The implementation of the new electronic health record system, Millennium, in the Västra Götaland region of Sweden, has been met with widespread criticism and concern, prompting a formal investigation by the Swedish Health and Care Inspectorate (Ivo). Healthcare professionals have reported a litany of issues, ranging from disappearing patient data and misplaced test results to potentially life-threatening medication errors. The severity of the reported problems led to a temporary halt of the system’s rollout just one week after its launch, forcing a return to the previous system. For some staff, like district nurse Alexander Westberg, the week of the Millennium implementation was the most challenging of their professional lives, highlighting the immense strain the flawed system placed on healthcare workers.
The transition to Millennium triggered a wave of protests from healthcare staff who found themselves grappling with a system that seemed to hinder rather than help their work. District nurse Alexander Westberg, initially optimistic about the new system, quickly lost hope as its flaws became apparent. He, along with many of his colleagues, witnessed firsthand the system’s shortcomings, including the disappearance of crucial patient information and the misdirection of test results. This chaotic situation resulted in widespread frustration and anxiety among healthcare providers, who were struggling to provide adequate care under the constraints of the malfunctioning system. The widespread concern culminated in numerous complaints filed with Ivo, prompting the agency to launch a comprehensive investigation.
Ivo’s investigation encompasses 27 complaints specifically related to Millennium received in 2024, along with six additional complaints submitted in 2023. Ingela Ottoson, unit manager at Ivo, emphasized the importance of these reports, stating that public feedback is crucial for identifying and addressing potential patient safety risks. Among the reported issues, the most alarming involves a patient with sepsis whose antibiotic dosage was not only delayed by 18 hours but also doubled by the system. This incident underscores the gravity of the situation and the potential for serious harm due to system errors. Ivo recognizes the life-threatening nature of sepsis and the significance of this error, making it a focal point of their investigation.
Beyond medication errors, other reported problems include the disappearance of key words from the system, leading to potentially dangerous misinterpretations of patient information. For instance, the phrase ”no bleeding” was reportedly changed to simply ”bleeding,” a critical error that could drastically alter a patient’s treatment plan. These types of errors, seemingly minor on the surface, can have profound consequences for patient care. The investigation will also examine information security breaches, as Ivo has confirmed at least one instance where the required designated contact person for critical incidents was no longer employed, despite the region failing to report their departure. This lapse in protocol raises concerns about the region’s adherence to information security regulations and its ability to respond effectively in emergencies.
Ivo’s investigation will delve into both patient safety and information security aspects related to Millennium. The agency has already identified a breach in information security protocols, stemming from the Västra Götaland region’s failure to update their designated contact person for critical incidents. This failure to comply with regulations underscores a systemic issue within the region’s information security practices and highlights the need for a thorough review of their procedures. Ivo has sent a detailed questionnaire to the Västra Götaland region, requiring a response within 30 days. While no firm deadline has been set for the conclusion of the investigation, Ingela Ottoson stressed the importance of a thorough and timely process to ensure patient safety and address the underlying issues with Millennium.
The Millennium case highlights the complexities of implementing new technology in healthcare. While electronic health record systems offer potential benefits in terms of efficiency and data management, their successful implementation requires meticulous planning, thorough testing, and ongoing support. The problems encountered in Västra Götaland serve as a cautionary tale, emphasizing the importance of rigorous oversight and the potential consequences of rushing the implementation of complex systems. The outcome of Ivo’s investigation will likely have significant implications for the future use of Millennium and could influence the development and implementation of similar systems across Sweden. The case also underscores the crucial role of healthcare professionals in identifying and reporting system flaws to protect patient safety and ensure the delivery of quality care.
