That’s the conclusion of a new report from Auditor General Kim Adair-MacPherson. She says the business model, which saw the New Brunswick Medical Society go into business with a private sector company to create Velante Inc. and sell the software, was doomed from the start.
“Such a structure was not capable of generating value for taxpayer dollars and was not in the best interests of New Brunswickers,” writes Adair-MacPherson in the audit tabled in the Legislature on Tuesday morning .
Although there were clear signs that the program was failing in 2015, the Department of Health continued to extend physician enrollment times and spend money, until it finally ended. exclusively for Velante in 2019.
“We have not been able to find valid reasons why the Department has continued to spend public funds on an obviously doomed program,” says Adair-MacPherson.
System still not fully integrated
The medical company said in 2019 it would end Velante after the province ended the company’s exclusivity.
The province still has one of the lowest rates of physicians using electronic records and the system is still not fully integrated with the electronic records system used by hospitals and other health care facilities.
The primary goal of the system was to share patient information from physician offices with the largest digital health records system in the province. But only three of the nine planned “integrations” were completed, the audit said.
Plus, says Adair-MacPherson, the same poor monitoring that led to Velante’s problems could create the same problems that doctors are adopting from other electronic recording systems.
The province contracted to provide the medical record program to the medical society in 2012. The company and Accreon created Velante.
The company was funded in part by Canada Health Infoway Inc., a not-for-profit organization created by the federal government to encourage the adoption of electronic medical records.
Its installation costs $ 24,000 per doctor. The doctors had to pay $ 8,000 themselves, with the province paying $ 4,000 of the cost and Infoway covering the rest.
By early 2014, only 240 doctors out of 950 had signed up with Velante and then health minister Ted Flemming said only 34 doctors actually used it.
Some doctors have complained of feeling ostracized by their own organization when it forced them to adopt the tool.
As of September 2014, only 350 doctors were registered and only 90 were using the system. At that point, the federal and provincial governments added more incentives, including grants for physicians to leave the systems they had adopted before Velante was created.
Adair-MacPherson found “significant weaknesses” in the province’s oversight of the program.
“There was no performance measurement or progress report on program implementation,” she writes.
The medical company was required to submit quarterly reports to the health department updating project progress, goals achieved and timelines, “we found no evidence that such reports had been provided to the Department of Health. department. ”
Doctors who stopped using the system did not have to repay their grants, and the province often paid multiple times for the installation of the same system, such as in cases where a doctor stopped using it and handed it over. to another doctor.
Accreon drew $ 9 million from the program before relinquishing its stake in 2015.
Adair-MacPherson says Accreon’s exit was one of many “clear signs the program was in jeopardy.” Others included missed deadlines, concerns about Infoway’s lack of progress and a lack of cash at Velante that forced the medical company to inject an additional $ 1 million.
In 2017, the province agreed to give Velante $ 2.8 million to help it continue to operate while the program was reviewed.
The first payment was $ 1.5 million and Velante was supposed to show the province how it was spent before he could get the remaining $ 1.3 million. But the second payment took place even though the information was never transmitted.
After the province ended Velante’s exclusivity in 2019, it agreed to give the medical company $ 3 million to help doctors adopt other electronic medical record systems.
Of the provinces that have adopted electronic medical records, only Newfoundland and Labrador had a lower rate of physicians using them in 2017. Prince Edward Island does not have a system in place.
New Brunswick’s struggles with electronic health records predate the creation of Velante and the attempt to deploy its software in physician offices.
In 2011, CBC News revealed that an internal audit revealed potential conflicts of interest in the management of contracts awarded for the creation of the electronic health record system for provincial facilities.
He said external consultants hired as project managers could see invoices and other documents from competing companies, giving them an unfair advantage in bidding on additional contracts.
In May 2011, Health Minister Madeleine Dubé said better surveillance had been put in place.
” It’s clean. Everything has been examined. Controls have been put in place and procedures are now established. A more stringent assessment is underway, ”she said at the time.