The Cochrane Report

The Cochrane Report

The report recommends a way forward from the current position. This includes the rapid assessment of the functional requirements of delivering care, and the reaffirmation or refinement of these needs in an expeditious manner. —Dr. Doug Cochrane

Message from our Board Chair

On behalf of the Island Health Board of Directors, I am pleased to accept the report and recommendations completed by Dr. Doug Cochrane on the early functioning of our IHealth system implementation.

The Board’s plan now is to work through the recommendations with physicians, clinical teams and Island Health leaders and chart our course forward.

The work that has been done to prepare Island Health to implement an electronic health record including a cross continuum of clinical systems is ground breaking and will change the way care is delivered on Vancouver Island, in the Province and potentially across the country. This work has been hard and I applaud our clinical teams, physicians, front line staff and leaders for your efforts to navigate our organization through this important work.

As noted by Island Heath President and CEO Dr. Brendan Carr in his message to employees and our physician partners, the report contains 26 recommendations all of which will help us refine our processes and continue on our journey to provide our patients with the highest level of safe, quality care.

I would like to thank Health Minister Terry Lake and our colleagues at the Ministry of Health for their ongoing support since we began the IHealth journey. I would also like to acknowledge and thank Dr. Doug Cochrane for leading the review and making recommendations that will allow us to implement one of the safest, most efficient and integrated health and care systems in the country.

Thank you to each and every one of our staff and physician colleagues for continuing to maintain high quality service, support and care in all communities across Island Health while this transformation has been ongoing, particularly those working in Nanaimo.

Thank you
Don Hubbard
Board Chair Island Health

Expression of Interest

This invitation is being sent on behalf of the Revalidation Oversight Committee Chairs:
Dr. Lynn Stevenson, Associate Deputy Minister, Ministry of Health and
Dr. Dorothy (Sam) Williams, Island Health’s Health Authority Medical Advisory Committee Chair

We are inviting Expressions of Interest from staff and physicians at NRGH, OHC and Dufferin to participate in the Revalidation Oversight Process. Please indicate your interest in participating by completing the Expression of Interest – Revalidation form and submitting it by February 7, 2017.

If you have any questions, please contact:

Nurses, Clinicians, and Allied Health:

Physicians & Ordering Providers

Frequently Asked Questions

What is IHealth?

IHealth is a transformative approach to health and care within Island Health and our community. IHealth is a quality initiative at that will:

  • support quality, safe patient care
  • harmonize and coordinate care across sites and systems
  • help decrease the risk of medication-related errors

IHealth is anchored on an electronic record that will integrate a patient’s health and care information in one record and plan of care.

Are we modelling IHealth and the EHR after other health authorities or healthcare systems? Has it been tried anywhere else?

We are definitely not the first site to do this, including not the first in Canada. EHRs have been used for decades in other settings. North York, Mt Sinai, PEI and London Health Sciences already moved in this direction, primarily in acute and ambulatory clinic spaces. However, in Island Health we are not just looking at individual sites; we are looking at how to use a single, integrated EHR to provide care across all areas where residents of Island Health access the health care system.

Why was the system reviewed?

It is not uncommon for large projects to undergo early review to gather feedback and identify areas that might need to be modified.

Who conducted the review and wrote the report?

Dr. Doug Cochrane, Chair & Provincial Patient Safety & Quality Officer.

Who was interviewed for the review?
  • Physicians
  • Front Line Staff
  • IHealth leaders
  • Users of the system
  • Executive Leadership
Were doctors and other clinical staff consulted before IHealth was implemented?

Yes, they were consulted throughout the development of IHealth.

Was implementation of IHealth slowed while the review was underway?
  • We continued to move forward during the review to refine workflows.
  • We have been continually working with physicians and staff on implementation.
  • We want to ensure the IHealth system is fully stable in Nanaimo before we implement in other areas.
What did the review find?

The report makes 26 recommendations in the areas of improved safety, efficiency and future implementation to support IHealth’s advancement.

The recommendations include the establishment of an Oversight Committee co-chaired by the Ministry of Health and Island Health, with local medical staff representatives. The role of the committee will be to oversee the two recommendations that speak to the validation of the order entry and clinical documentation functions of IHealth and promote a collaborative way forward.

Has NRGH leadership reviewed the report and recommendations?
  • NRGH site leadership is now reviewing the report and recommendations.
  • The IHealth and NRGH leadership teams will be meeting with staff groups to discuss the report in the days ahead.
  • The report is available to all Island Health staff and the public on our public website.
Have physicians seen the report?
  • Medical staff have access to the report on the website and it is our understanding the report was shared with the medical staff association leadership.
  • We thank our physicians for their input into this review process.
Is Island Health accepting of the report and its recommendations?
  • Yes, we are fully supportive of the report and recommendations.
  • Many of the recommendations identify work that is already underway.
  • We are looking forward to working with our physician colleagues, clinical teams and IHealth leadership to move forward.
Is Island Health confident in the use of IHealth?
  • Yes. We will continue moving forward with IHealth implementation and stabilization.
  • Patients can be assured that they will continue to receive safe, quality care at NRGH, Dufferin Place and OHC.
What are next steps?
  • Island Health will thoroughly review the report and recommendations with our physician partners and clinical teams.
  • No significant modifications to the order entry and clinical documentation functions will be made until the validation process is completed. This work will be completed as quickly as possible.
Will use of the system be paused?

No. The report affirms that we should continue to use the system while reviewing and validating workflows and making refinements to fully integrate IHealth with clinical care processes.

Which recommendations are the priorities, and what is the timeline to implement priority recommendations?
  • Our first step will be to collaborate with our NRGH clinical and medical teams to review and prioritize the recommendations.
  • Our goal is to implement the recommendations as quickly as possible.
Will the ICU and ED immediately fully implement the use of IHealth?

We will be working with specific clinical teams to determine how best to continue to move forward in specific areas.

What additional costs will be incurred to implement the report?
  • We have not had an opportunity to fully analyze the report or determine cost implementations.
  • The most significant cost will be additional training costs.
  • Additional costs are always built into large projects like this in anticipation that modifications will have to be made along the way.
How will the review and its recommendations be used for future site implementation?
  • Our learning in Nanaimo, including the work of the Oversight Committee on order entry and clinical documentation functions, will inform how we implement IHealth at other sites.
  • We will not implement IHealth at other acute care locations until it has been fully stabilized in Nanaimo – this has always been our plan.

Backgrounder on IHealth

Click image to enlarge.