapped to their chests.

Instead, health staff in Nunavut will be able to send the patients' medical histories down south by e-mail beforehand.

By switching to electronic health records, Nunavut hopes to get rid of mix-ups, poor care and gaps in health records that occur when paper gets lost.

This means there will be fewer of the "horrific examples" cited by Tina Mackinnon, the territory's director of health information, at a meeting of northern public health directors last week in Iqaluit.

Mackinnon told them how one woman recently brought her young child into the Rankin Inlet health centre, where a nurse said the child needed a vaccination and then gave it to the child.

But the child had already been vaccinated in another Kivalliq community. The mix-up occurred because her health records didn't follow her to Rankin Inlet.

"This happened, and it happens on a regular basis," Mackinnon said.

Another example cited by Mackinnon involves a Nunavut man who went south for a magnetic resonance imaging test, which provides a three-dimensional view of the body.

But the man's MRI results only came back to Nunavut after the man died.

These chronic shortfalls in health information and communications means Nunavut health workers can't react quickly to new situations or keep track of their work.

The public health department faces huge challenges in compiling and producing even the most basic reports on most reportable diseases.

To provide "better information, better care," Mackinnon said the goal is to cover 75 of the needs of Nunavut's entire health and social services system by 2012.

That's when a new, integrated electronic health records system will connect health centres in Cambridge Bay, Rankin Inlet and Pangnirtung to a hub in the Qikiqtani General Hospital.

Nearly all community nursing stations will be able to exchange patient information electronically.

Built-in safeguards will protect patient privacy and prevent abuse of the database, which will also allow information about x-rays and laboratory work to be registered within the same system.

Pharmacists will be able check instantly to track prescriptions, avoiding duplication and error.

The system, which will also see medical travel information go electronic, is expected to reduce travel costs by increasing efficiency and cutting duplication.

But the move to electronic health records won't solve every problem.

And it's "not a magic wand," Mackinnon emphasized.

That's because Nunavut still needs more access to costly satellite bandwidth to make the network work.

She said electronic connections to the 11 decentralized communities work well, because they're all linked by the Government of Nunavut's computer network. But the non-decentralized communities are connected by less reliable telecommunications systems.

And high staff turnover in the health department will also make it more difficult to get the system up and running.

About 80 per cent of the setting up the new paperless system will be paid for by the Canada Health Infoway, a federally-funded, independent, not-for-profit organization whose members are the 14 federal, provincial and territorial deputy ministers of health.

The GN and other federal programs will cover the balance of the new system.

The model for electronic health records in Canada is Alberta, which has already spent more than $116 million setting up its Netcare system.

Quebec is already well-advanced in its move to electronic health records. Nunavik's hospitals in Kuujjuaq and Puvirnituq regularly consult with Montreal-based specialists by video-conferencing.

And community health clinics will soon have access to a new electronic health records system, thanks to the increased bandwidth at the Kativik Regional Government's Tamaani internet provider.

Nunavut is "behind the times" and a digital "chasm" separates it from the rest of Canada, Mackinnon told the public health directors from the Northwest Territories, Yukon, Alaska and Nunavik.

"We have to change that and set the bar at an acceptable level," she said.