Electronic health records
eHealth mismanaged in Prince Edward
– Yet another province has delivered disappointing results when it comes
to eHealth. This time, it’s in the province of Prince Edward Island,
where Auditor General Colin Younker (pictured) found the government’s efforts to
create an integrated network were poorly managed. As a result, there
have been delays and cost overruns, with a system that’s still
The auditor general’s critique was part of his annual report, delivered
in April, with 23 pages given over to an analysis of the provincial
In PEI, the provincial government expected costs of $12 million to
create an integrated network. That was supposed to be fully funded by
the federal government and other sources.
But two years later, the costs had more than doubled to $27 million,
with P.E.I. taxpayers being on the hook for $12 million.
Costs have since ballooned to more than $33 million, with taxpayers
having to dish out $15.6 million.
Meanwhile, the program is still not fully operational, and the province
is expected to spend another $6 million over the next five years on
capital costs associated with electronic health records.
“I don’t think we could use the word scandal,” Younker told reporters
following the release of the report. “There were problems with planning,
governance, oversight and project management especially between 2005 and
Most analysts agree that integrated, electronic healthcare systems will
lead to faster, more accurate decision-making for clinicians. The
problem has been one of translating theory into practice, and building
networks that work with the needed interoperability – on budget and on
Younker was highly critical of how the Department of Health managed the
rollout of electronic health records in Prince Edward Island. In his
report, Younker writes: “... the Department of Health did not provide
adequate oversight for the EHR initiative.”
A steering committee had been established that reported to the deputy
minister of health. But Younker says progress reports were not prepared
on the overall project.
In the spring of 2007, Younker said it was clear there were problems
with costs and timelines and the provincial cabinet demanded biweekly
However, these updates did not include financial comparisons of actual
costs to the budget. Moreover, the Department of Health handed out
contracts for professional service without going out to a competitive
bid, something that is required for contracts over $100,000.
In one instance, payments were made to a contractor but the Department
of Health could not provide any contract.
Younker points part of the blame at the constant restructuring at the
Department of Health. The implementation was delayed because of an
“absence of senior management during the critical start-up phase” when
all the regional health authorities were disbanded.
More delays occurred after the information technology section of the
Department of Health was eliminated.
In 2008 the province was notified that the operating platform used for
the clinical information system was not going to be supported after
2012. Consequently, the province will have to invest $15 million over
the next 10 years to migrate the system to a new operating platform.
The auditor general is calling on the province to publicly report
information on the progress achieved in implementing the rest of the
program, including a comparison of the actual and expected costs. He’s
also calling for strengthening of the project’s oversight.
Younker also wants a competitive process to be used prior to the
awarding of contracts. The province didn’t only underestimate the
capital costs associated with electronic health records it also
underestimated the ongoing costs.
The province had anticipated annual operational costs of $3 million with
about 24 people supporting the program.
Two years later those costs had increased to $4.7 million with 53 people
supporting the program. Those ongoing costs are now expected to hit $6
Posted May 6, 2010