Own the StackBritish Columbia’s Clinical + Systems Transformation project (CST) is a joint initiative of Vancouver Coastal Health, the Provincial Health Services Authority, and Providence Health Care. Its purpose was to replace a collection of clinical systems with a shared Cerner-based clinical information system. The implementation and the resulting platform are commonly referred to as CST Cerner.
The $842-million figure
BC government records describe CST as a 10-year program with an estimated total cost of $842 million. That figure represented the planned cost of the overall program—not the amount paid to IBM and not an amount already spent when IBM’s role ended.
In May 2015, Health Minister Terry Lake likewise described CST in the Legislative Assembly as one of British Columbia’s largest healthcare projects and gave its value as $842 million. In the same exchange, the minister said approximately $72 million had gone to IBM by that point.
IBM’s role and the dispute
The project contracted with an IBM-led consortium in March 2013 to design and implement the Cerner-based system. A chronology released through BC’s freedom-of-information system records that:
- planning, strategy, and validation began in April 2013;
- design, build, and integration began in January 2014;
- by fall 2014, IBM and the participating health organizations disagreed about the project’s scope and design methodology;
- the parties began negotiating how to address additional design, build, and validation work in December 2014; and
- the health organizations and IBM agreed to end the contract in March 2015.
The Health Minister told the Legislature that the parties had tried to settle their differences but ultimately agreed it was better to part ways. The IBM team transitioned off the project, and the health organizations brought Cerner in directly.
Cerner takes the lead
By August 2015, Cerner had replaced IBM as CST’s lead contractor. Contemporary reporting described the project as behind schedule and reported that the remaining Cerner work would be funded from the existing program allocation. Cerner was not replacing its own software: CST had been intended to implement a Cerner clinical system from the beginning. What changed was the lead implementation contractor—from an IBM-led consortium to Cerner itself.
The distinction matters. The evidence supports describing CST as a $842-million, ten-year program that separated from IBM after a scope and methodology dispute and then placed Cerner in the lead implementation role. It does not support describing $842 million as the amount IBM received or as expenditure already incurred by 2015.
The term “CST Cerner” remains in active use. BC Cancer, for example, says that five of its six regional cancer centres now use CST Cerner.
Sources
- Government of British Columbia, freedom-of-information response HTH-2015-50640, pp. 80–81. The records state that IBM’s contract was signed March 28, 2013 and that CST’s estimated total cost was $842 million over ten years.
- Legislative Assembly of British Columbia, Hansard, May 13, 2015. Health Minister Terry Lake describes the efforts to resolve differences with IBM, the parties’ separation, Cerner’s arrival, the $842-million project value, and approximately $72 million paid to IBM.
- Government of British Columbia, freedom-of-information response HTH-2017-70403, CST project chronology. The chronology records the IBM-led consortium, the disagreement over scope and design methodology, the March 2015 contract ending, and the subsequent project reset.
- Canadian Healthcare Technology, “Cerner to take charge of BC EHR project”, August 19, 2015. Contemporary reporting identifies Cerner as IBM’s replacement as lead contractor.
- BC Cancer, “CST for Patients”. The current patient information page identifies five of six BC Cancer centres as CST Cerner sites.