From scouring a crowded screen just to find important information, to racing to a caller’s home only to discover they’ve already been taken to hospital, several Montreal-area paramedics say the new computer-aided dispatch system (CAD) in their ambulances is plagued with problems — and they fear it’s putting patients at risk.
Urgences-santé, which offers ambulance services in Montreal and Laval, launched the new computer system in May. The program connects dispatchers to paramedics out on the road in real time, providing them with patient information, addresses, directions and more.
Some front-line workers say the transition has been difficult, and they worry it could affect how fast they’re able to get to patients in an emergency.
CBC News spoke with five paramedics who say they’ve been sent out to respond to 911 calls unnecessarily — either because the call had already been handled by another team and reappeared in the system or because several ambulances were dispatched to the same call.
Two paramedics described incidents where they had been preparing to get the door opened by force because they couldn’t get a response from the patient, only to realize just in time the call was a duplicate.
Urgences-santé and the union representing paramedics say they don’t have any reports of doors being mistakenly broken down.
CBC is not naming the paramedics because a clause in their contract prevents them from “speak[ing] badly about their employer or hurting their reputation in any way,” their union confirms, and they fear repercussions for speaking out.
New ambulance dispatch system riddled with problems, Montreal-area paramedics say
Paramedics said these duplicate calls occasionally happened with the old system but that they ramped up in the first few months after the new model was implemented. A few told us they were still happening over the last few weeks.
“The union absolutely believes that the [CAD] is causing significant delays in its current condition and we can see that by all of the reports that we’re being sent by multiple different paramedics,” said union representative Charles Duff Murdoch with the Syndicat du préhospitalier (FSSS-CSN).
“If an ambulance is sent twice on the same call, obviously that second ambulance that could be used somewhere else is causing delays for other calls.”
He says these glitches make their already packed days more challenging.
Urgences-santé insists there’s been no impact on patient care since the CAD was implemented, adding that “growing pains” are to be expected with every new system.
“We’re making sure the double calls don’t happen. They have happened in the beginning. We are six months into the implementation of our new system. So there’s still a learning curve that we’re in,” said Jean-Mari Dufresne, operations supervisor at Urgences-santé.
He added the system is in “evolution” and that new features should be able to prevent the duplicates down the line.
When asked for data on ambulance response times, Urgences-santé said it was not readily available and advised CBC to make an access to information request.
Murdoch points to other concerns reported by the union’s members, including alleged instances when the CAD system failed to capture the ambulance’s location through GPS for entire shifts. He says if dispatchers aren’t able to see the ambulance on the map, it can be difficult for them to decide which one to send on a call.
“You’d either have ambulances that would be completely forgotten about or they would have to very often be called upon to see, ‘OK ‘what’s your location?’”
Murdoch says paramedics have also reported receiving a new emergency call in their ambulance at times when they were with a patient and were supposed to be unavailable.
Three paramedics told CBC they have worked entire shifts where the CAD system was completely down and, with a high volume of calls, they couldn’t take the time to have it fixed.
In those situations, they said they had to rely on backup methods, such as communicating with dispatchers through radio or phone and writing down addresses on paper.
Murdoch confirms the union has also received similar reports, especially in the first month after the new system was implemented.
Dufresne of Urgences-santé pushed back, saying he believed that reports about the CAD system being unavailable for entire shifts “aren’t accurate.”
He said the organization’s GPS system “is very up to date” and that the dispatch centre is able to “see all the ambulances and vehicles that need to be seen.”
He says that when choosing the ambulance to send on a call, dispatchers take other factors into account besides distance, including the priority of the call and where paramedics are on their shift.
Most paramedics CBC spoke to said the system also isn’t user-friendly, which makes their job harder when they’re on the move. Some said they often have to scroll through a crowded interface to find a lengthy address or the status of other emergency services deployed to the same call.
The majority also said they hadn’t received enough training.
“They were just kind of thrown in and had to figure it out on their own,” Murdoch said, adding that was a big complaint from members.
He acknowledges that newly hired paramedics that never worked with the old system seem more comfortable with the new one but that “there are still going to be frustrations and delays.”
Murdoch says the union brings up its members’ concerns during regular meetings with the public organization.
“We do see that Urgences-santé, along with the company, they do have many updates related to the [CAD] so we do notice that they’re trying to make it better,” he said.
Dufresne says the previous system was more than 10 years old and wouldn’t have been able to keep up with necessary updates.
Public documents also show that the new system is the first step in a provincewide effort to standardize all the computer-aided ambulance dispatch programs used across Quebec into one single system.
He says the program has cost just over $6 million so far and is set to cost about $320,000 per year for regular updates and maintenance.
“As for any new software that we install, glitches are to be expected. They were anticipated to a certain extent, and measures were taken and are still being taken to make sure those kinds of situations don’t happen again,” Dufresne said, referring to the calls that reappear in the system.
He says there are backup systems in place, like having different ways to communicate with paramedics if there are issues with the dispatch program “to ensure that we don’t miss any calls.”
Dufresne also says Urgences-santé has a team monitoring the computer system 24/7 and is in constant collaboration with the program’s supplier to correct any technical issues if they arise.
He said the organization offers ongoing training, holds briefings and that documentation is available to paramedics on their online employee portals.
CBC reached out to EMERES INC, the company that developed the system, for comment. They responded that “by policy, EMERES does not comment on customer specific environments or issues” and referred us to Urgences-santé.
Last year, the company was awarded a contract to develop a new CAD system for the Montreal police and the Montreal fire department for a maximum amount of just over $25 million after a call for tenders, according to public documents.
Santé Québec didn’t respond to a request for comment.
