Auditor general chides Health Department for lack of IT leadership

Nova Scotia Auditor General Michael Pickup is accusing the provincial Health Department of not properly leading the charge to make the health-care system fully integrated when it comes to information technology.

In his report released Tuesday, Pickup said that lack of leadership carried substantial risks, including the "unauthorized disclosure of personal health information, increased wait times for services, increased costs to the system, and overall negative impacts on the health and well-being of Nova Scotians."

"We're telling you now you've got some oversight and governance issues," Pickup said during a news conference with reporters. "If they don't get fixed, your risk just went way up that something bad is going to happen in terms of the availability of systems."

Auditors with Pickup's office noted a lack of formal agreements between the Health Department, the Nova Scotia Health Authority, and the IWK Health Centre when it comes to the delivery of IT services. The report said roles and accountabilities were unclear as a result.

Pickup said he was particularly troubled by the inability for officials with the Health Department and provincial health authority to reach agreement on who is responsible for the province's drug information system.

"That makes no sense to me," he told reporters. "It's one government … How can you possibly have a disagreement on who is responsible for one of our health systems?"

Lack of leadership

Auditors also chided the province for not monitoring service levels and claimed IT risk management was "inadequate."

"The Department of Health and Wellness has not provided the level of leadership and direction required to effectively transition the health sector to centralized information technology services," concluded the report.

There are draft IT agreements between the health entities that call for an executive committee to oversee IT services to ensure they "meet the needs of the health sector."

But auditors found that executive committee, comprised of representatives from the health authority, IWK and departments of Health and Internal Services, is not meeting.

"Somebody needs to bring these folks together and say, 'This is unacceptable. These things have to get done,'" Pickup said.

Health minister must take responsibility

Given that the four entities "all report up and are part of the same government," it would make sense for Health Minister Randy Delorey to take a lead on the file, said Pickup.

Tory Leader Tim Houston said there have been too many recent concerns with various government IT systems and services for officials not to act on Pickup's latest report.

"In terms of this situation, they're health records — it's the minister of health" who needs to take the lead, he said.

NDP Leader Gary Burrill said he was perplexed as to how the committee tasked with overseeing health IT matters could go without meeting.

"You couldn't run a lemonade stand like this," he said.

6 recommendations

Pickup made six recommendations, which the province has agreed to implement.

The province has been working for years on a project to consolidate health records into a single system called One Person, One Record, but that move to modernize the system has been halting and cumbersome. Records are now being stored in what auditors described as "hundreds of aging clinical applications."

That project is too important and too significant to have the outstanding IT concerns unresolved, said Pickup.