EMR Certification FAQ

In 2009, the Manitoba government (Manitoba) completed a Request for Qualification process to identify Manitoba Approved EMR Vendors and their EMR solutions. In this competitive process, EMR products were evaluated against a robust set of requirements including basic and advanced EMR functionality as well as ancillary services such as pricing, support and solution usability. Four vendors were selected.

EMR Certification is a non-competitive process which focuses on the EMR product to determine if it meets a baseline set of clinical and administrative requirements critical to support core clinic operations and provincial initiatives, and to ensure the product can reliably and securely integrate with Manitoba’s provincial services. Certification does not include assessment or evaluation of the product’s usability, the EMR applicant’s financial viability or their ancillary services (e.g. pricing, EMR implementation, operational support, etc.).

In both models, EMR purchasers have the responsibility to ensure the product meets their individual needs. Read our Purchaser Responsibilities summary for more information.

Provincial standards ensure EMRs have a solid foundation to support delivery of quality patient care. Provincial standards also support:

• information sharing and interoperability between primary care sites and specialists to improve continuity of care
• consistent and measurable preventative care and chronic disease management
• advancement of primary care renewal efforts
• consistent data collection and submission to support health system planning

Certification of EMR products against provincial standards supports achievement of these objectives, while managing cost and risk.

By using a Manitoba Certified EMR, clinics have some assurance that the EMR meets core requirements. It also ensures that they meet privacy and security requirements which protect patient personal information and ensures secure connections with provincial systems. Only Manitoba Certified EMRs will have the opportunity to integrate with provincial services such as eChart Manitoba and eHealth_hub, ensuring providers have critical information to support quality patient care.

Depending on the level of certification, EMR products may provide access to the provincial Client Registry system, primary care quality indicator reminders, clinical information sharing opportunities and centralized patient enrolment functionality. Manitoba, Manitoba clinicians, and EMR vendors of certified products will work as a collaborative team on product enhancements to meet customer needs and support the advancement of Manitoba’s health-care system.

Manitoba’s EMR Certification is limited to the requirements developed and agreed upon by Manitoba physicians and other clinicians, as well as Regional Health Authorities of Manitoba, Shared Health, and Manitoba Health. Before making a purchase, there are a number of important factors to consider. Customers have specific responsibilities to ensure that the product and the vendor meet their individual needs beyond the scope of Manitoba EMR Certification. Read our Purchaser Responsibilities summary for more information.

Manitoba recognizes the importance of this decision to clinics and patients. An overview of the factors that should be considered when choosing an EMR is available in our Purchaser Responsibilities summary. Home Clinics can also contact their Home Clinic Liason to discuss the impact of EMR purchase decisions related to patient enrolment, submission of the Primary Care Data Extract if applicable, and for any other Home Clinic activities.

Manitoba recognizes that a clinic’s needs may vary based on practice context and has supported this by developing two levels of EMR Certification. Standard Certification includes assessment against Manitoba’s baseline clinical, administrative, and privacy/security requirements along with the eChart Manitoba context-sensitive launch specification.

This first level may be appropriate for EMR vendors whose target customer includes specialists and/or other clinicians whose needs may be met with a basic level of EMR integration. Standard Certification may also appeal to EMR vendors wanting to enter the Manitoba market with a lower initial investment. EMR vendors may choose to enhance their EMR product over time to achieve full Integrated EMR Certification.

Integrated EMR Certification builds upon the Standard Certification foundation, offering the highest level of integration available. Target clinics include primary care or community specialty clinics of all sizes who are seeking a highly interoperable EMR system and those involved in provincial initiatives such as Home Clinics and My Health Teams.

More information about the two levels of certification can be found on our website.

In order to move to the next level of certification, your EMR product would be required to meet the assessment criteria of the higher level certification, as outlined on the Shared Health website. The flexibility of our process allows EMR vendors to work towards Integrated Certification in a phased approach through the selection of optional components. Applications for any or all of the optional components may be submitted at any time once Standard Certification has been achieved. This allows vendors of Certified EMR Products to work towards Integrated Certification over time, at their own pace, driven by customer demand. Information on application and status on assessment for optional components will be posted on the EMR Certification Status page. We recommend speaking with the EMR product vendor to better understand their future plans in this regard.

Manitoba’s EMR Certification is a non-competitive process. Certification is accessible to any EMR vendor owning the intellectual property of their EMR product. The EMR vendor should be confident their product will be able to meet all assessment criteria for the certification level being requested (as published on the Shared Health public website). The initial application window for EMR Certification was between Feb. 8 and April 1, 2016.

After April 1, 2016, EMR vendors are welcome to submit an Expression of Interest at any time. Manitoba may open further application windows if, for example:

• existing certified EMR products are not meeting the needs of the Manitoba marketplace; or
• there is sufficient customer support for an EMR product not yet certified in Manitoba.

Contact emr@sharedhealthmb.ca for more information.

Information will be posted to the EMR Certification Status page of the Shared Health website regarding an EMR product’s status throughout the certification process.

Manitoba will utilize a variety of assessment methods during the certification process. These methods include Assertion (based on the vendor’s self-assessment of product), Verification (by a member of the Manitoba EMR Certification Team), Demonstration (by the vendor to the Manitoba EMR Certification Team) and System Integration Testing (specific to interoperability functions).

Assessment methods will be clearly indicated within provincial specifications publicly available on the Shared Health website.

There is no fee to vendors for Manitoba’s EMR Certification.

Each EMR vendor will have a dedicated Product Lead from the EMR Certification Team coordinating all assessment activities and providing subject-matter expertise on all EMR requirements involved in Certification. Throughout the assessment process, Product Leads will provide EMR vendors with current state product deficiency documentation. Vendors will be expected to remedy all deficiencies to achieve certification. Every effort will be made to work collaboratively with EMR vendors to complete EMR Product Certification within agreed upon timelines.

The Agreement for EMR Certification with each vendor is considered evergreen in that it has no stated expiry date. This supports Manitoba’s efforts to establish long-term partnerships with vendors to support the needs of the EMR purchasers and end-users, as well as those of the health-care system. See the next question and answer for information about maintaining certified status over time.

The Agreement for EMR Certification encourages a long-term, collaborative relationship between vendors of Certified EMRs and Manitoba. From time-to-time, EMR requirements from the certification process may be updated or new requirements may be introduced to support best practice guidelines or provincial programs. Vendors of Certified EMRs, as key stakeholders, will be provided opportunities to contribute to development and review of provincial standards.

Updates to requirements will be posted on our website and vendors will be fully informed of any mandatory changes through a formal Change Order Process occurring at maximum twice per year. To maintain certification, EMR products will be required to certify against updated or new requirements as applicable to their level of certification. The Shared Health website will be updated with each product’s certification status.

Manitoba may choose to remunerate for activities related to Certified EMR Product enhancements. Many factors will be taken into account, including the complexity of the changes, and will be determined on a case-by-case basis.

This EMR Certification approach reduces the probability of de-certification, and Manitoba will do everything within its control to mitigate this risk going forward. However, there are scenarios under which a product could be de-certified. Reasons may include, for example, product non-compliance or events in the marketplace. If a product no longer meets assessment criteria, Manitoba will work with the vendor to correct the deficiency before de-certification is considered. Information regarding the certification status of each EMR product will be shared through the Shared Health website.

The software market is dynamic and subject to change (e.g. mergers, acquisitions, withdrawal from a market, other changes in the vendor’s strategic direction, etc.). These changes could lead to de-certification and are beyond the control of EMR Purchasers and Manitoba. EMR purchasers must be aware of the business risk associated with any important technology purchase. Read our Purchaser Responsibilities summary for more information.

If an EMR product is de-certified, this does not mean that your clinic must change products. EMR purchase decisions are individual clinic decisions, and are dependent on the strategic priorities of your clinic. Manitoba will assess the potential implications for any clinic known to be using that EMR, and communicate directly with them. Our team will be available to answer questions, and ensure clinics have the information available to make informed decisions.