Dr. Julian Surujballi, Medical Director, Cancer Care Program, Central and Western Zones & Interim Medical Lead for Quality, Cancer Care Program, is supporting the design, build and implementation of the Clinical Information System (CIS) for One Person One Record (OPOR). Learn what motivated him to get involved, his advice for fellow physicians and what he finds most exciting about this project.
Q. How long have you worked with Nova Scotia Health and what is your current role?
A. I started working with Nova Scotia Health in the summer of 2024 as a Medical Oncologist. I also serve as Medical Director of the Cancer Care Program for the Central and Western Zones, along with several other leadership roles.
Q. How have you been involved with OPOR and the clinical information system (CIS) implementation?
A. I’ve been involved with several oncology-specific aspects of OPOR, including design workshops, functional testing, order set validation, workflow review, and cutover planning. If it involves oncology, I’ve probably been involved in some way or another.
Q. What motivated you to become involved with OPOR?
A. Two major reasons. First, as a healthcare leader, I have a responsibility to help navigate major system changes, which of course includes OPOR. Second, prior to moving to Nova Scotia, I had already been through several electronic medical record (EMR) implementations. May 9 will mark my fourth Go-Live event. The other two comparable ones were as an end-user during the PowerChart implementation in London, Ontario, and the Epic EMR implementation in Ottawa, Ontario.
Q. From your perspective, why is this transformation important for Nova Scotia Health?
A. Having come directly from systems that have implemented integrated EMRs, it’s hard to overstate the benefits of having a well-designed, stable electronic system. Currently, patient information is often fragmented across multiple systems, with continued reliance on paper orders and dictated documentation. As a result, I’m significantly slower in clinic than I was in those other systems. Realistically, I’m operating at about half the speed I was before, which means seeing fewer patients in a day compared to when I worked in other centres.
As Quality Improvement Lead for the Cancer Care Program, I’m also very much looking forward to having access to the robust administrative data that comes with an integrated EMR. In our current state, we struggle with data access and integrity issues, often resorting to manual data collection, which is slow and resource intensive. The ability to pull real-world data with less effort and lead time will be a game changer for the types of system-level quality improvement projects we can take on.
Q. What advice would you give colleagues who may be feeling uncertain about the implementation?
A. EMR implementations are one of, if not the biggest, changes a healthcare system can undergo. I think a lot of the uncertainty comes from the fact that those who have adapted well to the current state are going from a place of high optimization to one of low familiarity. What I try to focus on is that while the transition will be challenging in more ways than one, the ceiling in terms of safety, efficiency, and data will be much higher.
Q. What do you think the biggest impacts will be for providers, clinicians and employees with implementation of the CIS?
A. Safety, efficiency and access to data are the main impacts. They won’t appear overnight, but with ongoing optimization after Go-Live, the potential improvements will be well beyond our current state.
Q. What are you most excited about with the launch of this clinical transformation?
A. As a physician, efficiency. I’m looking forward to things like order favourites, autotext and saying goodbye to dictation. As a quality improvement leader, access to administrative data will be life-changing. In both areas, I’m hoping that by this time next year I’ll be operating at the same level of efficiency and performance that I experienced in other EMR systems.
Thank you to Dr. Surujballi, and to all those dedicating their time to the development and implementation of the CIS. Learn how you can get involved here (note: NS Health or IWK logins required).
