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Alberta Health Services — Wave One Implementation of Connect Care Clinical Information System

Report of the Auditor General — February 2020
 

Connect Care is a clinical information system that will touch nearly every aspect of the care for Albertans at Alberta Health Services (AHS) hospitals, clinics, and the labs and other partners that support them.

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At a cost of more than $1 billion, Connect Care will have over 100,000 clinical system users. It will house detailed health information of more than four million people across the province.
AHS communicated that Connect Care also has potential to save money and improve patient care and experiences in AHS hospitals and clinics over the long term. In short, it has the intent to transform healthcare delivery in Alberta. Currently, there are no plans to implement Connect Care at primary care networks (PCNs) or other clinics and clinical settings not administered by AHS.
 

There is risk in implementing any large computer system. More than half of new computer systems fail to launch, or do not work properly after the initial launch. These failures can result in costs to an organization in terms of dollars, time, and reputation. For a clinical computer system in a hospital, failure can also be as serious as life and death.

This audit is unique in that we conducted it before AHS launched the first wave of Connect Care. We do not normally audit government processes and systems until they have been running for some time. Because of the size and scope of the project to implement Connect Care, combined with the potential risk if something were to go wrong, we felt it warranted an audit looking at the common causes of computer system failures before its launch. This could allow us to identify potential problems and add an outside perspective on important parts of the program, in advance, rather than after the fact.

Wave One of Connect Care launched on time in early November 2019 at the Walter MacKenzie Health Sciences Centre as well as various ambulatory clinics and pharmacies in the Edmonton area.

AHS experienced a few technical issues, some service delays, and some initial frustrations immediately following the launch. However, overall AHS felt the launch and immediate sustainment of Wave One was a success and, most importantly, was safe for patients undergoing care at that time.

We found AHS had processes, controls and plans in place to manage the risks to launching the first wave of Connect Care safely and effectively.

Among the key drivers of success for the Connect Care program we observed to date are:

  • The program was not led or managed as an “IT project." Representatives of operations, clinical staff and physicians and AHS IT co-led the program. The involvement of operational and clinical staff in the program was pervasive.
  • AHS assigned three of its senior executives as program “sponsors.” These were not passive roles. The extent of their involvement, the depth of their understanding, and the presence of these sponsors at critical times leading up to launch was noteworthy.
  • We saw consistent evidence of a culture in the Connect Care program of transparency, accountability, and dedication. Teams gave straight answers, did not sugar-coat bad news, and asked for help. Leaders did not relent on important questions and were active in finding the resources teams needed if they were falling behind.

It is important to note that our audit focused on the processes, controls and plans specifically for the Wave One launch. AHS will be implementing eight additional waves through to 2022. The outcome of the Wave One launch does not guarantee similar results for these future waves. We plan to complete future audits of Connect Care as AHS continues implementation and has had an opportunity to stabilize its ongoing operations.

 
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