A computer pilot project implemented at the CIUSSS de l’Estrie-CHUS has been the source of many errors that have compromised the health of hundreds of patients in Estrie for two years.
In a letter sent to the College of Physicians of Quebec (CMQ) on March 17, of which VAT News obtained a copy, a dozen radiologists are asking the CMQ for “ethical support that could help resolve the issues of a dangerous informational practice at the CIUSSS-CHUS”.
This is the final step before filing a formal complaint against the CIUSSS.
It all stems from a pilot project developed by the Ministry of Health and Social Services (MSSS) called “Centers for the distribution of requests for medical imaging services (CRDSi)”.
This project was designed with the aim of computerizing, harmonizing and centralizing requests for medical imaging services within the same health establishment, in order to replace paperwork and faxes.
It is with this in mind that in the spring of 2020, in the midst of the COVID-19 pandemic, the CIUSSS de l’Estrie-CHUS agreed to join the pilot project.
A few months later, in September, the general practitioners and specialists of the CIUSSS began to electronically send requests for magnetic resonance examinations, computed tomography, general ultrasound and breast ultrasound via the standardized form developed by the MSSS. .
This is where the problems started according to radiologists to whom VAT News spoke and who wish to remain anonymous for fear of reprisals.
First, these requests must be transmitted electronically to the ARIANE computerized clinical record (DCI), a DOS system favored by the CIUSSS for decades, which is described as obsolete by most of the employees with whom we spoke.
They explain the difficulty they have in understanding what the doctor who sends the request is looking for, since the pre-programmed choices in the form are often not the right ones or are downright incomplete.
Also, since boxes must be checked for the document to be sent, this generates errors and causes clinical information essential to the correct diagnosis to be lost.
However, when a doctor prescribes a medical imaging examination, he is seeking to confirm a diagnosis. It must therefore be as precise as possible if he wants the radiologist who interprets it to confirm or invalidate it. The form therefore becomes an essential communication tool.
“There are hundreds of patients who have received far more radiation than they should have received. All this because of false indications included in boxes that the doctor had to tick if he wanted to send his request, ”argued a radiologist.
Exasperated by these problems, a radiologist sounded the alarm four months after the implementation of the pilot project.
In an e-mail sent to the head of radiology, a copy of which we obtained, he asked that the project be interrupted, the time needed to ensure that the correct information could be entered in the form.
“This morning alone, I found myself interpreting two cases from home, with no clinical information in the Picture Archiving and Transmission System (PACS). One of these two cases was miscoded […]. The patient will have to come back for a new MRI on the 3T machine. The other (patient) has no information in the PACS. And I think that’s just the beginning.”
While the waiting list for a medical imaging exam is full, it is difficult to say how many patients have had to repeat their exam since the start of the pilot project.
Despite numerous complaints from radiologists and their repeated requests to end the pilot project, the management of the CIUSSS and the MSSS decided to continue it.
Another error occurred, this time with a teenager. The region of the body to be examined by the radiologist was the wrong one, because no box was provided for this examination in the said form.
The young patient had to repeat the examination, which led to a treatment delay of 10 days when his condition required him to be treated in less than 24 hours. He now lives with a high risk of medium and long-term complications.
After this event, last May, radiologists from the radiology department of the CHUS and the CSSS Memphrémagog reiterated their concerns in a letter addressed to the President and CEO of the CIUSSS, Stéphane Tremblay, and to the establishment’s board of directors.
They received an acknowledgment of receipt in response.
The CIUSSS de l’Estrie-CHUS declined a request for an interview with VAT News.
Reference-www.journaldemontreal.com