What is OPOR?
One Person One Record (OPOR) is a clinical transformation initiative that will improve delivery of healthcare for patients across Nova Scotia with IWK Health and Nova Scotia Health.
Regardless of where a patient accesses care, if they are adults or children, they will benefit from their care teams having real time, comprehensive access to their health information, and to standardized, best care practices. The implementation of a secure, personalized, comprehensive province-wide clinical information system is foundational to improving the healthcare system for Nova Scotians.
- Improved patient safety, outcomes, and experience: Reduce errors, adverse events, and redundancies.
- Quality and consistency, every day, everywhere: Support clinical standardization.
- Patient information where you need it, when you need it: Real-time information healthcare providers need.
- Improved health management and continuity of care: Supporting proactive care, seamless transitions, and reliable, transparent communication with patients and their caregivers.
- Data driven decisions: Timely and reliable data to make measurable improvements to the healthcare system and patient care.
- Increased system strength and support for clinicians: Improved software and networks for a safer and sustainable system, streamlining workflows and reducing administrative burdens and delays while adhering to confidentiality and security requirements.
What is the OPOR Clinical Information System?
OPOR is driving healthcare transformation with the implementation of a provincial Clinical Information System (CIS) that will connect patient information and care plans across IWK Health and Nova Scotia Health. The provincial system will replace or integrate over 80 healthcare applications currently used. The OPOR-CIS will allow us to transition from paper-based care processes and documentation practices to a provincial electronic system, enhancing patient safety through standardized care pathways and workflows, and improved communication.
A CIS is more than a digital patient chart – it is a mechanism to facilitate collaboration and establish new ways of working together. The OPOR-CIS is a clinician-led project with the support of Nova Scotian subject matter experts representing different specialties and impacted groups in the design of the system.
A CIS supports patient and family centred care by improving access to information and standardizing best practices across the healthcare system. Healthcare providers, clinicians and everyone who is part of the patient’s circle of care will have secure access to real-time data and more efficient systems and processes with a single log-in, while maintaining a commitment to confidentiality and security.
One Person One Record will transform the way physicians, clinicians, and healthcare workers work to deliver care more effectively and efficiently to all Nova Scotians.
- Enable digitization and automation of all current paper/manual/fax processes.
- Provide access to clinical information from across the province in a single electronic platform.
- Facilitate digital charting for all hospital-based acute and ambulatory care.
- Support standardization of physician and clinician workflows.
Clinical standards are benchmarks, measures or quality statements. They are created based on evidence-informed best practice guidelines to provide safe, high quality care.
Clinical standardization is the process through which standards and protocols for health care practitioners and learners are identified, adopted and put into practice.
Clinical standardization:
- Supports patient safety and provides consistency in care
- Delivers patient and family-centered care
- Increases efficiency and optimizes health care resources
- Improves health outcomes, as well as practitioner and learner accountability
The One Person One Record program, through the development of Clinical Standards, envisions a healthcare system where patients and providers have equal access to quality no matter where care is given or received.
Some updated physical computing devices will be required by clinical providers in Nova Scotia and IWK Health facilities for delivery and use of the new Clinical Information System (CIS) software. These non-clinical devices will be used to process patient health information. Teams will also address the required accessories for the devices, such as mounting points, mobile carts, input devices like barcode scanners, and any output devices which includes things like printers.
The IT Device Team is addressing the required accessories for any new or upgraded devices, such as mounting points, mobile carts, input devices like barcode scanners, and any printers or other output devices.
Site Assessment
Every space in every hospital facility will potentially need to accommodate new hardware and it will be critical to ensure we’re only dealing with what needs to be there. An important first step will be to implement a site assessment strategy. This will start well in advance of any implementation and will be led by a Project Manager who will meet with department leaders to review the strategy. All available space and storage will be reviewed, and anything deemed surplus needs to be discarded.
Clinical engagement aims to bridge the gap between the management and delivery of healthcare by fostering effective communication and partnership between clinicians, administrators, and all of our partners. It recognizes the valuable insights and expertise that clinicians possess, incorporating their perspectives into the strategic planning, execution and delivery of change management supports, education and learning, and effective closed loop communication.
In summary, clinical engagement is a collaborative approach that involves clinicians in healthcare decision-making, ultimately leading to better patient care, improved organizational performance, and the development of a more patient-centered healthcare system.
•One Person One Record will require a Clinical Support Model (CSM) that is rooted in user experience. Processes will be well-defined, documented, and accessible to clinical support staff and clinicians/users.
•The OPOR Clinical Support Model will be developed through a partnership between NSH, IWK, and CSDS and will incorporate clinical and technical knowledge through onsite and remote support. Guiding principles are as follows:
Developed by Clinicians
- The OPOR CSM aims for first call resolution in 90% of cases.
- Clinical Support will be a 24/7-365 service
- Access to clinical support will be intuitive and patient/clinician-centered
- CSM will employ a triage system that helps diagnose and assign issues to the right person for the quickest solution
- The CSM will track how long on average it takes to start working on the request and how long it takes to resolve
- The CSM will ensure effective and proactive communication with end users
- The CSM will be well understood by support staff and clinicians with transparent processes and clear escalation guidelines
- Administrative burden and troubleshooting will not be the responsibility of the end user- the CSM will ensure that clinicians are focused on the patient in front of them
- Clinical users will connect with a clinical informaticist as the first point of contact unless the issue is clearly technical
- On site informatics support will be a priority – embedded in informaticians as well as peer-mentors
- Users will have the opportunity to quickly identify the system issue – clinical, solution, or technical
- Peer mentors will support the CSM and will be identifiable within the department
- Clinicians will have multiple means of connecting with support via in-person interaction, phone, Teams channel, or ticket depending on the most appropriate pathway
- Clinical Support Model will allow for differentiation between education, break fix, and design issue and will triage accordingly
- Clinical Support will provide clear timelines for resolution and provide status updates as progress is made
- CSM will prioritize customer satisfaction
- CSM will support independent problem solving where appropriate
- Questions and concerns will be available via Teams Channel or other communication tool for quick reference
- CSM will encourage feedback from users on service levels
- Role clarity and scope of support staff will be defined
What is the Cerner Canadian Reference Model?
OPOR is embarking on the design phase of the program, building off of the Cerner Canadian Reference Model (CCRM). The CCRM acts as a starting point of recommendations, workflows, and best practices. During the design and configure process we are not starting from scratch, we are validating content and localizing for Nova Scotia when necessary. Of the Canadian sites using Oracle Health, Kitchener, Windsor, Kingston, Niagara, and Nova Scotia are using Cerner Canadian Reference Model content.