Facts About VCUR 2008

December 3, 2009

The New EMR Solutions are Here: POSP Tells You the Facts

In October Alberta Health and Wellness (AHW), Alberta Health Services (AHS) and the Alberta Medical Association (AMA) announced that the Physician Office System Program (POSP) electronic medical record (EMR) solutions are in the market.

Physicians have asked POSP to address some of the rumours they are hearing as a result of this announcement.

Status of vendors:

• All three vendors (qualified service providers) - Med Access, Practice Solutions and Wolf Medical Systems - substantially completed the required build out and conformance phase and have fully demonstrated the capabilities of their solutions. They are now entering into their business pilots with clinics making the transition to VCUR 2008 solutions.
• The objective of the business pilot is to verify that the integrated EMR operates effectively in a live production environment for each qualified service provider (QSP). The focus is on the operational viability of the application in a clinical setting within an application service provider deployment.
• Vendor capacity to meet demand has been recognized as an issue from the time of RFP vendor selection. POSP has been working closely with the selected vendors to ensure an orderly transition. A tri-partite Deployment Committee has been formed to guide deployment priorities and activities.

Reimbursement:

• Physicians will be reimbursed up to $35,000 over five years (70% of $50,000). This means physicians will pay up to $15,000 over 60 months for an average cost of $250/month. This amount may might be higher, but only if the physicians choose to purchase optional items for their solution.
• The term of the current trilateral agreement ends March 31, 2011 and further funding for the POSP is a matter for Negotiations 2011. Therefore, the agreement vendors sign with physicians for the new EMR solutions must include a termination clause that allows physicians to terminate the agreement, with 30 days written notice, if the Master Services Agreement expires or is terminated, or if the physician ceases to be eligible for reimbursement funding under the Physician Office System Program.
• The requirements physicians must meet to be reimbursed for the VCUR 2008 solutions are essentially the same as those required for the VCUR 2006 solutions, but with more detail and structure.
• POSP will reimburse physicians as they pass specific milestones in their transition. Physicians are first reimbursed at Milestone 2 - Approved Project Plan. At that point the maximum amount a physician will have paid to the vendor is $9,800.
• In addition, physicians have 60 days to pay the vendor invoices. With the possible exception of Milestone 1, physicians who submit their invoices to POSP immediately will likely receive their 70% reimbursement payment before the vendor invoice is due. View details about the milestones and reimbursement.

Data migration and record retention:

• POSP is aware that data migration is an area of concern for physicians, especially those with existing EMR solutions. The migration of data is based on the Medical Summary for Transfer of Patient Data (ToPD). This is a provincial standard for continuity of care as determined by a committee that included physician representatives, and accepted by HISCA (Health Information Standards Committee of Alberta). A ll sections of the AMA were given an opportunity to review and provide feedback. It establishes the necessary and sufficient patient information that should be transferred from one physician office system to another to support informed medical care in the absence of the entire medical record.
• ToPD is the functionality implemented in VCUR 2006 compliant products to export (extract) and import (insert) the Medical Summary. It does not replace the need for physicians to preserve and retain their original patient records for medico-legal reasons. Under the Health Information Act (HIA) and College of Physicians and Surgeons of Alberta guidelines, custodians must retain patient records for a period of 10 years or until two years after the age of majority of the patient.
• POSP is investigating potential practical solutions for retention of patient information to assist physicians in the short term while the College and other stakeholders seek a longer term solution. POSP's primary objective is to find a solution that preserves the integrity and context of patient information to support patient record retention requirements for transitioning physicians. Maintaining a read-only version of a legacy system is one option.
• A data quality assessment pilot was conducted to test the materials and procedures developed by the vendor (Bridge Forward) contracted to facilitate data migration. All legacy systems' ToPD extraction processes, a requirement for vendors offering the VCUR 2006 solutions, are being tested for use in migration. Some legacy vendors have been very cooperative with the ToPD extraction process in recognition that the patient data belongs to physicians and their patients. As a result not all legacy products were tested in terms of the Bridge Forward materials and procedures.
• POSP is investigating options for dealing with those legacy vendors that are not supporting unfettered access to the ToPD functionality in their products, including alternative means to extract the Medical Summary data elements.
• A "Custodian Assessment Service" will be performed prior to the beginning of the implementation to provide the physicians with clear information about their options in terms of data migration (the medical summary data elements), data retention (original records, audit logs, context) and the results that can be expected based on the original data quality and the legacy vendor cooperation and product capability.

POSP has change management advisors, portfolio coordinators, and field and physician resources available to assist physicians through every phase of their transition. To learn the factual information about transitioning to the new VCUR 2008 solutions, POSP encourages you to contact your change management advisor, call the POSP toll-free number at 1.866.817.3875 or email.

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