A 302 page Provincial Auditor’s Report was tabled in the legislature today (Wed), touching on everything from a computer system going way over budget which has yet to be implemented, lowering wait lists for neurosurgery and clarifying agreements with contracted special-care home operators in Saskatoon and area.
The computer system which has yet to be implemented is the Saskatchewan Health Authority’s Administrative Information System. Tara Clemett says work began on the development of AIMS in 2018 and was supposed to be running by March of 2021 at a cost of $86 million. It was implemented in 2022, but it failed. The SHA has spent nearly $157 million on this business-wide IT system and it is now forecast to cost almost $240 with no date for implementation yet. Clemett is recommending a formal lessons learned report on the project so other government agencies can avoid system implementation failures on similar projects.
The report also has recommendations for eHealth, which is the health sector’s primary IT service provider. As of last March, eHealth and the SHA didn’t yet have an adequate service level agreement in place. Clemett’s concern is that without a clear understanding of expectations and whether they are fulfilled, the SHA’s systems may be breached or unavailable. As well, eHealth has disaster recovery playbooks of all of its critical IT systems, but has yet to fully complete disaster recovery testing for these systems, which is needed to ensure they can be restored in a reasonable time. The Provincial Auditor says eHealth has more work to do to protect critical IT systems from known vulnerabilities and without proper maintenance of IT services, eHealth may be at risk of system failures and security breaches.
The Provincial Auditor also has recommendations for the Ministry of Health to shorten the waitlist for neurosurgery, which includes surgery related to the brain, spine or nervous system. At the end of April of this year, about 240 patients had been waiting more than a year. Her recommendations include analyzing the appropriate number of staff and physicians to meet surgery expectations and establish action plans to address workforce gaps. The Ministry also needs to increase the use of the Saskatchewan Spine Pathway referrals, to assess whether surgery is even needed. In the 2022-23 fiscal year, less than 20 per cent of patients assessed by the Spine Pathway required surgical consultation.
Clemett noted the recommendations made in 2017 about overseeing private contracted special-care homes in Saskatoon and surrounding area have yet to be fully implemented. Tara She says the Saskatchewan Health Authority needs to continue working with special-care homes to address non-compliance with performance measures around quality of care. “For example, the number of residents in special-care homes on anti-psychotic drugs without a diagnosis failed to meet expectations. This is often an indicator that special-care home staff are chemically managing the residents.” Clemett recommends the SHA and private operators of special-care homes continue to work on developing a new contract to clarify accountability relationships and define service expectations related to quality of care. Saskatoon and area has 15 private special-care homes contracted by the Saskatchewan Health Authority.
The Provincial Auditor’s report also touches on conserving agricultural Crown land. Clemett reports that the Ministry of Agriculture has over 7,000 leases on its managed Crown land. Clemett says the Ministry need to complete land health assessments and communicate those results to pasture associations with recommendations in a timely way. This work began in 2018 with about 44 per cent of its 1.6 million hectares of Crown land not yet assessed. Clemett believes properly managing and protecting portions of the province’s agricultural land helps to sustain land resiliency. She says, “Having a risk-based plan to complete periodic assessments, as well as sufficiently monitoring land trends and the use of Crown land over time keeps agricultural land healthy and productive.”
