When it comes to digitising medical records, Bermuda is far ahead of many other islands a KPMG partner said at the firm’s Healthcare CIO Connect 2025 conference this week.

“One of the things that is really underrated about Bermuda, is how successful the electronic health record implementation was,” said Edward Fitzgerald, head of healthcare and life sciences in KPMG's advisory practice.

He said when the Bermuda Hospitals Board launched the Patient Electronic & Administrative Records Log, known as Pearl, in October 2022, there was no way anyone in the hospital could miss the event because of the hype.

“Just a few days before Pearl went live, I remember hearing clapping, and lots of noise, and in comes the hospital mascot, Eddie the elephant. Eddie and the staff were handing out sweets and letting everyone know that Pearl was about to be implemented. The implementation was done particularly well.”

He said Pearl put Bermuda way ahead the majority of other islands that he works with.

Speaking at the KPMG event which brought together healthcare technology leaders from across North America, Europe and Bermuda, Dr Fitzgerald said Trinidad and Tobago — with a population roughly 25 times that of Bermuda — was ready to start implementing an electronic medical records system when there was a political election and the government changed hands.

“Now, it is back to square one for them,” he said. “Barbados has just put out tenders to start launching a system.”

He said Bahamas learnt the importance of having digitised records when Hurricane Dorian hit them in 2019. One of the main hospitals on Grand Bahama, the Rand Memorial Hospital, was severely damaged by wind and flooding from the category 5 storm.

“Rand Memorial Hospital didn’t have a digital health record system at that point,” he said. “All the paper records for the whole island were just completely gone. The impact was really profound.”

He returned to the island three years later and found they were still experiencing the fallout from the storm.

Dr Fitzgerald was made partner at KPMG earlier this month and settled here in 2021. Before that he made frequent trips to the island.

In July 2020, during one of those visits, he was in a serious road accident while on his way to talk with staff at King Edward Memorial Hospital.

“I was pedalling to the hospital that morning, but instead arrived by ambulance,” he said.

After a week in intensive care, he was ready to go home, but quickly found that an antiquated medical records system slowed things down. Pearl was still several years away from launch.

Staff at KEMH took good care of him, but there was no integrated way for them to book follow-up appointments for him.

“I had to do that, and see people and explain my story and journey to each of them,” he said.

It brought home to him, how much he had taken for granted the connectedness of the National Health Service in Britain.

“I got a good understanding of Bermuda’s healthcare system from that experience,” he said.

Working on islands as diverse as Malta, Barbados, Bermuda and the Isle of Man, he noticed things that make islands unique environments for healthcare.

“It is massively underestimated how much more important the issue of privacy is on islands,” he said.

He has heard many islanders express concern that digitisation may accidentally expose their data.

“I always balance that by saying that with a paper record, anyone can open it and look at it,” he said.

He has also found that health literacy is often lacking on small islands.

“That has to be incorporated into implementation plans in healthcare planning,” he said.