Lessons from Nova Scotia’s OPOR Digital Healthcare Transformation

Lessons in Facility Readiness for Large-Scale Digital Healthcare Transformation

Healthcare organizations across Canada are continuing to modernize their information systems, workflows and infrastructure in support of more integrated patient care. In Nova Scotia, that transformation is taking shape through a province-wide Clinical Information System (CIS) initiative designed to create a single, digitally-connected health record across IWK Health and Nova Scotia Health.

The One Person One Record (OPOR) initiative represents one of the largest healthcare transformation efforts in Atlantic Canada, replacing or integrating dozens of legacy systems while moving healthcare teams from paper-based processes toward a unified digital system.

IWK and Nova Scotia Health launched the OPOR program to improve patient care and clinical integration. It quickly became clear that a successful digital transformation program would depend on infrastructure readiness, operational coordination and alignment of project collaborators.

Our project managers were part of the infrastructure readiness effort supporting early implementation phases at IWK Health. With a launch date set, we worked alongside IWK’s facilities, operational and clinical teams to plan, coordinate and execute digital infrastructure upgrades to support the new OPOR system within an active healthcare environment.

The experience highlighted several important lessons for healthcare organizations preparing for similar digital infrastructure transformations.

Lesson 1: Digital healthcare transformation is also an infrastructure project

One of the earliest challenges was understanding the true scale of the infrastructure upgrades required to support implementation.

Clinical Information Systems often focus on software and workflows, but transitioning from paper-based or hybrid systems to a fully digital model will typically require extensive physical upgrades, including:

• additional power and data capacity;
• the installation of new computers and mobile clinical workstations;
• modifications to nursing stations and millwork;
• the placement of printers, scanners and other point-of-care devices; and
• upgrades to existing electrical and IT infrastructure to support long-term system demands.

To meet the launch date, IWK Health and its project collaborators faced pressure to meet evolving infrastructure requirements while implementation was already underway.

Early in the process, uncertainty around the scale of required upgrades also created concerns for IWK Health around potential project costs. Aging infrastructure, the presence of asbestos in some spaces, infection prevention requirements, and limited access to fully operational clinical areas all had the potential to significantly affect implementation scope and budget. As the teams began to better understand the infrastructure requirements, they were able to identify practical solutions, refine priorities and reduce uncertainty around delivery.

For healthcare organizations, this reinforces the importance of assessing facility readiness early – particularly in older or high-occupancy healthcare environments where digital infrastructure capacity may be constrained.

Assessing existing facility infrastructure and validating project requirements early on can help healthcare organizations better understand the risks, manage costs and make more informed decisions before implementation moves too far along.

Lesson 2: Flexibility is essential in active healthcare environments

Unlike new construction projects, CIS implementation often occurs within fully operational healthcare facilities. Patient care is a top priority, and while there are ways to mitigate impacts on patients and healthcare staff, in many instances the care itself must continue.

Working with IWK Health, our project management team navigated:

• active patient care environments;
• infection prevention requirements;
• fire safety constraints;
• asbestos-containing spaces;
• limited swing space; and
• rooms that could not be temporarily vacated due to clinical complexity.

We kept in close communication with IWK Health’s project team, facilities staff and clinical leadership to sequence construction and maintain the project schedule while minimizing operational disruptions.

Maintaining strong communications with project collaborators and flexible delivery strategies is essential when working in active healthcare environments. The OPOR project demonstrated the importance of that collaboration and flexibility, as it enabled IWK Health to continue delivering quality care services throughout the project.

Lesson 3: Engage clinical teams early and continuously

One of the strongest lessons from the OPOR implementation was the importance of structuring collaboration in a way that supported the clinical teams.

During implementation, clinical leaders were balancing day-to-day operational responsibilities alongside workflow planning, operational readiness activities, infrastructure reviews and implementation coordination. Recognizing the demands already being placed on frontline teams, the project team introduced streamlined communication pathways and structured decision-making processes to minimize complexity and protect clinical capacity.

Where possible, our team designated points of contact to consolidate feedback, coordinate discussions and reduce the number of competing requests directed to care teams. This approach improved communication flow and maintained momentum across interdependent workstreams.

Helping the clinical teams visualize process changes early on was also critical. The placement of mobile workstations, scanners and other point-of-care devices directly affected future clinical workflows and daily operations. Without mock-ups or demonstrations, it was sometimes difficult for frontline teams to fully envision physical changes to the space and how those changes would affect existing workflows and digital processes.

Future healthcare transformation projects can benefit from earlier workflow visualization, mock-up environments and continuous collaboration between clinical, operational and infrastructure teams throughout implementation.

Lesson 4: Clear governance structures support faster implementation

Another defining characteristic of the OPOR implementation was the timeline. Meeting a fixed launch date meant planning, approvals and construction activities needed to progress steadily in a highly coordinated and time-sensitive environment.

As infrastructure requirements evolved, clinical and facilities teams were challenged to make decisions effectively, while consultants and contractors relied on that feedback to maintain progress. To support this, the project team focused on streamlining communication pathways and clearly defining points of contact for reviews, approvals and issue resolutions. This helped reduce duplication, improve responsiveness and support faster decision-making throughout the project.

Establishing designated contacts and coordinated governance structures can help future healthcare organizations engage key experts – like clinical and facilities teams – more effectively, while incorporating operational and workflow feedback into the decision-making process.

Looking ahead

Programs like OPOR are shaping how healthcare organizations think about digital infrastructure transformation. While technology transitions may be the ultimate objective, the success of these initiatives also depends on infrastructure readiness, operational planning and stakeholder coordination behind the scenes.

As health information systems continue modernizing across Canada, healthcare organizations that invest early in facility readiness, governance and clinical engagement will be better positioned to support long-term digital transformation successfully. Interested in learning more? Connect with our healthcare team at info@colliersprojectleaders.com.