PORT HAWKESBURY: The Halifax-based Occupational Stress Injury (OSI) Clinic that retired Cpl. Lionel Desmond tried to access mental health services through now doesn’t require their patients to have a family doctor before receiving their services.

“It wasn’t a rule when I came to the clinic in February of 2018,” Patrick Daigle, the facility’s manager said. “I think there may have been something in place prior to that.”

Daigle testified at the Desmond Fatality Inquiry on March 11 that in a recent conversation with the clinic’s former manager, despite not being able to fully recollect the details, he believes the requirement to have a family doctor was previously enforced.

Since then, the clinic now has a family physician on staff, however the former manager indicated the process of hiring a family physician “predated the tragic events” in Upper Big Tracadie.

Dr. Abraham Rudnick, the clinical director of the Nova Scotia OSI Clinic, testified better national data is desperately needed regarding how to properly treat Canada’s veterans for conditions such as post-traumatic stress disorder (PTSD).

“Robust and systematically collected data would help with better treatment planning,” Rudnick said. “We need statistics for that to know what works and what doesn’t work at all those levels of the journey by a soldier and then a veteran.”

He suggested without it there may be cases, as in Desmond’s, where health-care providers are “spinning our wheels” and providing a treatment plan that may not fully maximize their recovery potential as “we may have gaps that are not identified.”

Rudnick testified soldiers who receive early intervention following a traumatic event are less likely to develop chronic symptoms connected to it.

“Early intervention, like in all medical health care these days, is crucial to try to reduce that conversion from acute stress disorder to PTSD,” he said. “We need a data set that’s national so that we can improve services.”

Desmond never received any assistance from the Nova Scotia OSI Clinic, after being referred by their sister clinic in Fredericton. Specifying the three-hour travel time each way to the Halifax-based clinic being an obstacle, his Veterans Affairs case manager was instructed Desmond wanted to receive his therapy in his home community.

As multiple health-care professionals weren’t able to fully access Desmond’s health records as he asked them for help with his PTSD, a clinical nursing informatics officer with Nova Scotia Health testified on March 12 that the systems Nova Scotia uses to keep track of medical records remain outdated.

“Many of the systems across the province are old and in need of an upgrade,” Alyson Lamb said.

Lamb explained Nova Scotia currently uses numerous patient information systems, some that date back to the 1980s, most of which aren’t connected electronically making it extremely difficult for practitioners to share patient files.

“If you were to draw it, it often looks like spaghetti on a plate,” Lamb said. “There’s so many systems with feeds going everywhere.”

The inquiry also heard from Linda Plummer, Nova Scotia Health’s director of health information services, who said the various systems the province uses aren’t connected to any of the federal systems.

Plummer suggested that level of record sharing should be within the responsibilities of Veterans Affairs Canada, especially when a case manager is appointed to a veteran to offer additional help.

Nova Scotia is still in the process of transitioning to an informatics system that she said will allow for full integration of all electronic patient records, but the project is still a few years from being fully implemented.

The new internet-based system will allow patients to easily access their personal health records with their smartphones through a patient portal, which would allow any individual to share their health records with any health-care provider in any hospital, clinic or province they’re attending.

The inquiry will resume hearings on March 23.