Transforming clinical systems in British Columbia
The Clinical & Systems Transformation (CST) project is designed to modernize and enhance the quality, and consistency of patient care across three health organizations in the Canadian province of British Columbia. These organizations include Vancouver Coastal Health (VCH), the Provincial Health Services Authority (PHSA), and Providence Health Care (PHC).
More than 40,000 health professionals across VCH, PHSA, and PHC are adopting common clinical and process standards, with patient records being updated and shared electronically via a system named CST Cerner. This shared clinical information system, using Cerner Millennium® software, is replacing paper charts and older systems.
As of November 5, 2022, Vancouver General Hospital started using the new system marking the largest “go-live” in the history of the CST project. Notably, CST Cerner has connection points (or interfaces) with more than 65 current systems for convenience. To date, approximately 3.8 million patient records across VCH, PHSA and VCH have been successfully loaded in to the system. With this activation, the number of health-care professionals using the system at these three health organizations has grown by 7,000 to a total of more than 35,000.
This latest milestone is modernizing care and helping to enhance the quality and consistency of health care delivery to the more than 329,000 patients who visit the Vancouver General Hospital campus annually. It is already being embraced by users, with 99.6 per cent electronic documentation coverage and an average of 18,623 orders being made through the system each day for the past 60 days since golive1
Vancouver Coastal Health’s CST journey began in 2018 with Lions Gate Hospital, Squamish General Hospital, Pemberton Healthcare Centre, and Whistler Healthcare Centre. Having one shared electronic health record enables Vancouver General Hospital to provide more seamless care to patients who move across these sites, both urban and rural. Additionally, it better connects Vancouver General Hospital to other facilities such as St. Paul’s Hospital, BC Children’s and BC Women’s Hospitals and BC Cancer – Vancouver. As a result, whether visiting from another major hospital or a remote community, patients coming to Vancouver General Hospital will spend less time repeating medical history during consultations. That’s because their care provider will have their latest chart information readily available for view within one shared system (no more chasing down paper records).

Data source Oracle Cerner’s LightsOn Network. Statistics above are based on an average across the first 60 days of go live.
Benefits of CST Cerner
Medication orders and other instructions are entered directly into the CST Cerner clinical information system and immediately become part of the patient’s record with computerized provider order entry (CPOE).
From a clinical work perspective, real-time electronic charting at the point of care means more immediate information about a patient’s condition is available, e.g. symptoms of sepsis. Clinical decision support tools are available, including reminders for preventive care, alerts about potentially dangerous situations, evidence-based clinical guidelines, condition-specific order sets, and more.
Health professionals in acute care facilities use a fully electronic closed-loop medication management process. This helps improve patient safety by making sure each medication is prescribed and given to the right patient, in the right dose, at the right time, with the right documentation.
For health professionals, this means there is less unnecessary variation in care and more consistent clinical practices across VCH, PHSA, and PHC. An EHR results in no more searching for or waiting for the chart, writing orders on paper, or deciphering handwriting, while presenting easy-to-access information about the patient’s condition, allergies, medications, and previous medical history.
A system that makes life easier for providers also benefits patients. With real-time access to the health information providers need, patients will spend less time repeating themselves and undergoing duplicate tests. Instead, they will enjoy safer medication management, and receive quicker access to therapies and lab results, resulting in better continuity of care.
Clinical & Systems Transformation Project. CST Project Drivers. Retrieved November 2022 from cstproject.ca/about-cst