Nova Scotians’ paper health records being trucked to Ontario to be digitized

Nova Scotia Health is trucking boxes of Nova Scotians’ paper health records to Ontario to be digitized by a private company.

A Nova Scotia Health employee who spoke with the CBC News said 900 boxes of records are to be trucked to Iron Mountain in Toronto to be scanned and converted to electronic form. The CBC has agreed not to name the employee due to concerns that their job could be jeopardized if they are identified.

“The public needs to know. The patients of Nova Scotia need to know that their central zone records aren’t where they should be,” the employee said.

Sending files out of province could pose a health risk to patients, the employee said.

Under normal circumstances, if a patient goes to an emergency department, for example, a physician or surgeon can request that the patient’s records be retrieved and made available within 24 hours.

But if the records happen to be in transit to another province, or awaiting scanning, a delay could have ramifications for the patient’s treatment and outcome, the employee said.

“You don’t want to think of it, but you know, given the scenario, it could be death. That’s patient care. It’s not just paper. It’s the patient’s record.… It’s negligence, if I’m being honest.”

The employee said contracting the work out is unnecessary.

“We have people in the province willing and able to work. So if there was a scheduling issue or hiring issue, management should have done that from the get-go.”

Connection to OPOR

The employee said they believe the push to finish digitizing a backlog of 22,000 inches of records — nearly 56,000 centimetres, or more than a half-kilometre if the records are stacked in a pile — is related to One Person One Record (OPOR), which is scheduled to launch in the central zone in early May.

OPOR is the electronic record-keeping system intended to replace paper records and reduce the number of programs that health professionals use to track patient health information. OPOR rolled out at the IWK Health Centre in December but will eventually expand across the province.

Nova Scotia Health said trucking boxes to Ontario is “not a One Person One Record initiative,” and that the health authority regularly does business with Iron Mountain Canada, a subsidiary of the U.S. company Iron Mountain Inc.

The health authority did not make anyone available for an interview, but in a statement, spokesperson Brendan Elliott said Nova Scotia Health has used Iron Mountain for several years for paper record retention, destruction and, “more recently, scanning of paper records.”

Elliott said sending and receiving paper and digital records interprovincially has previously been a standard practice going back at least 10 years, but this is the first time the health authority has done so with Iron Mountain.

So far, Nova Scotia Health has sent 10 boxes to Ontario to test the process, but a “larger quantity” of records will be sent in the future, Elliott said.

Union concerns

The plan has prompted concern from the Nova Scotia Government and General Employees Union, which represents Nova Scotia Health employees who are normally responsible for scanning paper records to convert them to electronic form.

NSGEU president Sandra Mullen says the health authority has previously confirmed to the union that it needs 22,000 inches of documents converted.

Mullen said the plan could put the private health information of Nova Scotians at risk.

“If they’re taking our personal records and information and shipping them by truck to another province in the winter, there’s a serious risk of incident for loss and breach of privacy,” she said.

The union is also taking issue with the contracting out of its members’ work to the private sector.

“I can’t even imagine why we would consider shipping documents outside of Nova Scotia when we have a number of employees in this province who could do that work,” Mullen said.

The union said many of its members are willing and able to work overtime to process the files.

Mullen added that the scanners the health authority uses to convert the records don’t always function properly, and that more scanners would be helpful to speed up the conversion process.

The NSGEU has filed a grievance with Nova Scotia Health over the outsourcing of the work.

NSH responds to concerns

Nova Scotia Health said as of Jan. 15, the backlog was estimated at 15,000 inches, but that figure changes daily based on staff availability, the number of patient interactions and other factors.

Elliott said the health authority has increased staff, offered overtime and moved work to other zones within the province in an attempt to reduce the backlog.

He said the records are being sent to Ontario because “the backlog impacts Nova Scotia Health’s ability to provide timely medical information to both the patient and their care team.”

Asked whether there were privacy concerns about sending paper records out of province, Elliott said no, because Iron Mountain has securely transported records for several years.

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