The readiness phase involved a current state analysis, the development of clinical standards and workflows, preparation of the information technology and physical environments, as well as a new clinical support model.

A current state analysis was essential to understand how care is being provided across the province. The One Person One Record (OPOR) Team has mapped more than 350 workflows throughout zones, facilities, and service areas. Through Building Branches initiatives, OPOR built important relationships with the very people who will lead the change.

OPOR understands limited access to patient information causes delays in care delivery, and that poorly designed and fragmented eHealth infrastructure forces administrative pressures and decreases clinician productivity. The team also learned through the Building Branches exercise that mixed use of paper and standalone IT systems and databases doesn’t allow for reliable system analytics. Clinical standards, or evidence-based consistent approaches to managing specific illnesses or medical situations, will form the foundation for the transformation of care enabled through the OPOR Clinical Information System (OPOR-CIS). The development of standards is a collaborative process engaging clinicians who interact with the specific clinical process, patient population, or care location.

We know variation in the delivery of care increases patient risk. The OPOR-CIS will minimize those variations through clinical standardization. Currently, the use of technology is limited due to the differing technological capabilities across the system. The OPOR-CIS will improve user ability by developing technology standards. Workflows that move at different paces, or do not have similar components, limit the development of an intelligent and adaptive healthcare system.

The team is also working on Essential Data Sets (EDS), the standardized data elements that are essential to be documented for a patient within Electronic Health Records (EHR). The EDS for Adult Medical/Surgical Inpatients is complete and has been approved by the OPOR Clinical Practice Advisory Council (CPAC). Essential Data Sets will also be built for Critical Care, Emergency and Pediatrics, amongst 12 additional service areas.

Alongside standardization, technical readiness work is integral to the progress of the OPOR program. Teams are advancing Bring Your Own Device (BYOD), a technology enabling clinicians to use a device of their choosing when interacting with the OPOR-CIS. Upgrades are underway to modernize IWK Health and Nova Scotia Health networks to enhance speed and reliability, laying the groundwork for the delivery of improved functionality for clinicians and inpatients.