Many of Canada’s provinces now operate EMR funding programs to support the purchase of EMR products by physicians. Some of the programs have already been established for some time and have been through multiple iterations (Alberta, Ontario). Others are much earlier in their evolution (Manitoba and, recently, Quebec). In the short space of this article, it is not possible to do a detailed review of a single program, let alone multiple provincial approaches to EMR funding. As a result, what I would like to do is offer selected observations of the programs — what they have done well, and what I believe they could do to make themselves more successful. For individuals who are considering a funding application, please contact your individual program directly.
What have the provincial programs done well?
- By raising the visibility of EMR as an important component of care transformation and facilitating the adoption of individual EMR systems by implementing certification programs, the provincial EMR programs have raised the bar significantly in meeting the needs of early users.
- Funding provided by the provinces, in addition to funding provided by Canada Health Infoway, has created valuable peer support networks that have been critical in advancing adoption and use of EMRs through collaboration and education. It is not possible to improve practice performance without this type of collaborative network.
- The implementation of EMRs has forced discussion by many of the provincial colleges and licencing authorities to better understand issues relating to privacy and the sharing of clinical information using electronic systems. Certain provincial colleges (BC, Alberta) have developed data stewardship policies outlining the physician’s responsibilities in terms of information management in an electronic setting.
How could the provincial programs improve?
- Each of the provincial EMR programs has invested significant funds and resources to develop implementation and support strategies as well as educational programs and each has valuable lessons learned from their program. Through my work in different provinces, it is evident that there is limited sharing of the knowledge, resources, and expertise to reduce duplication of effort and reduce mistakes already well learned through the more mature programs.
- By moving away from certification programs focused on functional requirements to certification of the messages transmitted by the EMRs with a focus on achieving clinical and operational outcomes (Meaningful Use of EMRs), it will be possible to future-proof certification to a greater degree by facilitating information exchange rather than EMR functionality.
- Wherever possible, standardize the messages for information exchange across all of the provinces. It is not sustainable for EMR vendors to support different messaging requirements for referral/consultation, chart transfer, or ePrescribing in each of the provinces in addition to supporting other functional requirements for each provincial program. This will reduce the cost for vendors, allowing more resources to be applied to important usability improvements that need to be made to each of their systems.
If you have any additional observations on the provincial EMR programs that you would like to share, click on the “Comments” link below to add your thoughts.