This weekend, the health record system Helseplattfomen will be introduced at St. Olav. There has been unrest ahead of the introduction. Among other things, a hundred intensive care nurses have requested that the system not be introduced in the hospital. Martin Altreuther worked as a subject expert in the Health Platform for several years. He was involved in the development of a new joint patient record for the health service in central Norway, with a cost frame of NOK 4.2 billion (see fact box). He is a specialist in vascular surgery at St. Olav’s hospital and has worked on developing the IT system on behalf of the vascular surgeons. This summer he resigned from his position as subject expert. – It is difficult to argue with colleagues and friends. And it’s hard to realize that something you’ve invested so much work in doesn’t turn out so well that you can stand for it, says Altreuther. Grethe Aasved, managing director at St. Olav, believes it is natural to have concerns about major changes. She says the hospital is as well prepared as it can be. – Epic is one of the world’s largest suppliers of record solutions for hospitals, and it is reassuring that the supplier has not seen a hospital that is more prepared than St. Olav, says Aasved. Will never be good enough The subject experts in the Health Platform are hired specialists from the healthcare system who have helped develop and build up the record system. This is to ensure that the IT service meets the needs of all parts of the healthcare system. Altogether, close to 500 subject experts have been involved in various job percentages, figures from the Health Platform show. They do not have figures on how many subject experts have withdrawn in total, and refer to the hospitals and municipalities. Martin Altreuther has been involved since the beginning and has developed the system for the vascular surgeons. At the beginning, he had faith that the Health Platform could become a good and user-friendly system, which could be better than the Health Platform in Denmark, which has caused great dissatisfaction among healthcare personnel. Eventually the doubts came, he says. The health platform The health platform is responsible for implementing the introduction of a new and common patient record for the health service in central Norway If everything goes according to the health platform’s plan, the solution will be used by 40,000 employees in the health service 720,000 residents will then be able to access their own records digitally through the solution The project is owned by Helse Midt-Norge RHF and Trondheim municipality. The health platform is the region’s largest IT project and has a cost frame of NOK 4.2 billion. The health platform was introduced in Trondheim municipality in April. In November, St. Olav and six other municipalities in Trøndelag will introduce the record system. Then follows the hospital in Levanger and two new Trønder municipalities, and eventually Helse Møre and Romsdal and Ålesund municipality. So far, 19 out of 66 municipalities have signed the agreement, thereby becoming owners of the company. The aim is to get all municipalities in central Norway on the team, but for now several are waiting. Minister of Health and Care Ingvild Kjerkol has encouraged all municipalities in central Norway to join the Health Platform. The new versions of the journal system were ready, but Altreuther was not impressed with the result. – It is cumbersome and difficult to use and, as I see it, it will never be good enough, he says. He believes that Epic’s system, which lies at the bottom, is old and difficult to change and adapt to settings other than the American healthcare system. Finally, he decided to resign from his position. “The main reason is a concern that I have been dealing with for some time,” he writes in the resignation letter. – Why did you quit? – If I were to say it in one sentence, it would be that the system is not good enough. I didn’t want it on my conscience, says Altreuther. Altreuther believes the solution is still too complicated and difficult to change. He doesn’t see that it will ever be good enough. Photo: Stein Roar Leite / news Inconvenient to say from Altreuther is afraid that the system will lead to reduced efficiency, and that the waiting lists will therefore grow. A reduced efficiency of as little as 5 per cent could over time have serious consequences for a healthcare system that is already operating on the edge of the cliff, he says. – Don’t you feel a sense of loyalty to a system you yourself have helped to build up? – At the top is the loyalty to the patients and a functioning healthcare system. When I mean that what has been created puts both the patients and the healthcare system at risk by not being efficient enough to be able to do our job, then you have to speak up even if it is terribly inconvenient and it is deeply ingrained. – The health platform is to be introduced, and it is clear that there is no deviation from that plan. Wouldn’t it have been better to stay in the role of subject expert and help make the system as good as possible? – If I had believed that it could be done well enough, I would have done it. But I saw that in my mind we never came close to it being usable, he says. Quits for various reasons According to Altreuther, he is aware of several subject experts who have resigned for similar reasons. He mentions two other people at St. Olav, but thinks there are far more. Of the eight who have left Trondheim municipality, three of these have started working full-time in the Health Platform. At St. Olav, three of the subject experts have resigned from their role. 13 have chosen not to extend and three have quit their jobs at the hospital. Three resigned out of concern Grethe Aasved, managing director at St. Olav, says the hospital is well prepared ahead of the introduction. Photo: Bent Lindsetmo / news According to hospital director Aasved, subject experts are crucial for the solution to be adapted to the hospital and that some replacements are expected. – The subject experts will continue in their clinical work, and most of those who have left have returned to other positions and roles in and outside St. Olav. Three have justified the dismissal with their concern for propriety. The vast majority have been replaced by new subject experts, she says. Helse Nord Trøndelag has hired 28 subject experts to the Health Platform. A total of 13 of these have chosen to withdraw or not extend their contracts. The reasons are various. Some have had challenges working in English, some have found it too difficult to combine with clinical work and others have started working for the Health Platform. Two have resigned due to, among other things, a lack of motivation, according to Kathinka Meirik, professionally responsible for introducing the health platform in Helse Nord-Trøndelag. – None of our subject experts have resigned because they have been skeptical of the solution or the quality of the solution, it is more that the way of working has been demanding for some, says Meirik. She says Helse Nord Trøndelag is not worried about the dropout, and says it is a normal turnover percentage in the healthcare system. – We haven’t thought about it as anything special, says Meirik.
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