Exclusive: Santé Québec will still use paper records as it moves to digital medical files

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Santé Québec’s push toward establishing digital medical records for all Quebecers — to date over budget by $135 million from initial projections — has already been scaled down, as nurses will still have to take down patients’ vital signs on paper rather having the information uploaded into the computer system automatically, The Gazette has learned.

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In August 2023, in what was then hailed as a “major milestone,” former Health Minister Christian Dubé announced that the government had awarded a contract to Epic Systems, based in Wisconsin, to deploy a system of digital health records in two pilot projects. The goal was that within two years, Epic Systems would successfully deploy electronic records in the CIUSSS du Nord-de-l’Île-de-Montréal, overseeing Sacré-Coeur, Jean-Talon and Fleury hospitals; and in the CIUSSS de la Mauricie-et-du-Centre-du-Québec, also in charge of several hospitals.

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More than two years later, however, Santé Québec has postponed the start-up date of the pilot projects until May 9, four months from now. What’s more, the price tag has soared from the original figure of $268 million in 2022 to $402 million today. Of that sum, nearly $280 million has already been spent, according to the latest government tally on its information resources project dashboard.

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Yet despite the significant investment thus far, the pilot projects do not have the budgets to acquire vital-signs monitors that have the capability of uploading patient data — with the exception of those in intensive-care units. The oversight recalls the massive cost overruns in launching the SAAQclic website for vehicle permits.

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“You want to do away with all the paper, right?” a senior government source told The Gazette. “That’s why you’re bringing in electronic health care records. But they didn’t have the budget to buy the monitoring equipment to electronically transmit vital signs information from patients. So nurses are still going to have to walk around with paper recording people’s vital signs, and then manually put them into the system.”

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“It’s completely stupid,” added the source, who agreed to being interviewed on condition of anonymity to discuss the issue candidly. “So that’s just one example of downscoping,” the term used in the information technology industry for projects that are scaled down to cut expenses.

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Establishing provincewide digital health records had bedevilled the Quebec government long before Dubé made his announcement in 2023. More than a decade ago, in November 2014, former Liberal health minister Gaétan Barrette acknowledged that setting up digital health records was “a disaster” even then, with the provincial and federal governments having spent $1.6 billion on the initiative in Quebec since 2001.

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In October, Barrette suggested that Santé Québec had no choice but to delay the two pilot projects because it had not yet tested how various laboratory equipment would interact with Epic’s software.

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In a statement, Santé Québec defended the decision to exclude vital signs monitors from the pilot projects, known in French as Dossier santé numérique (DSN).