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Nova Scotia

Province signs deal to bring electronic health records to Nova Scotia

The Nova Scotia government has signed a $365 million deal to bring electronic health records to the province. Officials said a move that represented a game-changer in the way patient care is managed on Wednesday.

Health Secretary Michelle Thompson said the system would be phased in over two years, with a first computer portal ready in 10 months.

The change goes to the heart of longstanding complaints from healthcare providers about how they deal with inefficient recording systems and outdated technology, as well as from patients who are frustrated at having to repeat their medical histories with every hospital visit or doctor’s appointment with new providers, Thompson said.

“You’re both right,” she told reporters at a news conference in Halifax.

A woman with dark hair sits on a podium.
dr Christy Bussey is Medical Director for the Central Zone of Nova Scotia Health. (Robert Kurz/CBC)

Nova Scotia’s system still uses “20th-century methods” including the telephone, facsimile machine, and paper to record and exchange patient information, along with a number of computer systems that cannot communicate with each other. It is one of the few provinces still using a paper-based system, officials said Wednesday.

“We need to stop working on paper,” said Dr. Christy Bussey, medical director for the health agency’s central zone, told reporters.

“We have to get into a digital way of care.”

The new system, known as One Patient One Record, or OPOR, is a “network of communications” that will result in better, more timely decisions for patients, Thompson said. It should increase the capacity to treat patients, reduce waiting times for surgeries and improve efficiency in the use of acute care beds, as the system will track in real time what is happening in the province’s regional hospitals, the QEII Health Sciences Center and the IWK Health Center happens.

It has taken years to get to this point. A tender was first launched in 2015 under the previous Liberal government. Officials said on Wednesday four companies responded to a bid in 2017 before the 2020 field was narrowed to two. The process was suspended during the COVID-19 pandemic.

A man stands in front of flags.
Brian Sandager is Vice President of Oracle Cerner Canada. Nova Scotia is the ninth province to acquire the company’s systems. (Robert Kurz/CBC)

Oracle Cerner Canada, a division of US-based tech giant Oracle Corp., learned in recent days that it was the winner of the contract and a 10-year deal to design, build and maintain the system.

Oracle Cerner Canada vice president Brian Sandager said the company will start with a model tailored for that country’s healthcare system and then adapt it to the needs of practitioners. Nova Scotia is the ninth province to sign a treaty with Oracle.

Operating costs aren’t included in the contract with Oracle, and government officials said as recently as Wednesday those costs fluctuate and are updated every year through the annual budgeting process. Thompson said the province is hoping for financial support from the federal government.

Wednesday’s press conference focused squarely on what OPOR could do for Nova Scotia’s ailing healthcare system.

At its simplest, OPOR allows providers in any part of the province to see in real time what is happening to a patient as they are admitted into the acute care system. This means paramedics, emergency physicians, nurses and specialists all have access to the same information about a patient while it is being updated.

Laboratory tests and other diagnostic results are uploaded to the system instantly, and it can also communicate with paramedics, nursing staff and mental health services, including the SchoolsPlus program.

“It’s not often that I’m in the room with so many happy doctors,” joked Thompson, who worked as a registered nurse before entering politics.

A woman stands in front of flags.
dr Leisha Hawker is President of Doctors Nova Scotia. (Robert Kurz/CBC)

One of those lucky doctors was Dr. Leisha Hawker.

The President of Doctors Nova Scotia said it has been more than a decade since she first heard of discussions about a single electronic record for each patient and she expects it to be far more efficient than the current situation.

“Either I call the resident … on call, speak to the lead nurse who’s usually trying to find the nurse who’s looking after that patient, or I call the patient’s room directly and try to find out what’s going on.” them and help with discharge planning,” Hawker told reporters.

dr Steve Lownie trained and worked as a neurosurgeon in Ontario for 37 years before returning home to work in Nova Scotia in 2020.

Lownie said he left a hospital system in London, Ontario with OPOR only to find one in Halifax that uses technology more than a decade older than his previous job.

“I felt like I was going back in time,” he told reporters.

A bald man with glasses stands in front of flags.
dr Steve Lownie is a neurosurgeon who says OPOR will make a huge difference in patient care in Nova Scotia. (Robert Kurz/CBC)

Like other physicians speaking Wednesday, Lownie welcomed the efficiencies OPOR creates, allowing physicians and other practitioners to spend more time treating patients and less time filing paperwork or answering calls and to wait for faxes.

OPOR reduces medication errors and eliminates concerns about the legibility of orders and records because they are entered into a computerized system that is consistent across the province.

“This is the biggest thing since the MRI,” Lownie said. “This is a game changer and will be really great for the people of Nova Scotia.”

Future work

Bussey said primary care providers will be able to view OPOR and make digital requests for specialist referrals, consultations and testing through the new system, but will not be able to create their own charts or add progress notes.

Many primary care providers have their own medical record systems that people using OPOR can view. Bussey said future work will look at ways in which OPOR could be further connected to primary care providers’ existing electronic health record systems, or could combine everything into a single unit.

Opposition politicians welcomed the news of the contract but said it was important that the government spoke openly to the public about the system’s operating costs as soon as this information became available.

Bussey and Thompson were part of a Nova Scotia team that toured Vancouver General Hospital when OPOR was introduced there. Both were impressed by how smooth the transition went after extensive preparation and how it improved the practitioners’ workflow.

“They loved it,” Thompson said.


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