I started reading Tim Bousquet’s Morning Files just about from the start. I remember thinking that no one in the province was saying what he was saying. Then El Jones started writing for the Examiner and I thought no one in the province was saying what she was saying. I also remember saying to myself, “one day I will write for the Halifax Examiner.” I got that chance just over three years ago when I wrote my first Morning File. This is my favourite writing assignment as Tim just hands over a space where his writers can write about anything. This works well for me because I have a lot of questions and opinions on many things, and I get to write about those here. And now, I get the first peek at what the other Morning Filers write before it’s published. It’s amazing what they come up with each week.

Besides my coworkers, one of the best parts of the Examiner is its readers. I’ve met many of them over the last few years and they really take ownership of the Examiner. Really, our subscribers are part of the team.

If you’re a subscriber, thank you! If you’re not, you can subscribe here and be part of the team, too.

News

1. COVID update: 38 new cases

Photo by Markus Spiske on Unsplash

There are 38 new cases of COVID-19 in Nova Scotia. That was the announcement on Wednesday and Tim Bousquet had the full update.

So there are now 180 known active cases in the province. Here’s the breakdown of the new cases:

• 19 Central
• 14 Western
• 4 Northern
• 1 Eastern

Bousquet wrote this about yesterday’s relatively high case number:

The Department of Health notes that “Nova Scotia Health Authority’s (NSHA’s) public health team is investigating these new cases to understand the circumstances around the increased numbers.”

Here are the testing locations for today and tomorrow:

Today
Halifax Convention Centre, noon-7pm
Maggies Place (Family Resource Centre, Amherst),  9am-noon and 4-7pm

Friday
Halifax Convention Centre, noon-7pm
Maggies Place (Family Resource Centre, Amherst),  10am-6pm

Oh, and vaccination data is released tomorrow because it’s Friday.

Click here to read the entire story. 

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2. The Tideline: Episode 52, Allegra Swanson and Nova Scotia Music Week

Allegra Swanson.

Nova Scotia Music Week kicks off in Truro today. To celebrate and get the details of what’s on the next few days, Tara Thorne chats with Allegra Swanson, executive director of Music Nova Scotia, which organizes Nova Scotia Music Week. Swanson also tells Thorne about her work as an opera singer.

This episode includes a couple of tunes from multiple nominees Keonté Beals and T. Thomason.

Listen to the episode here for free. 

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From our subscribers:

Milena Khazanavicius and her guide dog Louis

Milena Khazanavicius and Louis. Photo  contributed

Now that I have had the Examiner arriving to my email inbox every morning for a year it has become my morning drug! Along with my required coffee and relieving of my guide dog, I eagerly await for the hard news reporting to fly in. The radio is on and reporting on this and that, but with never enough information, it seems of late. The Examiner and all its “dig in and get to the marrow” news provides, for me, the information I look for. Though I may not always agree with some commentary or points of view from some journalists, they are balanced out with the other side or sides.

The Examiner is a full-meal deal with an appetizer, a main meal, and Iris and her perspectives of the day, with the dessert-at-the-end-of-the-morning newsletters.

The journalists would appear to take it in stride with readers’ points of views and disagreements or agreements, and either apologize or further investigate into whatever the matter /story at hand should be. Furthermore, for those of us who are blind or partially sighted the Examiner has been working hard at text descriptions on pictures and making the stories more and more accessible. Still, work remains on accessibility, but thumbs up for now.

I’d have serious withdrawals at this point from not having my morning Examiner fix if it should ever be removed from my reaches. I’d definitely join the Examiner addicts-are-us group. Keep up the hard work and your clear and concise reporting, because who wants to eat runny oatmeal for breakfast when you can have serious bacon and eggs like the Examiner!

Bob Bancroft

I subscribe for a number of reasons, including having respect for the Examiner’s origins. As a wildlife biologist, I truly appreciate the in-depth articles researched and penned by Jennifer Henderson, Joan Baxter and Linda Pannozzo. Their articles are provincial standouts and reason enough to subscribe. Tim has also been kind in letting me publish in the Examiner. Nature is taking a beating. Mark Carney put it well: we’re “trading the planet for profit.” I applaud your writers for rooting out the economic skullduggery behind some of the demise of nature that is taking place across Nova Scotia.

3. Small business and anti-maskers

Alex Cooke at Global talks with Philip Holmans, owner of the World Tea House, who says he’s fed up with anti-maskers trying to enter his downtown store. Every Friday night for the last while, a group has gathered on Argyle Street in downtown Halifax to protest the province’s proof of vaccination requirements. The protestors have gathered in front of Holmans’ shop and calls those nights “hell.”  Holmans tells Cooke:

I’m all for people protesting and being able to voice their opinions,” he said. “But they insist on trying to enter my business without a mask on, and we do have a mask policy, as do most businesses in HRM.

Those protestors hung out on the patio at Holmans’ store and he actually served them outside. But as Cooke reports, Holmans took in that patio furniture after a group went inside the store while not wearing masks and harassed his staff. Holmans tells Cooke:

If you want to put on a mask, absolutely, you can take your drinks and go to your protest.

But without physically putting on a piece of cloth for that 10 feet, and that 30-second transaction — if you’re that adamant about not having that on, then I’m pretty adamant about not serving you.

Holmans says he’s talked with other businesses in the area, who’ve also had enough. Cooke writes:

“(The protesters) talk about their rights, violating their human rights and all that stuff. But what about us?” he said.

“Don’t we have a right to make a living? Don’t we have a right to feed our children? Don’t we have a right to create a good work environment for our staff and for our customers?”

He also said there are better places they can protest — such as government buildings — rather than outside the restaurants and businesses that are simply following the province’s rules.

Holmans has been sharing some of the negative reviews he’s getting from anti-maskers. He’s tweeting them all here.

The Examiner team was talking about this story and Holmans last night. Tim Bousquet says he often speaks with Holmans, who he said managed to stay open during the pandemic by going out and making cold calls when he couldn’t sell products to customers from his store. As Bousquet says, Holmans is “truly an example of someone just figuring it out.”

The last year and a half has been tough on small business and I can’t imagine being that selfish to make it tougher for them. Wear a mask and be extra kind to staff.

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4. Foster parents needed

Community Services Minister Karla MacFarlane speaks to reporters in Halifax on Thursday, Oct. 7, 2021. Photo: Zane Woodford

The province is spending $34 million to rework the system over the next three years in the hopes more people will sign on to foster. That spending was detailed in a news release from the province yesterday. 

“Foster parents are among Nova Scotia’s most dedicated volunteers, and we need to ensure they are well-supported,” said Karla MacFarlane, Minister of Community Services. “Right now, Nova Scotia needs more foster parents, and it is my hope that a redesigned system will encourage more people to consider this calling.” 

The redesign will include new financial supports and an immediate increase in per diem rates by $15 a day. It will also include: 

• engaging youth currently or formerly in care to hear their concerns and ideas 
• implementing a new system model that provides for a stronger community of support for foster families and children in care 
• new foster care placement types including enhanced respite care for children with specialized needs 
• improving communication and enhancing supports for foster parents during child welfare investigations.

Feleshia Chandler at CBC wrote a story about the foster care redesign plans and reported about previous recruitment efforts. Chandler writes: 

In March, the province announced it would spend $5 million on a new program called Because You Care Foster Family Initiative, which is aimed at helping recruit 500 more full-time foster families. 

Once the system redesign is fully implemented, there will be an annual increase in the foster care system budget of $16.7 million. 

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Views

Technology in health care is a matter of fax

Can you call the 80s on this thing?

On Monday night, I saw this tweet from Nova Scotia Health.

While it’s good to see that fax issue got resolved, what I really noticed in the thread that followed was that many commenters were shocked to learn our health care system still relies on fax machines. As one commenter tweeted, “This is 2021 not 1984. The elimination of faxes cannot come fast enough.”

I knew doctors and pharmacists still use fax machines, but I wanted to find out how often they’re used in the larger health care system in Nova Scotia. And it turns out a lot. And it’s not just Nova Scotia. In fact, most health care systems nationally and internationally rely on fax machines to share information.

So, I sent out some emails — not faxes — to learn more. Barb Johnson, a spokesperson at Doctors Nova Scotia told me every physician and health care provider in the province must use a fax machine:

The lack of an integrated clinical system in NSH/IWK forces lots of unproductive faxing. The fax machine will continue to be a key method for communicating among providers, until a new electronic system becomes available. Ideally, what’s needed is an integrated information technology system that would enable shared information among health care providers and remove the need for faxing forms between health-care providers.

Even physicians with an EMR have to fax requisitions for services. Insurance companies still use faxes, pharmacies fax to physicians, etc.

Government is working towards a new system called OPOR (One person, one record), which will integrate the province’s health information system so that faxing referrals among providers will no longer be necessary.

I have more on that in a bit.

First, I interviewed Dr. Tim Holland, who practices at the Newcomer Health Clinic in Halifax and shares a family practice at the Sipekne’katik Health Centre in Indian Brook. Holland would like to see health care ditch fax machines so much he talked about getting rid of the fax machine in his valedictory speech when he took on the role of president at Doctors Nova Scotia a couple of years ago.  

My main motivation to axe the fax isn’t necessarily driven by anything against the fax machine. It’s the first step in helping the medical community get up to date from a technological perspective to where the rest of civilization is heading. Health care in general has been very slow to adapt to change. There is a very conservative culture in terms of being cautious in making too big a change, too quickly. And it makes sense. Lives are on the line, it’s a massive structure, administratively speaking, in terms of the amount of human resources and technological resources that are involved. That hesitation [to change] comes from a place of wanting the safest thing for the patient has led us to a place whereby we’ve not been able to take advantage of the other technological advancements that are out there. And the fax machine is where you can see that more predominantly. 

Holland says while faxes are more secure than email because it’s more difficult to intercept a fax line — at least theoretically — he says faxes still get lost, dropped, or picked up by anyone just walking past the fax machine. Holland says even e-faxes, which are transmitted by computer, but not printed off on paper, are still archaic.  

He pointed out that COVID has forced health care to jump ahead in terms of technology. That’s a good thing. Think of the virtual visits many of us have with doctors now. Holland says the system still needs infrastructure changes to make getting rid of fax machines easier. He says he hopes that when we finally get past all the COVID restrictions that health care doesn’t regress back to its previous state.  

Getting rid of fax machines means having another communication system in place, though. Holland says part of that plan is OPOR (One person, one record).  

OPOR should be designed in such a way that it doesn’t rely on fax technology. There are some incredibly smart people who are involved at very high levels with OPOR and who are also very sympathetic to the need to take advantage of these technological opportunities, so hopefully that sort of thing will be implemented along beside OPOR, or at least some way to get around the archaic issues of fax machines.  

Before fax machines came along, results and paperwork were mailed out via snail mail. Fax, is at least instantaneous and doesn’t get lost in the mail. And it is secure as long as you put the phone number in properly. Also, insurance companies still use fax machines to send forms, requests for charts, and so on. I contacted Amy Wagg, a spokesperson for the Pharmacy Association of Nova Scotia (PANS), who told me by email that faxes are still used in pharmacies, mostly for receiving prescriptions, but also for communicating information to a patient’s primary healthcare provider. She gave me a rundown on exactly how faxes are used in pharmacies:

Sometimes the faxes are sent and received through computer systems instead of traditional fax machines (i.e. a physician can send a prescription through their EMR (Electronic Medical Record system) and the pharmacy may receive it through the Pharmacy Management Software — these would still be faxes but are sent and received completely electronically without the use of scanning a piece of paper). Alternatively, a fax may be sent via a traditional fax machine and received through a computer system, or vice versa.

If a pharmacy receives a prescription through a traditional fax machine, they would scan the prescription and attached the scan to the patient’s file. The hard copy of the faxed prescription would be shredded.

I also spoke with Keltie Jamieson, who said fax machines are the most “secure” — and she made sure to use air quotes — way to share information from a health care perspective.  

Because you don’t know where email services live, a lot of things aren’t safe to send through email because it could be in the US or another country where they don’t have the same privacy laws as us. You don’t want to use Google mail to be sending information that would need to be secure.  

Jamieson said to get rid of fax machines the system needs to have “modern, robust clinical information systems.” 

If you’ve been to your community physician provider, they use an electronic medical record for community providers. We need a clinical information system equivalent in acute care in order to be able to accept that information in an electronic way.  

Acute care is ambulatory care, emergency departments, and inpatient clinics where a lot of that information is still paper-based charting that is scanned into a PDF. Jamieson calls this electronic versions of paper processes. And while fax machines are used in health care systems around the world, there are places that are axing the fax with success. Jamieson pointed to National Health Service (NHS) in England where they’ve have a clinical information system for much longer. NHS in England also has a mandate to “axe the fax” in 2022. Like Holland, Jamieson says the technology needs to be in place before we axe the fax here.  

As for OPOR, Jamieson says that’s the clinical information system that will replace fax for registration, pharmacies, and labs. It would include clinical documentation online, online order sets, and online entry, a system for emergency departments, and an OR system. So, with OPOR, transferring a patient from Truro to Halifax would mean the chart transfer would be “seamless” because it’s one system. Right now, during that sort of transfer, a paper chart is tucked under the patient’s stretcher. 

As for the status of OPOR, Jamieson it’s still in active procurement and waiting for a “government perspective on next steps.” 

Jamieson says there are projects to look at as success stories, including several in Ontario and one in Alberta that’s halfway through a provincial implementation. She says there’s a “rosy outlook” on the future of a similar project here.  

Holland, meanwhile, says this issue isn’t just about the fax machine. He says axing the fax could mean moving along with more technology in other areas of health care such as using artificial intelligence.  

If you had OPOR in the health care system in such a way that you were appropriately tracking prescriptions going out based on certain diagnostic codes, you could have moment-to-moment information about how physicians and nurses are practicing across the province. The opportunity for data mining there, if it’s set up in an appropriate, anonymous fashion, is just huge, and [improves ] our ability to understand disease and therapeutic opportunities. Unless we’re able to get past the fax machine, unless we’re about to get past a lot of those hesitations, we’ll never be able to take those opportunities. 

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Noticed

I haven’t shared any terrible job postings for a while. There’s certainly no shortage of them as plenty of employers are looking for workers. But it seems the pandemic hasn’t changed one thing in the world of work: asking people to work for free!

Matt Dagley sent me this posting for a social media coordinator. This is a volunteer role with a private company. Here are the responsibilities:

• Responsible for posting and engaging daily on all social media channels (Facebook, Twitter, and Instagram) and blogs
• Create marketing ads to grow business
• Develop and execute a strategy to grow all social media channels
• Create trendy content for multiple social channels and blogs
• Write SEO-friendly content for web pages and perform basic keyword research
• Become a company advocate in everything social media related, engaging in dialogues and answering questions where appropriate
• Identify opportunities to guest blog and invite guest bloggers to participate
• Regularly provide feedback on insights gained from social media monitoring (Facebook Insights, etc.)
• Continuously monitor social media trends and tools for changes that affect our competitive landscape
• Use alerts, search, and other tools to monitor for mentions and interact daily
• Conduct market research through influencer and social media listening
• Attend industry events and retail trips
• Conduct, gather, and sort market research

Sure, the post says the gig is only five hours a week, but that’s a lot of work to squeeze into that short period of time, so you just know the person who takes on that job will work more hours. The post lists qualifications, which include knowledge of social media, writing, editing, photography, and a “passion” for health and nutrition. This is a job that should pay. It doesn’t matter if the company is a startup. Social media is often undervalued and managing it isn’t just posting on Facebook and Instaglam.

They also added this bit: “This is a great position for marketing students who would like some hands-on experience. There’s no such thing as a ‘perfect candidate. We’re looking for an optimist with grit and determination, who is excited to face the challenges of a growing startup.” You know, a marketing student could use the pay each week. Grit and determination won’t pay for rent or tuition.

I am always saying this, but don’t work for free. Your talents and skills have value. And employers, pay your staff.

Oh, and this one isn’t a work-for-free gig, but McDonalds at the Scotia Square location is hiring. You don’t work for free — it’s also certainly not a living wage — but this line stood out: “Bring your authentic self to work.”

Can we please stop using this “authentic self” line, please?

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Government

City

Thursday

Environment and Sustainability Standing Committee (Thursday, 1pm, City Hall and livestreamed) — agenda here

Women’s Advisory Committee (Thursday, 4pm) — livestreamed

Point Pleasant Park Advisory Committee (Thursday, 4:30pm) — livestreamed

Harbour East-Marine Drive Community Council (Thursday, 6pm, City Hall) — livestreamed

Province

No meetings

On campus

Dalhousie

Thursday

Mechano-sensors in the heart: interplay between mechanics and electrics (Thursday, 11am, Room 3H1, Tupper Building, and online) — Remi Peyronnet from the University of Freiburg will talk.

Transparency, Power and Influence in the Pharmaceutical Industry (Thursday, 12pm) — interdisciplinary panel discussion via Zoom:

Transparency in the realm of pharmaceuticals is a deeply contested policy issue. Doctors, patients, and their allies have fought for decades to make the evidence behind many prescription drugs publicly available.

While the level of transparency has improved significantly in recent years, a number of challenges remain. It’s not clear, for example, whether the evidence now on offer is actually being used to make better decisions about which drugs to prescribe. Worse, there are growing concerns that the added transparency is giving cover to parallel efforts to lower regulatory standards for drug approval.

Drawing upon years of research and advocacy to increase transparency in pharmaceutical research and regulation—including insights reflected in the panelists’ 2021 book, Transparency, Power and Influence in the Pharmaceutical Industry—this interdisciplinary panel discussion will interrogate the successes and failures of transparency, including in the context of COVID-19.

Friday

Industrial Colonialism and the Remaking of the Mi’kmaq Economy (Friday, 3:30pm, Room 1170, McCain Building and online) — Colin Osmond from Mount Saint Vincent University will talk.

In the harbour

Halifax
08:30: Gotland, cargo ship, arrives at Pier 30/31 from Rostock Port, Germany (itinerary)
11:15: Oceanex Sanderling, ro-ro container, moves from Pier 36 to Autoport
15:30: MSC Leigh, container ship, sails from Pier 42 for sea
16:00: X-press Irazu, container ship, sails from Pier 41 for sea
16:15: Oceanex Sanderling moves from Autoport to Pier 41
17:00: Maersk Palermo, container ship, arrives at Pier 42 from Montreal (itinerary)
18:00: CSL Tacoma, bulker, arrives at Gold Bond from Norfolk, Virginia

Cape Breton
05:30: Algoma Victory, bulker, arrives at Coal Dock (Point Tupper) from Baltimore
07:30: Rt Hon Paul E Martin, bulker, sails from Aulds Cove quarry for sea
18:30: Algoma Victory sails for sea

Footnotes

November is our subscription drive, but it’s also my birthday month. What are the chances of getting 51 new subscribers to celebrate?

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