MANDATORY EMR FUNDING ELIGIBILITY SCHEDULE

FOR CUSTOMERS WITHOUT AN AGREEMENT WITH PROVIDER

The following terms and conditions form a part of the terms and conditions of the contract to which it is attached as a schedule. The subscriber/licensee (in this Schedule, “You” or “Your”) will receive the benefit of them. These terms and conditions, which are required by OntarioMD Inc. as part of the EMR Adoption Program and which the service provider or licensor (in this Schedule, the “Provider”) agrees to with You, shall apply notwithstanding any provision in any contract to the contrary.

Provider certifies that the EMR Offering is Funding Eligible at the time of contract signing.

There are certain standard minimum service levels and remedies that will apply to the services You receive. They are set out in Ontario’s Electronic Medical Records Specification Version 4.1 (or greater) that is applicable to the version of the Provider’s Funding Eligible EMR Offering that You are using (the “Applicable Appendix H”) and they have the status of promises by the Provider to You. These service levels are the minimum service levels to which You are entitled, although the Provider is free to promise a higher level of service if it wishes to do so. As a minimum, the Provider will offer:

Implement each site to ‘Technical Implementation Complete’ state as per the table below (attach a separate page if additional space is required). Any changes to the date(s) must be mutually agreed upon by You and the Provider, and documented using the Provider’s official Change Request process. Changes in dates must be reported back to OntarioMD at emr@ontariomd.com.

Provider
MOH Group Name/Solo-Practitioner Name
Site Name	Site Location	Number of MDs	Site Lead MD	Technical Implementation Date
1.
2.
3.
4.
5.
6.

EMR Specification Releases will be implemented within eight (8) months of General Availability.

EMR Fix Releases will be implemented within four (4) months of General Availability, or sooner as specified by OntarioMD.

A Release Notification for all releases when the Release is made Generally Available.

Release Notes available for all releases when the Release is made Generally Available.

You and Your Provider are obligated to complete all items outlined in the Vendor and Physician Checklist which is attached as Appendix A of this Schedule. Each item will be reviewed as part of the OntarioMD audit prior to funding approval.

Notwithstanding anything contained in Your Client Agreement, if Your Provider’s EMR Offerings’ Funding Eligibility is suspended or revoked and Your Provider has not yet achieved the Technical Implementation Completion Date under Ontario’s EMR Adoption Program, or upgrade implementation date under Ontario’s EMR Upgrade Funding Program, You have the right to terminate Your Client Agreement with Your Provider. In such circumstances, the obligations of Your Provider regarding data portability will be observed and carried out for Your benefit. You will also be entitled, as a minimum, a refund of any prepaid subscription, lease, rental or licence fees.

Definitions relevant to this Schedule as set out in Applicable Appendix H.

General Availability	‘General Availability’ is defined as when the EMR Offering has completed the Provider’s quality assurance and beta testing processes and deemed fit by the Provider for general deployment to all customers; and the EMR Offering has completed the Validation Process as defined by OntarioMD. A Spec Release General Availability date is determined by OntarioMD when most or all EMR Offerings for a new EMR Specification have completed the Reference Site stage and are Funding Eligible. For example, for Specification 4.1 (which includes Specification 4.0 and this Appendix), the Spec Release General Availability date is April 1, 2012. The Fix Release General Availability date is the date the EMR Offering is generally available after the Provider has remediated any deficiencies under the current EMR Specification, completed the required Validation Process and the EMR Offering is approved by OntarioMD for release.
Technical Implementation Complete	‘Technical Implementation Complete’ is defined as when the EMR Offering is fully configured and ready for use in the live production environment at the Customer’s site, with all functionality as defined in the Customer Agreement. This includes the completion of agreed upon hardware and software installation, training and data migration.
Technical Implementation Completion Date	The date that the Technical Implementation Complete has been achieved.
Spec Release	A ‘Spec Release’ or ‘Specification Release’ is defined as a version of the Offering that is issued to meet a new/updated Ontario EMR Specification.
Fix Release	A ‘Fix Release’ is defined as a version of the Offering that is issued to bring the Offering into alignment with the current Ontario EMR Specification.
Funding Eligible	‘Funding Eligible’ means that the Offering has been Validated by OntarioMD and has been issued a Certificate. A Funding Eligible Offering is eligible for funding under Ontario’s EMR Funding Program. An Offering is not Funding Eligible if the Offering’s Funding Eligibility has been suspended or revoked.
Prepaid Fees	A ‘Prepaid Fee’ refers to a product or service that has not been delivered but the Provider has already been compensated. For example: if You provide a deposit for a product or service if You pay fees in advance of receiving the product or service For products and services that have been partially delivered, the refunded amount must be prorated to reflect the portion that has not been delivered. However, Prepaid Fees do not include: amounts You owe on products and services that have already been delivered amounts You have paid on products and services that have already been delivered perpetual license fees paid at the beginning of Your agreement with Your Provider amounts that considered ‘earned’ according to Your Client Agreement

Initials for both parties

APPENDIX A – VENDOR AND PHYSICIAN CHECKLIST

Vendor Checklist

Vendors are required to complete each of the following deliverables for implementations for OntarioMD funded physicians. Details on each deliverable are provided in the following sections.

EMR System Documentation

EMR Modules Documentation

Training Plan

Fixed and Variable Costs

Service Level Agreement

User Acceptance Testing & Signoff

Vendors are required to identify the items which are the responsibility of vendors, and physicians both for requirements as well as implementation.

EMR System Documentation

Vendor Responsibility	Physician Responsibility
EMR release notes for the version that is defined in the contract are delivered
If the physician prefers to use Apple/Macintosh hardware, software and/or server products, clearly outline any additional requirements for Apple products.
EMR system documentation that outlines all items that must be in place to support the implementation of the EMR is delivered
Ensure that the proposed configuration matches the OntarioMD allowed configurations: Local Config 1
Local Config 1 – with Data Sharing
Local Config 2
ASP

Documentation includes the following requirements. Please identify if the below items are vendor responsibility or physician responsibility to complete or provide the service.

Minimum and Recommended Hardware Requirements:

For any components listed that are not provided by the vendor, the vendor will provide the physician with a recommended requirements list and identify recommended providers where applicable.

Vendor Responsibility	Physician Responsibility
Desktops
Laptops
Mobile devices
Memory
Routers
Antivirus
Operating System
Server
Power supply
Firewall
Other - Specify

Network Bandwidth Requirements

The Vendor will provide the physician with recommended network bandwidth requirements and will identify recommended providers where applicable.

Vendor Responsibility	Physician Responsibility
Upload and download requirements
Data transfer volume requirements & data usage
Network configuration and cabling requirements
Other

Privacy and Security Requirements

Vendor Responsibility	Physician Responsibility
Secure server location
Firewall (ASP)
Firewall (Local)
Other - Specify
Configuration of remote access and security/passwords for all EMR users

System Software Licensing Requirements

For any components listed that are not provided by the vendor, the vendor will provide the physician with a recommended requirements list and will identify recommended providers where applicable.

Vendor Responsibility	Physician Responsibility
Specific licenses or providers must be identified.
Operating System Licenses
Database Licenses
Client Access Licenses
Drug Database licenses
Antivirus
VPN access
Other - Specify

Server Functional Requirements, Design and Configuration and peripherals.

For any components listed that are not provided by the vendor, the vendor will provide the physician with a recommended requirements list and will identify recommended providers where applicable.

Vendor Responsibility	Physician Responsibility
Database server
Thin Client or Terminal services
Network Services
Size of CPU
Disk Sizing for 3 to 5 years
Memory Requirements
Backup sizing
Peripherals
Fax
Scanning
Health Card Reader
Printer
Document management
Redundancy

Data Migration Requirements:

Vendor Responsibility	Physician Responsibility
EMR migration requirements and develop a migration plan:
Billing and or Scheduling to EMR
Paper to EMR
EMR to EMR
Upgrade
Identify data modules that require migration:
Billing
Scheduling
EMR
Other modules
Conduct a trial data conversion on a robust or representative sample of data and test converted data.
Identify and troubleshoot any issues that may occur with migrated data.
Document any instances of customization where the migration will not follow OntarioMD CDS standards.

Ontario MD review of activities outlined in the Vendor Checklist Section A) EMR System Documentation 1 through 6, above completed.

EMR Modules Documentation

Provide the physician with documentation of the EMR modules, interfaces including special configurations and customization.

EMR Set-Ups for all EMR components and modules.

Vendor Responsibility	Physician Responsibility
Registration
Scheduling
Billing
Encounters Templates
Labs
Prescriptions
Referrals
Data sharing
Other - Specify
Requirements for data access (permissions) to modules for each clinic staff member

Document any instances of customization or special configurations for each implementation.

Vendor Responsibility	Physician Responsibility
Custom fields
Calendars
Schedules
Identified clinic resources (exam and clinic rooms)
Define work flow and create "tags" as appropriate,
Pharmacy addresses and fax numbers

Interfaces to External Content Providers:

Vendor Responsibility	Physician Responsibility
Electronic Lab Results:
CML
Gamma Dynacare
Lifelabs
OLIS
Other - Specify
Drug Interaction Database Supplier
Hospital reports, e.g., Hospital Report Manager
Electronic Data Transfer set up and RA file format Confirm if the physician is practicing at multiple locations/across several systems and configure RA file receipt accordingly
Other interfaces as required
Specialty lab interfaces
SPIRE
Other hospital interfaces

Ontario MD review of activities outlined in the Vendor Checklist Section B) EMR Modules Documentation 1 through 3, above completed.

Training Plan

Document the training content and activities

Vendor Responsibility	Physician Responsibility
Document and define training activities which include business process analysis and system configuration This includes activities such as: understanding how each module relates to the office workflow, providing access rights and permissions to staff members.
Document the training plan and training delivery to the physicians
Training plan defines the following training deliverables: Content of training
Goals and objectives
Number of hours
Timeline (schedule)
How and where the training will be conducted
Training reflects the workflow of the physician office and covers all installed modules or activities
Basic training: the level of training required for staff to enable them to use all modules of the EMR software.
Advanced training: the level of training for more complex functions of the EMR: eg. preventative care, chronic disease management, data analysis & queries

Ontario MD review of activities outlined in the Vendor Checklist Section C) Training Plan, above completed.

Fixed and Variable Costs

Complete a cost breakdown of all goods and services

Vendor Responsibility	Physician Responsibility
Cost quotation for all goods and services included in the contract, includes estimated variable costs
If additional services are required, or changes to the initial documentation of costs, changes must be agreed upon by vendor and physician.

Ontario MD review of activities outlined in the Vendor Checklist Section D) Fixed and Variable Costs, above completed.

Service Level Agreement

Document the components of the service level agreement and any associated costs. (May include subscription or monthly fees)

Identify components of the service level agreement

Vendor Responsibility	Physician Responsibility
Ongoing Training
Upgrades
Maintenance
Patches
Support services
Regular Service Contacts
Emergency Contacts
Expected response times
Helpdesk services
Regular data migration tests
Business Continuity Services (define service level) may include: services for continuing operations under adverse conditions i.e. interruption from natural or man-made hazards
Disaster Recovery (define service level) Disaster recovery is a subset of business continuity and focuses on the IT or technology systems that support business functions
Backups (define service level)
Other Services as Defined - Specify

Ontario MD review of activities outlined in the Vendor Checklist Section E) Service Level Agreement, above completed.

User Acceptance Testing and Signoff

Develop and Implement a user acceptance testing process and signoff process for each implementation.

EMR System

EMR Modules

Training

Fixed and Variable Costs

Service Level Agreement

EMR System installation and configuration is complete

Vendor Completed	Physician Completed
Installation of IT platform infrastructure is complete
Installation test of EMR completed
Physicians listed on the Funding Agreement continue to use the EMR solution.
Audit Trails are “turned on”
Train physicians/staff on how to use remote access.
User acceptance testing of the server/platform implementation, data migration, remote access and any other applicable items is complete.
Physician has signed off items with the vendor.

EMR Modules installation and configuration is complete

Vendor Completed	Physician Completed
Supplementary data is configured (for example, contact information for specialists, lab order templates, medical encounter templates)
Implementation of all EMR modules and vendor testing of modules is complete
Implementation and testing of interfaces to Lab content providers are complete.
Implementation and testing of the drug interaction database are complete. Updates are enabled.
Electronic Data Transfer is operational. This may include: configuration, set up userIDs and passwords, verify transfer and receipt of data (RA files) specify and set up any wizards
Data migration is completed. Specifications for mapping of data fields are complete and any data filters and any special conversion requirements are complete.
Orientation of the completed data migration has been delivered to physicians/clinical staff.
Vendor has provided data validation and UAT testing scenarios to the physician.
User acceptance testing of EMR modules, interfaces and external content providers and any other applicable items is complete.
Physician has signed off items with the vendor.

Training

Vendor Completed	Physician Completed
Training is complete as specified in the training plan
Any additional advanced training sessions are scheduled
Physician has signed off on the training

Fixed and Variable Costs

Vendor Completed	Physician Completed
Physician has signed off on cost quotation

Service Level Agreement

Vendor Completed	Physician Completed
Backup and recovery functionality has been tested by the vendor and is operational
Vendor has tested that backups are encrypted
Vendor has tested that data can be been restored from a backup
Vendor has provided UAT test scenarios and data validation scenarios to the physician
Physician has conducted UAT and data validation and has signed off with the vendor.
Business continuity plan for each location (plan for continuing operations under adverse conditions i.e. interruption from natural or man-made hazards)
Disaster recovery plan for each location (disaster recovery is a subset of business continuity and focuses on the IT or technology systems that support business functions)

Ontario MD review of activities outlined in the Vendor Checklist Section F) User Acceptance Testing and Signoff, above completed.

Physician Checklist

Physicians are required to complete each of the following deliverables in order to meet funding criteria and achieve the Go Live Declaration (GLD) milestone.

The Below tasks are the sole responsibility of the physician and are supplementary to the tasks listed above that may include both physician and vendor. Details are provided in the below sections.

Check off each task when complete in the checkbox provided

EMR System

EMR Solution Security

User Acceptance Testing & Signoff

EMR System

EMR Vendor is in good standing at OMD (refer to OntarioMD.ca website) www.ontariomd.ca

For physician who OSCAR EMR: Selected Oscar Services Provider (OSP) is in good standing with OSCAR EMR (refer to Oscar website)

Hardware and peripherals are compatible with the EMR and Operating system required by the vendor

Pre-implementation site visit is scheduled with the vendor

The installed version is compliant with the latest OMD EMR specification

Vendor Name:

OSP Name (OSCAR EMR Only):

Product Name:

Version:

Internet and Network Services

Procure a Commercial Internet Service Provider (CISP) that meets EMR bandwidth specifications If initial scan of available CISP providers shows no alternatives, contact PMC to explore options for exemption Request an exception it internet continues to be provided by a hospital circuit for your implementation Propose the CISP alternative to eHealth Ontario for funding approval	If CISP is already in place, test the existing network & bandwidth to determine if it meets the requirements provided by the vendor

Physician must confirm the following items with the CISP and vendor for the Internet connection:

Ensure that all internet and required network hardware and software (routers, cabling etc) are installed and tested prior to the installation of the EMR. There is sufficient bandwidth for users at each location to support the EMR The internet service provider has installed a static IP address A firewall has been installed that restricts access to the location's Local Area Network (LAN) Physician has obtained supporting remote access materials and user guides from the internet service provider	Ensure the Internet service provider has installed and configured the following items: IP addressing scheme for LAN or wireless Network devices (printer, fax server, scanner, terminal server, health card reader) Workstations Wireless Access Point (WAP) configuration (if applicable) Physician must confirm that the design of wireless network meets privacy and security requirements and encryption

Ontario MD review of activities outlined in the Physician Checklist Section A) EMR System above completed.

EMR Solution Security

At the time of implementation, ensure the following items/modules are configured in alignment with privacy and security policies at your clinic:

Servers and remote access Desktop computers Portable devices (PDAs. Tablets, laptops etc) Encryption of data on removable media (external hard drives, memory cards, CD/DVD data etc.) LAN Network firewall and wireless network configuration (if applicable) Administration, usernames and passwords for all above devices/networks Database access for clinic users as well as for analysis software Router device Portals Types of connections Cable access IP network address	System Data including: Site name Full site address Phone numbers Fax numbers Emails Define Access rights for staff in your clinic including: Administration, usernames and passwords Hardware and software, networks, portable devices Data encryption Database access for clinic users as well as for analysis software (like crystal reports or other)

Ontario MD review of activities outlined in the Physician Checklist Section B) EMR Solution Security, above completed.

User Acceptance Testing and Signoff

Develop and Implement a user acceptance testing process and signoff process for each implementation.

EMR System

EMR Modules

Service Level Agreement

EMR System Installation and Configuration is complete:

Internet browser shortcuts to www.ontariomd.ca are located on each desktop.

Installation test of EMR completed

EMR Modules Installation and Configuration is complete:

Vendor has provided you with sample data validation and UAT testing scenarios for migrated data

Develop additional scenarios that apply to your specific clinic and workflow

Test data validity and usability within the new EMR interface

Raise and resolve any data integrity issues with the vendor prior to signoff

Confirm that EMR and peripherals have been installed and configured within security requirements (networks, servers, desktops, interfaces, mobile devices as applicable)

Service Level Agreement

Technical support provider is in place (hardware, network, system software)

Includes hours of service, helpdesk, and expected turnaround times for emergency requests

Backup and recovery functionality has been tested and is operational

Backups are encrypted

Ontario MD review of activities outlined in the Physician Checklist Section C) User Acceptance Testing and Signoff, above completed.