N.L. health authority spent just under $10M, so far, on a contract seeking efficiencies

While less than expected, to date, union president Sherry Hillier says she sees 'no improvements' in system

Newfoundland and Labrador's health authority has paid nearly $10 million to a private company tasked with creating efficiencies in the health care system, but now, as that contract nears its end, two union leaders say the company's work hasn't helped their members.

In a statement to CBC News, Newfoundland and Labrador Health Services (NLHS) says the contract with Change Healthcare Canada was, "set up to improve workforce scheduling and other operational processes. The aim is to find efficiencies, reduce administrative burden and workplace pressure on health-care providers where possible, and help ensure patients continue to receive safe, high-quality care."

Canadian Union of Public Employees Newfoundland and Labrador president Sherry Hillier says she doesn't see that happening.

"To be honest, there's no improvement," she said in an interview Monday. "With the system running the way it is, it's just not working."

Hillier has been critical of the contract from the beginning. CUPE called for a cancellation of the contract when it was first announced.

Newfoundland and Labrador Association of Public and Private Employees president Jerry Earle said he was optimistic for improvements in scheduling and staff work loads, aiding retention, but "that optimism is certainly dwindling."

Both Hillier and Earle noted they are still having problems with members getting leave time and the amount some staff are being mandated to work.

"What we keep looking at is the whole issue of retention, modernizing schedules to meet work-life balance and that, and we just haven't seen the evidence of that. I'm not sure the technology will fix that," Earle said.

The province's health authorities contracted Change Healthcare Canada in 2021 to, among other things, apply proprietary software of the company to local staffing needs.

The contract was originally due to end in September of this year. CBC recently confirmed the agreement was amended in September 2021, as a result of the COVID-19 pandemic, after a delay in the ramp up. The contract is now set to end as of June 1, 2027.

In the interim, the province’s four health authorities have been brought under one umbrella as Newfoundland and Labrador Health Services, established in 2023. The company has also changed, as Change Healthcare Canada has become HealthStream Inc.

The company is incentivized by the provincial health authority to make headway under the agreement. Real cost savings managed from things like achieving reduced overtime hours, sick time, fewer payroll errors and less time-keeping labour come back in a percentage credit — up to $35 million for the company over the course of the deal.

Other than a new end-date to the contract, communications staff at the health authority said nothing else in the contract has changed.

The company has, to date, been paid $9.87 million, including HST. Of that, $3 million was already reported by CBC, being an initial mobilization or start-up fee.

The total is less than critics were suggesting the cost would be in 2021, albeit with time remaining.

Hillier said, regardless, the work doesn't appear to be connecting with real issues her members have.

She gave an example of going into an online system to look at available beds in a particular care setting, when there's often a lack of availability across the board.

"It's all filtered through the computer system … it sends you a text message to accept a shift," she said, in offering another example.

"Most of our members are getting text messages to accept a shift when they're already at work. They're working their regular shifts and they're getting a message saying if you want a shift tonight at like eight o'clock," she said, saying that's not helping with the burnout.

"I hate to be negative, but I don't see a lot of positive into the system," she said.

At this point, a decision hasn't been made yet on any extension or renewal of the contract.

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Hillier suggested more work go into whatever iteration of the platforms and efficiency work comes next.

"Reinvest back in our province because you're spending our money, our tax dollars money, on a U.S. company that has no idea what our system is," she said.

For his part, Earle said technology like the software involved in the contract may be helpful in the long run, but that needs to go hand-in-hand with proper human resources.

"We continuously see the investments in these contracts, the costs to Newfoundlanders and Labradorians, and not the benefit that we had hoped for, again either to patients and clients of the system and certainly not to the staff," he said.

The Registered Nurses' Union opted not to comment for this story.

CBC tried to reach HealthStream for comment by phone and email, but received no response.

The provincial Department of Health and Community Services said NLHS continues to evaluate the success of the contract.

In an email to CBC News, department spokespeople Jennifer Konieczny and Khadija Rehma noted the many actions, in many places, required to improve the province's health-care system. They also flagged recent changes to the Pharmaceutical Services Act and revealed improvements at the Health Sciences Centre emergency department as examples of action being taken.

"We also recognize that there is more work to be done to support the health workforce throughout the province and have taken steps to reduce administrative burden and provide supports to health care providers," stated the email, committing the department to working with NLHS to improve conditions for health-care providers.

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Ashley Fitzpatrick is a reporter with CBC News based in St. John’s. She can be reached at ashley.fitzpatrick@cbc.ca.