Doctors and nurses say a provincewide network outage caused chaos in many hospitals and they hope a third party review, promised by Alberta Health Services, will result in a reliable backup plan.
According to AHS, the outage was triggered during routine maintenance early Monday.
"The cause of the outage was identified as a routine maintenance change that was made to the system early in the morning. We are working with the vendor to understand why this occurred," spokesperson Kerry Williamson said in an emailed statement.
The outage impacted a wide swath of services, including electronic medical record systems, Health Link and lab operations.
It left hospitals scrambling, delayed surgeries and created large backlogs in emergency rooms.
"It was quite chaotic," said Dr. Arun Abbi, an ER physician at Calgary's Peter Lougheed Hospital.
Staff were frozen out of computer systems. That included Connect Care — the new centralized clinical information system rolling out across the province — and medical imaging programs, according to Abbi.
Even the paging system was down, he said.
"You couldn't look at X-rays. You couldn't look at CTs. You couldn't look at any diagnostic imaging. You couldn't look up Netcare. You couldn't look up patient's history, labs, previous CTs, previous X-rays to compare," said Abbi, who is also the president of the emergency medicine section with the Alberta Medical Association.
According to Abbi, doctors were waiting up to five hours for blood work results.
All this led to large backlogs and long waits in an already stretched emergency room.
"I think when the computers came up … we were backed up 50 to 55 patients," said Abbi.
"This should be a never event," said Dr. Tony Gomes, president of the Alberta Association of General Surgeons.
"Frankly, it's unbelievable that this would have happened.… If this goes down for a day or two, it's a complete disaster. The system essentially grinds to a halt."
According to Gomes, elective surgery was shut down in most of Alberta, with a few exceptions, including the hospitals in Lethbridge and Medicine Hat, where Connect Care hasn't rolled out yet.
"Most hospitals in most of Alberta … were only able to do emergency surgery … that's things that had to be done within the next six hours."
Based on his discussions with his colleagues, Gomes estimates between 100 and 140 non-urgent surgeries were cancelled in Calgary alone on Monday.
"I think they have to find out what happened and make sure it never happens again. It's that simple."
Abbi agrees and he hopes AHS can find clear answers.
"I think they've got to figure out a backup IT power … system so if something fails, can you switch to another computer system that keeps the system running," he said.
AHS confirmed on Wednesday it has hired a third party, "which specializes in networks and infrastructure," to review the outage.
An internal review of the clinical response is also underway, Williamson said, noting it will look for any gaps in the response and for possible improvements.
Patients who had their surgeries postponed are now being rebooked. The health authority has not yet confirmed how many surgical patients were affected.
"We are extremely grateful for the work of AHS staff and physicians who did an outstanding job in difficult circumstances to provide patient care," said Williamson.
"They reacted quickly and calmly to switch to downtime procedures, which they are trained and ready to use when required."
Outpatient clinics at hospitals were impacted, too.
"In addition to that, outpatient clinics all over, within hospitals, were cancelled because lists of patients and their medical charts couldn't be accessed at all for essentially the entire day," said Gomes.
Registered nurse Rebecca Brown said the computers in her outpatient infusion clinic at the Foothills Medical Centre in Calgary went down one by one on Monday morning.
"It was like, 'what do we do now,' because everything is computerized at our hospital. The internet was down. The computers were down. Everything was down," she said.
"We tried to not let it impact our patients too much.… There are downtime procedures. So once we got to grips with what we had to do, we just got on with it."
That meant resorting to pen and paper.
"We were able to reschedule some patients to take the pressure off a little bit, but the whole day we kept thinking, 'it's gonna go up soon, it must go up soon, it must go up soon.' But it never came up the entire 12-hour shift," she said.
"For the entire province to go down, that's scary."