FAQ

The One Person One Record (OPOR) program enables a digitally supported, patient-centred healthcare transformation in Nova Scotia.  It’s a multi-year program designed to transform the way we use and share health information.  In collaboration with IWK Health, Nova Scotia Health, and the Nova Scotia Government, the goal of OPOR is improved patient care. OPOR will create a future where patients and providers have seamless access to the information and care processes they need, no matter where care is given or received within Nova Scotia.

The transformation centres around the implementation of a Clinical Information System (CIS). The OPOR Program also includes the development of new clinical standards, new devices and infrastructure, and the elimination of paper-based processes, all designed to help our healthcare professionals provide better care to more patients. This program will represent the most significant, transformative change in how healthcare is delivered in Nova Scotia.

A Clinical Information System (CIS) is a computer program designed to collect, store, analyze, and share information in the healthcare delivery process.  It will simplify the clinical processes that are used now in the hospital environment. The many fragmented Hospital Information Systems currently in use to collect patient information are costly to maintain and unable to share information across the continuum of care.  A CIS enables the replacement of many of those disjointed systems with a single all-encompassing mechanism that will enable the best possible level of care.

The OPOR-CIS is a clinically-led program that will transform the way physicians and clinicians work to deliver care more effectively and efficiently to all Nova Scotians

There are many systems our health professionals use daily, that help them make decisions about patient care. On average, they use up to five different systems each day. These systems are outdated, slow, and cannot share information between them. This is a problem when it comes to quickly responding to the needs of patients.  

The OPOR-CIS will provide improved quality across the continuum of care through immediate access to patient medication, drug interactions and medical history province wide. The OPOR-CIS will improve patient safety by eliminating the need to repeat requests for information with all relevant information accumulated in the electronic record.  This will enable improved planning and monitoring of patients through pro-active care which leads to an overall improvement in population health outcomes.

This clinical information system is a complex implementation which will affect more than 40,000 clinicians, physicians, and health system employees, involving multiple facilities across four zones and two organizations.

Currently, health professionals do not have real-time access to patient information in Nova Scotia. We are one of two provinces that still chart on paper, which must then be scanned and uploaded to another system for health professionals to access. We also have many systems that cannot share information between themselves or regions in the province.  The sheer variety of Hospital Information Systems currently in use are fragmented and costly to maintain. The system faces significant challenges, demanding change in how clinical services are managed and delivered. Our current systems require upgrades and, in some cases, full replacement in order to deliver improved, efficient, and cost-effective healthcare. Many Nova Scotians think we already have a fully functioning Clinical Information System (CIS), but the truth is technology has far outpaced our current state, leaving us with outdated systems that don’t properly support healthcare workers, or the people they care for.  A CIS enables the replacement of many of those disjointed systems with a single all-encompassing mechanism that will enable the best possible level of care.

The OPOR-Clinical Information System (OPOR-CIS) implementation is a multi-year project with six go-live implementation waves across the province. This is a single provincial build shared by IWK Health and Nova Scotia Health facilities and requires participation from all zones in design and build phases.

IWK Health will implement the new OPOR-CIS as Go-Live Wave One in the summer of 2025. Nova Scotia Health will begin implementation with Dartmouth General Hospital and its closest related facilities for Go-Live Wave Two in fall 2025, along with pharmacy, lab, and radiology for Central Zone.

The OPOR-CIS implementation timeline and go-live sequencing will be as follows:

• Go-Live Wave One: IWK Health (provincial implementation) – Summer 2025
• Go-Live Wave Two: Dartmouth General Hospital, Musquodoboit Valley Memorial Hospital, Eastern Shore Memorial Hospital, Twin Oaks Memorial Hospital, East Coast Forensic Hospital, Nova Scotia Hospital, and Central Zone Pharmacy, Lab, and Radiology – Fall 2025
• Go-Live Wave Three: QEII, Nova Scotia Rehabilitation Centre, Cobequid Community Health Centre, Bayers Lake Community Outpatient Centre, Hants Community Hospital, and remaining Central Zone sites – Winter 2026
• Go-Live Wave Four: Eastern Zone – Spring 2026
• Go-Live Wave Five: Western Zone – Summer 2026
• Go-Live Wave Six: Northern Zone – Fall 2026

Yes, the change will be significant. Clinicians will interact with technology to complete tasks they do not currently use technology for. A nurse’s workday will begin with logging onto the One Person One Record Clinical Information System, and they will continue to utilize the system to manage worklists and document throughout the day. At the bedside, a closed loop medication management system will scan the medication, scan the patient, and document that the medication was given.

The vision of the One Person One Record Clinical Information System (OPOR-CIS) is to build a single repository of patient information where care providers can access the right information, for the right person, at the right time.  It will enable clinicians across the system access to the information patients today assume they already have. Regardless of where care is given or received within the IWK Health and Nova Scotia Health facilities, records will be easily accessible. The OPOR-CIS will facilitate improved health outcomes through decreased medication errors, and the elimination of the current need to repeat personal health information within a single visit or across visits. 

We know variation in the delivery of care increases patient risk, and the OPOR-CIS will minimize variation through clinical standardization.  Currently, the use of technology by clinicians is limited due to the differing technological capabilities across the system. OPOR will improve user ability by developing technology standards.  Workflows that move at different paces or don’t have similar components limit the development of an intelligent and adaptive healthcare system. The OPOR team will work collaboratively with clinicians to build standardized future state workflows.

The One Person One Record Clinical Information System (OPOR-CIS) implementation will replace aging systems that have created high risk, resource heavy, low value environments. Eighty percent of physicians report facing regular problems with the current health information infrastructure. A single province-wide system works to eliminate technology-inefficiency related physician burnout. 

Fifty-six percent of physicians report having to log into five or more electronic systems to perform their daily clinical roles. The OPOR-CIS will eliminate the current paper scanning backlog which currently makes it difficult to access patient information at the point of care. Current inaccessibility of information adds 45 to 60 minutes to a typical workday, and the OPOR-CIS will remove repetitive logins and data entry.

A Clinical Information System supports physicians with the technology to work safely and efficiently, thereby freeing up valuable time to provide more patients with the care they deserve.  The OPOR-CIS will enable physicians access to data not only needed for clinical care, but also to support research, innovation, practice audits, and quality improvements.

Clinician burnout is a well-documented issue in healthcare. Studies show a percentage of clinician stress is directly related to the use of Electronic Health Records (EHR), and the increasing time spent navigating, reading, and updating the platforms.  The One Person One Record Clinical Information System (OPOR-CIS) can alleviate some of the stressors by applying user-centered design methods to a range of critical projects. The implementation of the OPOR-CIS will optimize EHRs, telehealth, and patient portal applications, along with other technologies, so providers can easily access the right information, at the right time, to support the best clinical decisions. Clinical informatics can help optimize an EHR by reducing the number of steps needed to access information, to display the most relevant historical information, or to build out preset fields that capture the most critical information based on the nature of the visit.  They also can streamline patient discharge processes, make patient portals more user friendly, adjust the number of times a clinician needs to enter login credentials across all IT systems and more.

The way the system works today cannot continue. Health records are inaccessible across Nova Scotia Health zones and IWK Health, and many medical records are still charted on paper and take weeks to be scanned. Those handwritten scans can also be difficult to read. The ultimate outcome is for patients and providers to have seamless access to the information they need, no matter which Nova Scotia Health or IWK Health facility the patient received that care.