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- What steps has Manitoba taken to qualify EMR products and vendors?
Manitoba issued a Request for Qualifications (RFQ) for EMR vendors to propose product, services and pricing on two alternative bases: with the software hosted in the physician’s office (Local) or hosted remotely from the physician’s office and accessed via the network (ASP). Vendor responses have been evaluated through a rigorous and structured process to assess the product and vendor against criteria for corporate capacity and financial viability as well as requirements for functionality, security, privacy, technical/operations, inter-operability, implementation and ongoing service. This process will result in a list of Approved Products and Vendors from which community physicians and Regional Health Authorities (RHAs) can purchase an EMR should they so desire. Manitoba itself will not be purchasing any EMR products.
- What steps in the processes have been completed to date?
The process began with an open tender to EMR vendors. The vendor proposals were evaluated by physicians, other clinicians and clinic management. A number of vendors were identified to move to Stage 2 which included usability demonstrations, technical due diligence and customer service due diligence.
Stage 2 is now complete and the EMR Candidate Approved Vendor list is available. Before becoming Approved Vendors the Candidate Approved Vendors are required to enter into a Master Standing Agreement and to modify their products to meet all of Manitoba’s core EMR requirements.
- If these products are only “Candidate Approved”, is it safe to acquire one now?
Clinics should be clear that there is no guarantee that any particular Candidate Approved Vendor will become an Approved Vendor. There is a possibility that the vendor may not sign the Master Standing Agreement or may be unable to demonstrate, through conformance testing within the six-month time limit, that its product meets all of Manitoba’s core requirements. For that reason, clinics are advised to defer acquisition of an EMR until their preferred vendor has become an Approved Vendor if this is feasible. Clinics can safely investigate the Candidate Approved Products and engage in planning, but are advised to avoid signing an agreement with the vendor until it becomes an Approved Vendor.
Manitoba recognizes that some clinics or RHAs may not believe it is feasible to delay their acquisition until their preferred vendor becomes an Approved Vendor. We will be taking steps to try and mitigate the clinic’s risk should it acquire a product from a Candidate Approved Vendor. More information will be provided shortly on these strategies to mitigate risk.
- Whose requirements are these EMRs intended to meet?
The EMR qualification process is intended to address the needs of all physicians and their practices (both family physicians and specialists) who provide care in the community, as well as other primary health care clinics. It is not intended to address the needs of physicians or other clinicians providing in-patient or emergency care within hospitals or long-term care facilities.
- Why is Manitoba taking these steps?
Manitoba is responding to requests from physicians and RHAs to provide leadership in this area, since the knowledge, experience and effort required to qualify EMR products and services is onerous for many individuals and organizations. Like other jurisdictions, Manitoba also wants to prepare the way for a much more inter-connected healthcare environment by laying the groundwork for system inter-operability and reducing complexity and redundancy of systems.
- Will physicians be required to purchase one of these EMRs?
The fact that Manitoba has qualified EMR products does not obligate anyone to purchase an EMR. However, if physicians have decided they wish to acquire an EMR, it is strongly recommended that they purchase one of the Approved Products. Manitoba will be working with the Approved Vendors on an ongoing basis to enable the Approved Products to provide the functionality needed to participate in initiatives like the Physician Integrated Network (PIN) and to integrate effectively with the emerging Electronic Health Record (EHR) in order to access lab results, drug history, diagnostic imaging results, etc. It should be noted that future EMR purchases by Regional Health Authorities will only be made from among the Approved Products.
- What about physicians who already have an EMR?
There is no immediate need for physicians who already have an EMR with which they are satisfied to change products. Physicians can continue to use EMRs that are not on the Approved Product list to manage their practice and submit claims as long as their EMR continues to support the claims interface. However, there may be a point in the future at which a physician or practice decides to convert to an Approved EMR product, in order to take advantage of connectivity or program eligibility that is only available through Approved Products.
- Will Manitoba offer physicians funding to help defray the cost of acquiring and maintaining an EMR?
At the present time Manitoba has no plans in place to provide funding assistance for the acquisition or maintenance of an EMR.
- How will the Approved Vendor / Product List be maintained?
Over time, the list could change for any of several reasons. Approved Vendors will be asked periodically to meet new requirements, which will become necessary as we move into the more inter-connected world of the Electronic Health Record. Approved Vendors will be given a reasonable period of time to address the new requirements, but eventually will be removed from the Approved List if they cannot meet the new requirements. If this occurs, Manitoba will have a right to replace the Vendor that has been removed with another Vendor. Likewise, Manitoba could replace an Approved Vendor on the list should it cease operations or breach its obligations under its agreement with Manitoba. Finally, after a period of several years, Manitoba will have the right to add other vendors, if deemed necessary, even if no vendors have been removed from the Approved List.
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