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More than 160 extra staff needed to launch new medical records system

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Cerner support for BHB nurses as the Pearl electronic medical records system was introduced (Photograph supplied)

More than 160 extra people were on the island to support the launch of a landmark electronic medical records system for the Bermuda Hospitals Board, the organisation reported yesterday.

The BHB said that having people from overseas “on-the-ground” ahead of and after the go-live date cost $1.7 million, which included a yearlong contract with the Hamilton Princess & Beach Club, valued at almost $735,000.

But the board pointed out that the overall figure was $1.3 million under budget after the Covid-19 pandemic meant many workshops and meetings for the project were held remotely.

Several agreements linked to the EMR were listed in the Official Gazette, where public authorities must show details of contracts worth at least $50,000.

The Pearl – patient electronic and administrative records log – went live in October at the King Edward VII Memorial Hospital, the Mid-Atlantic Wellness Institute and group homes.

An earlier notice showed that two contracts with US-based healthcare giant Cerner, which was the vendor for the EMR system, were for $25.8 million and $26.1 million over a total of ten years.

The BHB update said yesterday that “many cost savings” were expected through the implementation of Pearl, including efficiencies and the retirement of older systems.

It added: “The net cost of the project over ten years is expected to be in the order of $30 million.”

The update explained: “On-the-ground support and training from our overseas partners in the period leading up to and just after go-live cost $1.7 million.

“This includes the Hamilton Princess contract in the 2022 Pati listing, although other hotels and accommodations were used.

“This was less than the expected $3 million budgeted for on-island support throughout the project as most pre-go-live meetings were held remotely.

“Intensive in-person support is critical for the success of any EMR go-live, so could not be done remotely.

“Staff must be fully trained ahead of go-live and needed subject matter experts immediately available to troubleshoot issues so that care can continue to be safely delivered through the go-live transition.

“Unlike hospitals overseas, BHB cannot transfer care or emergency services to another hospital during a transition, so continuity of safe services was even more critical.

“On-the-ground support included over 160 additional people on island over the go-live period.”

KEMH incident command centre was staffed 24/7 during the first few weeks of the Pearl electronic medical records system (Photograph supplied)

It said that the BHB had contracted two main consultants to support BHB staff “especially with delays and resource issues caused by Covid”.

The Official Gazette notice showed that Channel 3’s consulting services were hired in two agreements for a combined total of almost $1.6 million from dates in May to November last year.

Two support services contracts with S&P Consultants were listed for about two years each, valued at a total of more than $1 million.

The BHB update added: “Work with other vendors related to building interfaces that were needed to connect to Pearl accounted for $513,000.

"An executive administrator managed all the meetings and arrangements for the EMR implementation project and go-live of $110,000.“

It said the board was moving “to a period of optimisation, in which improvements are made based on experience using the system to better work for staff and patients”.

Planned future phases include the introduction of a portal for patients to view their medical information.

Michael Richmond, the chief executive officer of the Bermuda Hospitals Board (Photograph by Akil Simmons)

Michael Richmond, the BHB’s chief executive officer and president, said: “Pearl is a national investment that has been significantly funded by internal cost savings at BHB, with our capped revenue being flat for the last four years.

“Our focus has been on ensuring the implementation was successful and that patient quality and safety is enhanced through its use.”

He added: “EMR implementations are extremely complex projects and research indicates more than 50 per cent of similar implementations either fail or fail to be properly utilised.

“Given the level of investment required, failure or significant and costly delays were not an option and BHB staff along with our partners have worked tirelessly for over 18 months to deliver the system effectively.

“The biggest thank you must go to our staff, who have shouldered a vast amount of work, from design and build workshops to extensive training, and adjusting to a new way of working.”

Dr Richmond said: "This is really just the beginning.“

He said: “We have addressed most of the issues that emerged as we went live with the new system, and our work now focuses on where Pearl can be optimised and improved for staff and patients to create value in the system.”

Wesley Miller, chief of staff at the Bermuda Hospitals Board (File photograph)

Wesley Miller, the chief of staff, added: “We did everything required to ensure go-live succeeded, but what happens next excites us the most, not just in the coming weeks and months, but throughout the ten-year contracted term.

“We are very appreciative of the community’s understanding as Pearl has gone live. Improving the care and experience of patients at the very heart of this project, but it does take time.

“We started looking at how to realise the benefits of Pearl this year and so we are ready to act and ensure our community gets the best value possible out of the new system.”

Arthur Ebbin, the chief financial officer, said: “We’ve had a tight governance and accountability framework in place, reporting through senior committees up to the board.

“We have also been proactive in getting the support our staff needed to succeed and worked hard to make the cost savings needed to pay for the project.

“The major contract with Cerner is paid over ten years, so it is a lot in total, but is affordable for us over time.

“EMRs help make savings too and the work now takes place to ensure this happens.”

To read the Bermuda Hospitals Board’s update in full, click on the PDF under “Related Media”.

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Published January 04, 2023 at 7:58 am (Updated January 04, 2023 at 8:18 am)

More than 160 extra staff needed to launch new medical records system

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