‘it’s almost like magic’: quebec health-care professionals sing praises of new digital records system

an administrative task that once took dr. léo jean perrin five minutes now takes him seconds. "it's almost like magic," said perrin, a doctor with the ciusss du nord-de-l’Île-de-montréal. that regional health authority is one of two where quebec's new digital health records system — known as the dossier santé numérique (dsn) — was launched last weekend as a pilot project ahead of a planned provincewide rollout.though the transition from paper to digital records has raised concerns about cost and data privacy, health-care professionals working in the pilot facilities say they can already tell the change will be beneficial in the long term.“i find that it reduces my administrative burden — the time spent charting — so i’m able to be more present at patients’ bedsides," perrin said. "i think it’s really going to help us achieve that goal."

to illustrate his point, perrin used the example of ordering an x-ray — a task that sounds simple in theory, but previously required several steps. just tracking down the patient's chart could take two or three minutes, he explained."sometimes the nursing students have it, sometimes the rehab staff have it," he said. then he had to track down a requisition form, put a label on it, fill it out by hand, hole-punch it ("because they aren't hole-punched," he pointed out), and add it to the chart. "the charts are huge paper files, and the rings are often badly aligned — just flipping through and finding the right spot to insert the paper? i lose another minute there," perrin said. all in all, such a requisition would take perrin about five minutes, he explained. it might not sound like much, but similar administrative tasks "happen constantly throughout the day," he said. "everything that used to be done on paper was long and tedious," perrin said. "now i just click, and it’s done."like any new system, there's a learning curve — steeper for some than for others — and there will be bugs, perrin pointed out. "but once we get used to it, it becomes much faster than it was before," he said. "i can already see how much more efficient i’m becoming day by day." the transition has been a bit more difficult for dr. jean-nicolas dubé, an intensivist and internal medicine physician at the centre hospitalier affilié universitaire régional in trois‑rivières, which is part of the second health authority involved in the pilot project, the ciusss de la mauricie-et-du-centre-du-québec. dubé was on shift in the intensive-care unit when the system went live in the early hours of saturday."i’ll admit, i found it difficult to navigate and orient myself within the system," he said. "but ... by sunday, i could already see a clear improvement." admitting that he was skeptical of the project at first despite months of training ahead of time, he said the practical potential became clear to him quickly. “i see it as a way to better organize ideas, better structure the work, improve communication and patient safety," dubé said.

evan buhler / montreal gazette

nicolas cliquennois, the director of community hospital management for fleury hospital and jean-talon hospital, said it's hard to see what the system won't improve across the health-care network.a nurse by profession, cliquennois highlighted the benefit of the real-time aspect of the dsn. "up until now ... if the doctor took the chart away for an hour to write notes in their office, that meant the rest of the staff had no access to it," he said. "now it’s the opposite. in real time, we immediately see the adjustments the doctor makes, what physiotherapy changes, what occupational therapy changes, and nurses can adapt their own actions, care and services for patients accordingly and in real time. it’s truly an incredible level of real-time access to all the information we need to care for patients."the system also adds a safety net to all aspects of care, said cliquennois, using the example of medicating patients. "nurses already perform checks before administering every medication," he said. "but with the digital system, we can standardize it. before giving a medication, we’ll have to scan the patient’s wristband and scan the medication to make sure it matches the prescription automatically. it doesn’t replace the nurse’s judgment, but it adds another layer of safety for patients. that’s really interesting." dubé made a similar point. despite the fact that doctors do their best not to make mistakes, at the end of the day, they're human. "the system includes safety features that help further reduce medical errors," he said. "for example: a patient may have many health problems, and i may forget that they have a severe penicillin allergy. then i might decide to prescribe penicillin, but the system will immediately alert me that the patient is allergic, and say, ‘do you really want to prescribe this?’" the system also provides support in terms of the organization of workloads and tasks, cliquennois said. asked if health-care workers felt like the transition away from paper records was a long time coming, cliquennois said many were enthusiastic about the shift once the benefits became clear.

evan buhler / montreal gazette

dubé said the only downside he sees is the short-term adjustment period, which he described as much more time-consuming than he was expecting. he used the analogy of a car to illustrate his impression of the transition as someone who has been practising within the old system since 2003. "i’ve always functioned with my old car that goes 70 km/h, that’s a bit rusty, doesn’t have much technology, it runs on gas, and it works fine, it always gets me from point a to point b safely — but slowly," he said. "what i’m being offered now is a sports car that can go 300 km/h, with lots of technology that allows me to see blind spots i couldn’t see before."that requires a significant adaptation period and could explain why there was reticence among some professionals in the beginning, dubé said. "but what i’m seeing on the ground is that people are seeing the potential," he said. "they’ve let go of the less pleasant or negative aspects in order to focus on the positive, because they can clearly see that what we’ve been given is something solid … and something that will do a good job for many years to come.”kthomas@postmedia.com