We all know it’s coming, and we all know we need to prepare. VPSA’s CST Task Group is working closely with VCH to present sessions to help us get ready. A recent townhall featured presentations by VCH and PHC Chief Medical Information Officer Dr. Eric Grafstein and PHC CST Physician Lead Dr. Charles Lo. CST Senior Manager, Provider Engagement & Adoption, Max Besworth also provided a demo and overview of the system.

Vancouver Acute Senior Medical Director Dr. Vinay Dhingra emphasized the imperative need for an updated system.

“One of the elephants in the room that we don’t talk about is our current information system, PCIS,” said Dr. Dhingra. “It was designed, built, and implemented in 1980… the same technology has been powering that system since that time with very little upgrades. The primary vendor stopped supporting the system 10 to 15 years ago and we’ve been using secondary vendors to keep it running. It’s at the point now where it is unable to support many of the functions we all would want in a modern IT system such as remote access. We’re reaching the limit on our users. As we change facilities and add locations, we are reaching the limit that we can have. Because of its limitations, many of our downstream IT systems that require connectivity have been unable to be upgraded.”

Dr. Grafstein offered an introduction to CST.

“Contrary to what some have said, CST doesn’t stand for Can’t Stand This,” he joked. “It stands for Clinical and Systems Transformation. It is one of the largest electronic health record implementations ever in Canada. Even in North America, it rivals some of the very largest ones. We have something like over 50 implementations and the project has been ongoing for several years. You should take comfort in knowing we have an amazing team of people who have experience of more than 20 implementations and have been working on the project for several years. You should have confidence in what is being designed; it really is state of the art.”

CST aims to achieve three transformations:

• Clinical – transforming processes such as workflows, order sets, closed-loop medication management.
• Systems – moving to an electronic medical record housed by a shared clinical information system.
• Quality culture – leveraging the power of our transformed processes and systems to continuously improve the patient and caregiver experience.

Dr. Lo joined the townhall to talk about the implementation experience at PHC as well as how physicians have come to appreciate the benefits of CST. Dr. Lo is PHC’s associate chief medical information officer responsible for CST implementation.

“We went live with CST in November 2019 at our three acute care sites and approximately 50 ambulatory clinics,” he recalled. “We also had a fairly short runway for our design and training and implementation. It was a huge challenge. There was quite a bit of reluctance and a lot of skepticism about the system itself and whether it would work with our perceived level of acuity and complexity.

“But we know now from our experience, and experiences at the now live BC Children’s Hospital and Women’s Hospital, as well as the BC Cancer Agency, that the CST Cerner build is a robust system. It does really function well in our space and in our workflows.”

Dr. Lo said the go-live was several weeks of challenge and anxiety. PHC reduced service volumes at the time and gradually returned to full through put.

“I would challenge you to find more than a handful of people who would ever go back to the pre-Cerner system,” he added.

Following a system demo and tips on what you will need to get ready (a current photo ID badge, a primary VCH network account, a single LearningHub profile, and FESR training), the floor was opened to questions. These focused primarily on training and system functions.

“We have formed a CST Task Group with physician participants’ time paid for,” said VPSA President Dr. Alison Harris. “You’re very welcome to join the group and get involved as much as possible. We are planning further activities and I encourage you to stay engaged. This is a journey for all of us.”

Editor’s note: The May townhall is now available for screening on YouTube.