The Honourable Ross Wiseman, Minister of Health and Community Services, today released results of the Estrogen Receptor/ Progesterone Receptor (ER/PR) database compiled by the Newfoundland and Labrador Centre for Health Information (NLCHI). The minister also provided details of a $2.3 million investment by the Provincial Government for an array of measures to strengthen the health care system, including the establishment of a Quality Network team to ensure best practices across the system.

In May 2007, the Provincial Government appointed Robert Thompson as Secretary to Cabinet for the Management of Health Issues. In this role, Mr. Thompson has responsibility for preparing the Provincial Government for full and open participation in the Commission of Inquiry on Hormone Receptor Testing. This work included the engagement of the Newfoundland and Labrador Centre for Health Information to develop a database to ensure a thorough understanding and documentation of key dates and results related to ER/PR testing by Eastern Health and how patients were contacted about the re-testing process. The database is now substantially completed.

"We have examined the database created by the Centre for Health Information and it reinforces a critical lesson for us on the inadequacy of the previous record keeping of Eastern Health related to the problems with ER/PR testing," said Minister Wiseman. "The database compiled is the most comprehensive one that exists and I am pleased that the Commission of Inquiry will now have this information as a resource for its use in examining the issues related to ER/PR testing. Our goal is that the people of this province have the best understanding possible of what happened with respect to hormone receptor testing for breast cancer patients."

The most recent database includes data changes from previously reported information. In May 2007, Eastern Health had reported that the total number of patients re-tested was 939 and of those patients, 176 were deceased by late 2006. The data compiled by NLCHI now shows that, overall, 1,013 patients have been re-tested and of those, 293 were deceased by late 2006. The number of deceased as of late 2007 is 322. In addition, it has been determined that for 44 patients, there is no documentation to verify that they were ever contacted. Of those, nine are now deceased and contact with the remaining 35 is in progress. As well, Eastern Health undertook a province-wide information campaign to ensure broad public awareness and provide contact information for patients.

"Both the health authorities and government are learning some good lessons here and to take action to ensure that the patients of our health care system are never faced with a situation again like we have experienced with ER/PR testing," said Minister Wiseman. "Even though the work of the commission is underway, there are specific areas where we can take action now."

"Our government will immediately establish a Quality Network team which will be led by my department to assess quality assurance initiatives, infection control programs, patient safety, risk management programs and best practices within our four regional health authorities," said Minister Wiseman. The Quality Network team will work to assess processes and ensure standards across the health care system.

"Our government is also committing $2.3 million today to enhance data management capabilities and quality assurance measures within Eastern Health and the regional health authorities," said Minister Wiseman. "This investment is a necessary one that will build on our lessons learned as we move forward."

To enhance data management, $2.1 million will be invested for the consolidation of clinical information systems within Eastern Health, a plan for consolidation of similar systems in other regional health authorities, a needs assessment for electronic document tracking systems for each health authority, and funding for five new data management professionals throughout the system.  These investments will help improve response times and completeness of data when searching for patient information in the future, and ensure that more tools are available when managing a response to an adverse event.

"The funding provided by the Provincial Government will assist Eastern Health in its ongoing efforts to improve our data management and the overall quality of care that we provide," said Pat Pilgrim, Chief Operating Officer for Cancer Care, Quality/Risk Management with Eastern Health. "Our staff has been fully engaged with the Centre for Health Information throughout this review process, and the experience has been a valuable one for our organization."

"Enhanced data management is a critical component as we look at the lessons we�ve learned. In addition, we also recognize the fundamental necessity of comprehensive quality assurance programs," said Minister Wiseman. "That is why our government is initiating province-wide accreditation for all laboratories and diagnostic imaging services � a measure that I know will be embraced by our four health authorities. We are allocating $100,000 for the necessary planning for the establishment of an accreditation system."

The Provincial Government has also approved an additional $175,000 per year for Eastern Health to follow through on education, training and quality assurance activities related to ER/PR testing. In particular, this funding will allow for pathologists and technologists to participate in relevant training programs each year, and allow for external reviewers to visit the Eastern Health laboratory to assess current practice against best practices elsewhere.

"I am confident this array of actions by our government will strengthen our health care system as we continue to work to ensure the provision of quality health care services and programs for the people of this province," said Minister Wiseman.

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• The Provincial Government is investing $2.07 million for the following items:
  1. $1.3 million will be allocated to Eastern Health to allow for consolidation of clinical information systems onto a single platform (laboratory, diagnostic imaging, medical records, admissions, nursing order entry, pharmacy and patient care inquiry). As the other regional health authorities are at different stages in clinical consolidation, a plan will be developed to ensure clinical consolidation in all areas of the province as soon as possible.
  2. $500,000 will be allocated for all regional health authorities to conduct an Information Management Capacity Assessment, which is the first step towards implementation of electronic document management systems.
  3. $270,000 will be allocated for new data management personnel.
• The Provincial Government and the regional health authorities will establish a new policy that whenever there is an adverse event that requires communication, testing or treatment for a group of patients, a single official is to be charged with clear organization-wide responsibility for directing patient contact and data management. This official must have access to an appropriately skilled data management professional trained to use or design an information system which can acquire comprehensive data for all events in the response process, provide timely reports, and can be audited