FAQs for Physicians and Healthcare Staff

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.

Currently in Nova Scotia, there are many ways patient care is planned, delivered, documented, and communicated, including the use of paper records. A provincial, standardized approach to documenting patient information and consistent use of evidence-based best practices across all facilities will support patients.   

When patient information is collected using different tools and standards, it is difficult to provide consistent care as a patient moves throughout the healthcare system. For example, today, if a nurse, physician, and physiotherapist all need to chart their assessments for a patient, they take turns with the paper chart or possibly different charts altogether. With a clinical information system, all care providers can digitally chart simultaneously making that information visible to care teams, instantly.   

In addition, communication flows seamlessly, such as referrals or discharge summary routing, reducing the time it takes for care teams to have the latest updates. OPOR is transforming healthcare for patients, providers, clinicians, and healthcare workers, improving experiences for everyone. With better access to more information, everyone will benefit.  

OPOR is a transformation in healthcare delivery for Nova Scotia. The vehicle for change is the provincial Clinical Information System (CIS), but the real change to patient care sits with providers and clinicians having the information they need to support patients and improve outcomes.   
  
For the first time, patient records from IWK Health and Nova Scotia Health will be on one system, improving access to vital information for healthcare teams and patients. The OPOR-CIS will transform documentation from paper to digital, with information, orders, and patient care plans entered in real-time. Care teams will have easy access to the information they need to make the best possible clinical decisions, and ultimately spend more time with patients and less time searching for records.   

Workflows will be streamlined across the overall healthcare system, facilitating compliance with evidence-based best practices and standardized guidelines across all IWK Health and Nova Scotia Health facilities. The OPOR Team has spent hundreds of hours with local subject matter experts to evaluate workflows, equipment, resources, and data, to inform the design of the new OPOR-CIS.   

From medication management to patient registration, everyone who interacts with the healthcare system, including patients, will be impacted by the new system. Patient, providers, and clinicians will be empowered to make the best care decisions with the right information, at the right time, in the right place.

A Clinical Information System (CIS) is a computer program designed to collect, store, analyze, and share information in the healthcare delivery process.     

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. This 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 centered 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. Non-clinical devices deployed across IWK Health and Nova Scotia Health facilities to access the CIS means there will be no waiting for a patient chart for documenting or viewing.  

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.

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.  

You can find more details about the implementation schedule down below

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. The OPOR-CS will provide clinicians across the province access to the information patients assume is available today.   

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 Program Team is working 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.  

No decisions have been made on when SHARE will be discontinued. Providers are encouraged to switch to Provider Portal for new patient information going forward to become familiar with the new system.   

The Provider Portal Working Group was comprised of physicians and clinicians from across Nova Scotia and participated in the design and testing of the system. OPOR is committed to providing tools that support the healthcare system in our province by meeting the needs of our healthcare teams and patients.