'Difficult situation': Royal Columbian Hospital ejecting patients ahead of tech upgrade

One of the largest hospitals in the Fraser Health authority has begun sending home patients and will soon turn away non-urgent patients transported by ambulance as it prepares for a challenging technology upgrade.

In an internal memo dated Aug. 22 and obtained by CTV News, the Vice President, Regional Hospital and Health Services told emergency department employees that the upgrade to Meditech Expanse from the current paper-based system requires “collective effort and support” across the region, as well as fewer patients at Royal Columbian Hospital.

“Decanting will begin Aug. 24, 2024, and continue to approximately Sept. 21, 2024,” wrote Laurie Leith, using a government euphemism for ejecting patients from hospital. “This decanting process is crucial, as it will provide RCH staff and medical staff a necessary reduction in capacity to support adapting to the new MediTech Expanse system and workflows.”

In addition, some stroke and cardiac patients will be taken to hospitals in the Vancouver Coastal Health region, while ambulances with non-urgent patients will see “formal diversion during go live Sept. 5-9th,” including for medevac patients who will be sent to Vancouver General Hospital.

The upgrade to fully digital health records was supposed to happen in April, but sources tell CTV News several doctors and nurses raised safety concerns, insisting patient care would be compromised by a rushed rollout. The new launch date is Sept. 7 at 5 a.m.

“We're caught in this weird space where we recognize that electronic health records are important for the future of the health-care system, but this rollout is coming at a very difficult time for the healthcare system,” said Dr. Ahmer Karimuddin, president of the Doctors of BC, referencing emergency department service disruptions in Fraser Health. “We're going to have some degree of slowdown no matter what we do.” 

Rough transition in B.C. hospitals

Last year, both Vancouver Coastal Health and Fraser Health acknowledged challenges upgrading from old paper-computer-hybrid systems to fully digital systems; adding to the complexity, both health authorities used different software platforms that require a third program to share information between them.

CTV News has heard from multiple frontline sources, who spoke on the condition of anonymity, that they are deeply frustrated that patients going between health authorities cannot easily have their records accessed by their health-care providers, and that the new systems are “administrative nightmares.”

They say the forms are too long and complicated in most cases and have them spending far more time on clerical tasks of limited value, compared to face-to-face time with patients.

Eagle Ridge Hospital was the first Fraser Health facility to upgrade and for months, they saw roughly 30 per cent fewer patients because doctors were so bogged down by additional paperwork, while waits grew longer for those in hospital.

Fraser Health responds

CTV News asked the health authority for a senior official to address the ejection of patients and scaling back of services as the transition begins at the end of next week, but they claimed no one was available to speak to the matter.

“We appreciate feedback being provided by staff as Fraser Health modernizes our health system and moves away from paper-based patient recordkeeping toward electronic health records,” wrote a spokesperson. “Any patient presenting to the hospital will receive the care they need.” 

Karimuddin urged Fraser Health to improve communication with the public and frontline care providers, who are feeling considerable angst about unanswered questions, particularly around contingency plans.

“Patients are going to be in a difficult situation, the physicians are going to be feeling stressed. So, in that context we need transparency,” he said. “We need adequate resources and we need some degree of transition planning, which we're not seeing.”