EMR Purchaser Responsibilities

Are you considering implementing an EMR in your practice or switching to a different EMR product?

If so, it is important that you understand the scope of Manitoba’s EMR Certification and your responsibilities in making this important decision.

Manitoba’s Certification is focused on ensuring the EMR product:

• meets a minimum provincial standard for clinical and administrative functions
• reliably and securely integrates with Manitoba’s provincial services

There are many other factors outside the scope of Manitoba Certification that you need to consider. Identified below are some areas to consider during your decision-making process.

EMR requirements

What are the features and functions required by your practice above and beyond those covered by Manitoba Certification requirements? You may wish to consider:

• ability of the product to support your unique workflows
• ability of the product to support you in meeting your obligations as trustee of your patients’ personal health information (for example, capture of disclosure directives)
• availability of pre-defined templates and other features to improve efficiency
• access to pre-defined or configurable ad-hoc reports
• access to integrated clinical decision support tools, such as reminders to assist with preventative care and chronic disease management

Ancillary services

What type of ancillary services might you expect the vendor to provide? Examples include:

• EMR hosting (Cloud-based application service provider [ASP] or external service). Be sure to inquire about the vendor’s data storage and transmission practices.
• implementation (data conversion, training)
• support (hours of operation, response time, local resource availability, remote options)
• additional modules or features outside the scope of assessment of EMR Certification, such as virtual care, secure messaging, patient portals, and online booking

Ease of use

How “user-friendly” is the EMR product related to your needs and practice context? You may wish to request product demonstrations to compare:

• general navigation through EMR
• number of clicks to complete a function
• efficiency features unique to the product
• software design and layout

Certification status

Is the product Manitoba Certified or being considered for certification in Manitoba? You should consider:

• Use of a Manitoba Certified EMR is required to integrate with current provincial services such as eChart Manitoba (provincial electronic health record) and eHealth_hub (secure electronic delivery of data to and from the EMR), and may be a requirement for participation in future provincial initiatives. Choosing an EMR that is not Manitoba Certified will limit your ability to leverage these services and/or participate in these initiatives.

Sustainability

Will the vendor and the EMR product be able to support your needs over time? You may want to:

• confirm ability of vendor to deliver and maintain the current solution as well as their plans to enhance the product in the future (e.g. size and scale of current company, including available resources for development and support)
• discuss frequency that product enhancements are made available to purchasers and by what method
• check customer references for level of satisfaction
• research or request information on long-term financial viability
• understand the position of the vendor in the Manitoba and national marketplace (is the vendor gaining or losing market share?)

Total cost of ownership

Have you fully investigated product pricing models, including assessment of value for money over time (e.g. compare products over a five-year period)? It is important that you understand the upfront investment as well as the ongoing operating costs. You should consider:

• initial costs such as hardware, software licence purchase, implementation services, training
• ongoing operational costs, which may include licence fees, EMR upgrades, training

Closing the deal

Once you’ve determined which product best suits your practice, you will need to enter into negotiations with the vendor before signing a Vendor-Purchaser Agreement. You may wish to seek legal counsel to ensure:

• you fully understand your contract terms and conditions, including obligations of both parties (purchaser and vendor)
• you are confident the contents of your agreement meet all your needs (e.g. business, clinical, privacy and security, data sharing)
• you understand negotiable versus non-negotiable terms and conditions
• the termination options of both parties are clear, and there is an exit strategy for, at minimum, your patient and billing data, should the contract terminate or expire