Patient information, in real-time and in one place

Patient medical records are being streamlined into a single digitized record system in Nova Scotia, preventing overlap and delays in what officials say could be a valuable model for other provinces to emulate.

The new system – dubbed One Person One Record – was implemented last month at Halifax’s Izaak Walton Killam Hospital (IWK) Health Centre and is expected to go province-wide by year’s end.

“The clinical information system reduces a patient’s need to repeat health history for each provider and streamlines appointment scheduling and transitions between providers and care settings,” Nova Scotia Health and Wellness Minister Michelle Thompson said in an email to National Post.

Dr. Krista Jangaard, IWK Health’s president and CEO, said the system’s “biggest strength” is giving healthcare professionals access to patients’ complete, up-to-date health information from ambulatory clinics, emergency department visits, mental health and addictions treatment and inpatient care.

It “prevents duplication and unnecessary tests and ensures timely decision making,” she told the Post.

Officials say that more than 26,000 medical providers will have access to the new system, run by Oracle Health Canada under a 10-year, $365-million contract.

“We have heard from primary care providers that they are receiving timely information about their patients’ care at hospital facilities. This all enhances the patient’s care experience,” Thompson told the Post.

The system also helps address Nova Scotia’s doctor recruitment challenge. About 68,000 people are on the official waitlist to get a physician; a 2022 report  found provincial recruiters discovered that medical students and incoming doctors felt paper records were a “deterrent” for entering the field in the province.

Thompson called the new portal “another attractive option to recruit and retain healthcare professionals who want to work in modern facilities with modern tools.”

There have been some minor startup issues with One Person One Record, according to Dr. Howard Conter, vice-president for medical operations at Signature Health, a private executive health and corporate wellness clinic in Halifax.

But he said the program itself was not the problem: “It was the implementation, because a lot of the people just hadn’t paid attention to the fact that we were approaching the starting line. It was very much more the fact that your players on the field had not read the playbook.”

There was never “any danger to patients or patient care,” he said.

Conter noted the new format allows patients, parents and medical professionals to “get a much better looks at files” that “aren’t in bits and pieces,” and typed out for clarity. Previously, he lamented the “freehand” notes that “could have been in Swahili, as far as that was concerned.”

Jangaard said 100% percent of providers, physicians and nurse practitioners had completed training, but some disruptions were “to be expected with any undertaking of this magnitude,” as staff adapt.

Thompson agreed “a period of learning and stabilization, as teams become more comfortable using the new clinical information” is to be expected. But the eventual advantages, include less time spent on charting and repetitive administrative tasks, she said.

Jangaard noted that only authorized medical staff are permitted to collect, use and disclose personal health information, obviating any privacy concerns.  She added: “Patients have the right to see who has looked at their electronic health record by requesting a Record of User Activity” under the province’s Personal Health Information Act.

Jangaard said the IWK has “embedded lessons learned and practices from the experiences of other Canadian health organizations,” and there may be opportunity for the hospital to impart “example and guidance” to other institutions.

“Once the clinical information system is fully implemented, we look forward sharing our experience as a resource for other provinces who are looking to embark upon a similar province-wide implementation.”

The portal will expand to the greater Halifax area in the spring, Thompson said.

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