Implementing the Digital Health Record: Quebec Civil Servants Forced to Work in English

Health network employees have filed a complaint with the Office québécois de la langue française against the Quebec government because they have been forced to work in English since the $1.5 billion contract was awarded to US giant Epic Systems.

The American company won the largest IT contract in Quebec's history last year to digitize the entire health network.

The first phase of the contract is a pilot project to implement the Digital Health Record (DSN) at the CIUSSS du Nord-de-l'Île-de-Montréal and the CIUSSS de la Mauricie-et-du-Centre-du-Quebec.

This project, called “Vitrine DSN”, is being carried out in collaboration with the staff of these two institutions. However, meetings and trainings are held in English, as Epic's staff does not speak French.

A few weeks ago, complaints were filed against the Ministry of Health and the CIUSSS de la Mauricie-Centre-du-Québec, our parliamentary office has learned. Remember that the working language in Quebec is French and there is no requirement for employees to know English.

The Office du Québec de la langue française (OQLF) confirms that it has indeed received these complaints and is conducting an investigation.

“The checks are underway. The office will ensure that the linguistic rights of workers are respected in relation to the training provided to employees to implement the digital health record,” said spokeswoman Chantal Bouchard.

MSSS defends itself

For its part, the Ministry of Health believes that it respects the law.

“Further investigations are ongoing and steps are already underway with Epic to find permanent solutions,” said spokesperson Marie-Pierre Blair, noting that MSSS has offered its full cooperation with OQLF. The Department of Homeland Security maintains that “many of the elements in these complaints” are unfounded.

The ministry said it had put simultaneous interpretation in place as a “transitional measure” if training was not yet available in French.

“During meetings, when teams call on English-speaking experts, the conversations are translated. The goal is to have access to the best expertise, while ensuring that French remains the reference and working language,” said Ms. Blair.

When the DSN is complete, doctors in different institutions, for example, will be able to view a patient's history without having to transfer the paper file from one hospital to another.

About 400,000 healthcare workers will have to learn how to use the new tool. Remember that the network currently includes 9,000 information systems, 65,000 connected devices, 2,000 telehealth devices, and 220,000 computers.

Another struggle

Moreover, as our parliamentary office recently reported, the signing of a $1.5 billion DSN contract with US giant Epic Systems has also led to a radical change in the ministry’s orientations in the Your Health project.

In the summer of 2022, the Ministry signed a contract with Lévis Akinox to develop the Frontline Access Meter (GAP) and continue the creation of the Vos Santé smartphone application, a comprehensive portal for citizens.

The GAP digital service allows orphan patients to make an appointment with their family doctor.

Your Health app is out there and will be ready to go live quickly, either on Google Play or the App Store, but it is being shunned by senior MSSS managers.

According to our information, management wants Epic Systems to start from scratch and create another application directly linked to the DSN, even if it does not have this expertise or this authorization.

“Three complaints” against MSSS

• The Charter of the French Language provides for criminal and other sanctions to be imposed on any person who violates any provision of the Charter or its regulations.
• These fines range from $1,500 to $20,000 in the case of a legal entity such as the Ministry of Health and Social Services and the CIUSSS de la Mauricie-Centre-du-Québec.