On September 15, 2010, the Alberta POSP (Physician Office System Program) published a notification on their website regarding Practice Solutions Software, one of three VCUR 2008 EMR solutions available in Alberta that are eligible for reimbursement through POSP.
The notification states:
"At present, Practice Solutions is experiencing difficulties implementing their EMR solutions in the Alberta market. POSP is working very closely with Practice Solutions to ensure they have the strategies and practices in place to successfully deploy EMR solutions.
POSP is taking the following actions:
POSP also describes a number of steps being taken to communicate with Alberta physicians and resolve these issues plus interim steps agreed to by POSP and Practice Solutions.
- POSP continues to meet regularly with Practice Solutions senior management and sales teams to review project status.
- POSP has assigned resources to work directly with Practice Solutions sales (change management), deployment and migration teams to discuss clinic-specific─and broader─issues.
- Practice Solutions has assigned a Data Management Project Manager to work with POSP’s Data Management Leader to manage the process, including weekly meetings."
This was followed by a September 17, 2010 letter to members (.pdf) from Dr. Christopher J.(Chip) Doig, President of the Alberta Medical Association. In an excerpt from this letter, Dr. Doig states:
"Below, I will outline the information we have to date and the Alberta Medical Association’s (AMA’s) position as one of the responsible parties for POSP under the trilateral master agreement.
...55 Alberta physicians using Practice Solutions have informed us of significant problems with successfully completing deployment of the EMR. Notwithstanding substantial efforts by POSP and personal intervention by the trilateral co-chairs of the POSP Committee, an effort we recognize and appreciate, the vendor has not resolved these concerns. Some of the physicians have stopped moving forward with the EMR because of problems encountered.
As POSP physicians were notified in an email bulletin from the program this week, for the time being Practice Solutions has agreed to halt the sale and deployment of its product in Alberta – presumably until there is a resolution of these problems."
In the letter, Dr. Doig also offered an apology from the Alberta Medical Association to inconvenienced members and recognized some responsibility shared by the AMA as one of the trilateral parties who sponsor POSP.
The most important part of Dr. Doig's letter outlines the actions being undertaken to resolve the issues, including:
- A clear determination of what went wrong and what will be done to help those affected;
- A strategy to prevent problems with this and other EMR products in the future;
- How best to move forward.
While embarrassing for the affected organizations and distressing for physicians and practice team members affected by breakdowns in the rollout of an EMR system in an organized manner, there are lessons that can be learned from this occurrence. Given the oversight intended by a program such as POSP, this situation should never have arisen, however it did. What are the lessons learned and what should we be cognizant of going forward?
- Large IT projects (such as provincial EMR programs) are complex, multi-faceted and have a certain risk of failure. While it is extremely unfortunate that individuals (in this case physicians and practices) become the collateral damage, this is not the first large project to encounter difficulties and it will not be the last;
- Sometimes the only way to effectively resolve a complex issue is to be completely transparent, air the issues in public and determine an accountable and documented process to resolve the problems;
- Regular and clear communications are a critical component of projects, particularly when problems occur. It is often a breakdown in communications that result in situations becoming extreme;
- There is a need for comprehensive independent user-generated data to monitor the performance of EMR vendors across Canada and programs in each jurisdiction. Without metrics and real-time measurement of performance, it is impossible to anticipate and respond to problems before they trigger the need for extreme responses.
I would like to invite readers of this blog to submit responses and comments. I have presented the facts above as available through the public record. Share your thoughts by clicking on the 'Comments' link below.
(All comments are moderated before publication - Ed)