Listen to this article
Estimated 5 minutes
The audio version of this article is generated by AI-based technology. Mispronunciations can occur. We are working with our partners to continually review and improve the results.
One of the officials tasked with overseeing the rollout of Nova Scotia’s $365-million electronic medical record system says lessons from the project’s debut at the IWK Health Centre are already being applied ahead of the next launch in the central health zone.
Tanya Nixon, a vice-president with Nova Scotia Health assigned to the One Person One Record (OPOR) project, said officials are listening to the experiences people at the Halifax-based children’s hospital are having and taking note.
“The feedback we’ve received from the IWK team, including the clinicians, has been candid, it’s been constructive and it’s been exceptionally helpful,” she said in an interview.
The introduction of OPOR, intended to eventually do away with paper records and give all providers treating a patient access to the same information, launched at the IWK in December.
Since then, representatives for doctors and nurses at the site have raised concerns about flaws in the system that they say have had an impact on patient care. The president of the NSGEU, the union that represents administrative professionals and health-care workers other than doctors and nurses at the children’s hospital, said it’s been “a real rocky start.”
Sandra Mullen said people are arriving for scheduled appointments only to learn they do not exist in the system. People who need bloodwork are being asked to make appointments elsewhere, due to problems with the IWK’s online booking system related to OPOR.
Mullen said it’s been a stressful time for everyone.
“For example, when you require that medication and you put in for it and it doesn’t show up in five minutes and it’s over an hour getting to you, that can cause serious issues,” she said in an interview.
Nixon said such a major shift in technology is bound to have challenges, and they are being worked through. Some of those challenges are related to people becoming more comfortable with the new system, while others are related to technology.
For example, one of the things that’s created problems with the routing of information at the IWK is that the physician dictionary, a list of key information about physicians and other providers within the clinical information system, was not built in the way it was expected to be used, said Nixon.
Challenges were to be expected
Despite the problems people are experiencing, Nixon said officials with the IWK, Nova Scotia Health and the Health Department collectively decided things were ready to go in December following a “rigorous 90-60-30-day assessment process.”
“The technological challenges that we’re experiencing are not out of the realm of what would be expected,” she said.
“And as the issues are being identified, they’re being responded to in a timely way.”
As the process plays out at the IWK, Nixon said it’s also informing preparations for when OPOR goes live in the central health zone on May 9.
Changes to learning process
One of the direct changes being applied based on the IWK experience is to education and learning.
“We heard from our IWK colleagues that simulation and practice labs were really essential for readiness and we’ve implemented those and have a strategy for central zone,” she said.
Simulation labs will create an experience where people training will be able to practise providing care with the clinical information system in advance of going live, providing a degree of realism that was not part of the IWK training.
Nixon could not say why such an approach was not used at the children’s hospital because those decisions were made before she joined the project. But she said the point of a staggered rollout across the province is so each zone can benefit from the lessons learned in areas that went live before them.
To that end, there is also more integrated planning happening now with regards to clinical workflow and technology.
“Those conversations were not as in depth as they probably should have been with the IWK,” said Nixon.
“We realize there was an opportunity that was missed, and we are working together with our central zone colleagues to ensure that it’s not replicated and/or duplicated.”
Assuming things go according to plan, OPOR will be rolled out in the eastern, northern and western health zones through autumn and winter of this year.
Nixon said people working in other jurisdictions that have undergone similar transformations have warned that it’s difficult in the beginning because it changes almost every aspect of the clinical workflow. People need to remain patient, she said, adding that it can take three to six months for things to stabilize at a site following rollout.
Ultimately, however, she said the province will have a system that’s been shown to reduce patient safety incidents and duplication, while providing “a full picture of the patient’s care experience” for everyone who interacts with the patient.
“And the benefits associated with that are second to none.”
One of the executives tasked with overseeing the rollout of a new electronic medical record system in Nova Scotia says adjustments are being made based on the experiences of employees at the IWK Health Centre. The IWK went live with the system in December and the program will launch in Nova Scotia Health’s central zone in May. The CBC’s Michael Gorman has the story.
MORE TOP STORIES
