EMR Funding FAQ

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​​Frequently Asked Questions

  1. What is a certified Electronic Medical Record (EMR) offering?
  2. What support is available to help physicians prepare for and successfully use electronic medical records?
  3. What is the difference between an ASP EMR and Local EMR?
  4. Are all of the physicians within my Group required to use the same EMR Offering and Version?
  5. How does the funding and adoption process work?
  6. How does OntarioMD treat the departure of a physician from a group?
  7. Are original signatures required for the Non-Participating Physician Consent Form?
  8. The Lead Physician in my group is not participating. Is his/her signature mandatory on all declaration forms i.e. Vendor Contract Declaration, Go Live Declaration, Non-Participating Physician Consent, etc?I have contacted my potential EMR Vendor and they have done an assessment. Will this suffice as the Readiness Assessment needed?
  9. What is the timeline between the the signing of the Funding Agreement and my first payment of the $3,500 Readiness Grant?
  10. I have contacted my potential EMR vendor and they have done an assessment. Will this suffice as the required Readiness Assessment?
  11. What if I don't submit a Go Live Declaration within 10 months of signing my Funding Agreement?
  12. What if I don't submit a Performance Declaration and EMR User Survey within 22 months of signing my Funding Agreement?
  13. Once a certified EMR has been implemented in my practice, what is expected of me?
  14. In addition to how I must use my EMR offering, i.e., making patient appointments, billing for services etc., what else is required of me?
  15. If my EMR vendor releases an upgrade to my current EMR offering, is anything required/expected of me?
  16. How do I notify OntarioMD that I have upgraded my EMR version?
  17. Why do physicians who select an ASP EMR receive more funding than those who select the Local EMR?
  18. What is a Vendor Collaborative Network (VCN) and how does it work?
  19. What if I select a Local EMR and don't want to join a Vendor Collaborative Network (VCN)?
  20. What are my responsibilities in the EMR System Management Independent Undertaking?
  21. If I choose an ASP why don't I have to join a Vendor Collaborative Network or sign an EMR System Management Independent Undertaking?
  22. At what point, or at which milestone is the EMR System Management Independent Undertaking Form due?
  23. When do I have to complete an EMR User Survey?
  24. How is network connectivity provided under the EMR funding programs?
  25. Does funding include a connection to the Internet?

 

Answers

1. What is a certified Electronic Medical Record (EMR) offering?

An OntarioMD-certified Electronic Medical Record (EMR) is a software application that integrates the clinical and administrative aspects of a practice. Use of a certified EMR is a requirement for receiving funding from the legacy funding programs of the EMR Adoption Program. OntarioMD-certified EMRs, unlike EMRs that are not certified, give physicians access to provincial ehealth information systems such as the Ontario Laboratories Information System (OLIS) and and the award-winning Health Report Manager (HRM) as well as any future services that will be offered by OntarioMD.

OntarioMD collaborates with physicians, the Ontario Ministry of Health and Long-Term Care, EMR vendors and other stakeholders to develop an EMR Specification which establishes baseline functionality requirements that a vendor's EMR offering must meet during conformance testing conducted by OntarioMD.

A certified EMR means that the EMR vendor's EMR offering has been validated by OntarioMD and demonstrated that it performs the functions set out in the current EMR Specification (refer to the Spec Requirements) OntarioMD does not perform comprehensive testing of the functions in the EMR Specification, nor does it test any function that is not part of the EMR Specification. OntarioMD does not guarantee the software in any way. The list of certified EMR offerings can be found on the Certified EMR Details page.

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2. What support is available to help physicians prepare for and successfully use electronic medical records?

OntarioMD offers a number of related support programs designed to help physicians and their teams adopt and implement electronic medical records and to move from basic to enhanced use. Please contact OntarioMD's Customer Service Team at: 1-866-744-8668 (Option #2).

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3. What is the difference between an ASP EMR and a Local EMR?

An ASP EMR is hosted at a secure data centre and is accessed by physicians and their staff over communications lines. The data server for a local EMR is situated in one of the locations for the group of participating physicians. In both cases, EMRs can be accessed from the practice or another location, such as home.

The ASP EMR provides systems management functions including disaster recovery, data security, business continuity, capacity planning and server infrastructure, and facilitates interfacing with ehealth applications. There are three certified ASP EMR solutions in Ontario - Accuro EMR, Nightingale On-Demand and TELUS PS Suite.

With the Local EMR solution, the group is responsible for implementing and maintaining system management functions. Guidance for most of these system management functions are provided to the physician group through the Local EMR vendor's Vendor Collaborative Network. Local EMR vendors may offer, as an additional service, vendor-monitored backup.

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4. Are all of the physicians within my group required to use the same EMR offering and version?

Yes. All participating physicians within a group are required to use the same EMR offering as well as the same version of the EMR offering.

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5. How does the funding and adoption process work?

For physicians who currently have a Funding Agreement with OntarioMD, there are a series of steps that are fully described in the EMR Adoption Program Terms & Conditions:

    • Readiness Assessment: OntarioMD will conduct a detailed Readiness Assessment of your practice. Based on the results of the Readiness Assessment, the applicant may need to complete various activities described in a Readiness Plan prepared by OntarioMD before funding is approved.
    • New EMR Adoption Program Extension 2 Funding Agreement: A New EMR Adoption Program Extension 2 Funding Agreement is signed by the applicant and by OntarioMD. It sets out milestones for the selection of an EMR and the EMR Go-Live date.
    • Vendor Contract Declaration: The applicant is required to select an EMR and sign a contract with an EMR vendor and submit the Vendor Contract Declaration, Mandatory EMR Funding Eligibility Schedule, and Vendor and Physician Checklist (Appendix A) to OntarioMD within six (6) months of signing the New EMR Adoption Program Extension 2 Funding Agreement.
    • Go-Live Declaration: Within ten (10) months of signing the New EMR Adoption Program Extension 2 Funding Agreement, the applicant needs to undergo acceptance testing of the EMR, start to use it and submit the Go-Live Declaration, Initial Acceptance Testing (IAT) Review and the Vendor and Physician Checklist (Appendix A). if not received within 10 months, the one-time payment for this milestone will not be paid. Where Go Live requirements have not been met due to reasons beyond the control of the physician (e.g., vendor-related issues) and where an exemption has been granted in writing, the Go Live one-time payment may be permitted. In any case, monthly payments will not be made after October 31, 2018.
    • Performance Recognition Declaration: Within twelve (12) months of submitting the Go-Live Declaration, and once the physician has established EMRs for 600 or two-thirds of his or her rostered or active patients, whichever is less, the physician can submit a Performance Declaration and EMR User Survey to OntarioMD to receive the one-time Performance Grant. Where Performance Recognition requirements have not been met due to reasons beyond the control of the physician (e.g., vendor-related issues) and where an exemption has been granted in writing, the Performance Recognition payment may be permitted.

OntarioMD offers ongoing support designed to help physicians and their teams progress from novice EMR users to optimizing their EMR use at their own pace. Please contact OntarioMD's Customer Service Team at 1-866-744-8668 (Option #2) for more details or visit the Transition Support Program, Peer Leader Program and EMR Practice Enhancement Program.

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6. How does OntarioMD treat the departure of a physician from a primary care group?

The departing participating physician should have an agreement with his or her group (the EMR funding applicant), which describes what EMR assets and patient electronic records, if any, will be taken by the participating physician upon leaving the group and any payment made by the group to the participating physician for his or her share of the EMR funding paid up to the departure date of the participating physician. The EMR assets and patient electronic records taken by the departing physician may affect future EMR funding if the physician re-applies for EMR funding.

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7. Are original signatures required for the Non-Participating Physician Consent Form?

Yes, original signatures are required for the Non-Participating Physician Consent Form.

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8. The Lead Physician in my group is not participating. Is his/her signature mandatory on all forms, i.e., Vendor Contract Declaration, Go Live Declaration, Non-Participating Physician Consent, etc.?

Yes, even though your group's Lead Physician is not participating in the EMR Adoption Program, he or she must sign all the forms pertaining to the program.

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9. What is the timeline between the the signing of the Funding Agreement and my first payment of the $3,500 Readiness Grant?

Funding is committed to you once you and OntarioMD sign the New EMR Adoption Program Extension 2 Funding Agreement. You will receive your first payment of, the Readiness Grant of $3,500, after you choose a certified EMR offering and complete the Vendor Contract Declaration (VCD), the accompanying Mandatory EMR Funding Eligibility Schedule, and Vendor and Physician Checklist (Appendix A). Certified EMRs are considered funding eligible under the requirements of the EMR Adoption Program. If you are already using a certified EMR offering, the timeline to receive the first payment may only be a matter of weeks. If you are with a group that has many physicians, and are not yet using an EMR, once you have signed the Funding Agreement, you can expect to spend up to three months choosing an EMR before receiving your first payment. Monthly payments commence with submission and approval of the Go Live Declaration and the Initial Acceptance Testing (IAT) Review and Vendor and Physician Checklist (Appendix A).

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10. I have contacted my potential EMR vendor and they have done an assessment. Will this suffice as the required Readiness Assessment?

No. All Readiness Assessments must be conducted by an OntarioMD Practice Management Consultant (PMC). The assessment results are used to determine the quickest way to get you started with the EMR adoption process and provide funding to you.

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11. What if I don't submit a Go Live Declaration within 10 months of signing my Funding Agreement?

If you don't submit a Go Live Declaration within 10 months of signing your Funding Agreement, you will not receive the one-time payment for going live. Once you do go live, the monthly payments for 36 months will commence. Where Go Live requirements have not been met due to reasons beyond the control of the physician (e.g., vendor-related issues) and where an exemption has been granted in writing, the Go Live one-time payment may be permitted. In any case, monthly payments will not be made after October 31, 2018.

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12. What if I don't submit a Performance Declaration and EMR User Survey within 22 months of signing my Funding Agreement?

If you don't submit a Performance Declaration and EMR User Survey within 22 months of signing your Funding Agreement, you will not receive the one-time Performance Grant available to you. Where Performance Recognition requirements have not been met due to reasons beyond the control of the physician (e.g., vendor-related issues) and where an exemption has been granted in writing, the Performance Recognition payment may be permitted.

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13. Once a certified (funding eligible) EMR has been implemented in my practice, what is expected of me?

Physicians are expected to use their EMR, where possible for:

Usage CriteriaFamily PhysicianSpecialist
i.   making patient appointments, ??
ii.  billing for services,  ??
iii. electronically receive patient reports directly into the EMR from hospitals where a hospital reporting facility is available for the EMR offering??
iv.  entering the encounter notes for the patients seen, ??
v.   entering problem lists for patients seen,??
vi.  storing patient care related documents not originated from an EMR, which contain information not already within the EMR, ??
vii. creating new prescriptions and renewals,??
viii. generating automated alerts, and reminders to support the delivery of care,?If Applicable
ix.  receiving lab results electronically and directly into the EMR from either the private labs supported by the EMR Specification or the Ontario Laboratories Information System (OLIS),??
x.   searching OLIS directly from the EMR for lab results pertaining to patients once OLIS is Generally Available and has been deployed in the practice, and??
xi.  exporting qualified patient information to the Diabetes Registry once the Diabetes Registry becomes Generally Available.??

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14. In addition to how I must use my EMR offering, i.e., making patient appointments, billing for services, etc., what else is required of me?

The intent of the EMR Adoption Program is to encourage daily use of the EMR and to integrate it into your practice's workflow (Refer to Section 9 of the program's funding Terms and Conditions). This includes having the EMR configured so that:

    • You, your support staff, and other authorized health care providers on your 'team' (if applicable), have ready access to the EMR at all points of care within the practice;
    • Your support staff has ready access to the EMR to support billing, scheduling and clinical workflow activities; and
    • You, and your support staff, have ready access to a printer to support care delivery activities (e.g., patient education, prescription printing) and administrative activities.

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15. If my EMR vendor releases an upgrade to my current EMR offering, is anything required/expected of me?

Physician practices are expected to upgrade their EMR offering to the latest OntarioMD-certified (i.e., funding eligible) version released by their vendor. Groups will have up to eight (8) months from the latest EMR Specification's General Availability Date to upgrade their system.

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16. How do I notify OntarioMD that I have upgraded my EMR version?

Please contact either your OntarioMD Practice Management Consultant, or OntarioMD Support at 1-866-339-1233.

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17. Why do physicians who select an ASP EMR receive more funding than those who select the Local EMR?

ASP EMRs, unlike Local EMRs, need a dedicated communications line to access patient data hosted at a secure, data centre. Funding for an additional network circuit has been provided for the ASP EMR in case the primary circuit is not available. Local EMRs have been funded for a single communication line so the EMR can communicate with external ehealth applications.

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18. What is a Vendor Collaborative Network and how does it work?

A Vendor Collaborative Network (VCN) is established by a Local EMR vendor to provide physicians who wish to join the VCN with formal guidance and support regarding training, local IT and communication network support requirements, business continuity planning, data migration planning, data and network security, and information regarding the Vendor's Health Canada Class II Medical Device licensing plan.

A physician who chooses a Local EMR must indicate on the Vendor Contract Declaration that he or she is either joining a VCN or is taking full responsibility for various EMR System Management planning and support.

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19. What if I select a Local EMR and don't want to join a Vendor Collaborative Network (VCN)?

If you don't want to join a VCN, you will need to sign an EMR System Management Independent Undertaking indicating that you are taking full responsibility for planning and support. When you submit your Go Live Declaration, your practice management consultant will need to review your completed training plan, local IT support plan, business continuity plan, data migration plan, and data and network security plan and processes.

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20. What are my responsibilities in the EMR System Management Independent Undertaking?

A physician that chooses a Local EMR solution and does not choose to join a VCN must sign an EMR System Management Independent Undertaking stating that he or she will undertake to do the following:

Training
1.      To obtain training, including instituting and following a plan to obtain ongoing training, for all persons using the EMR in accordance with best practices.

IT Support
2.      To develop and implement a support plan based on the EMR vendor's recommendations, for the configuration of the EMR and associated hardware and communication network.
3.      To keep the EMR upgraded to the most current version within the required compliance period.

Business Continuity
4.      To develop and implement a disaster recovery plan so that patient data and clinical management data resident on the undersigned's servers ('Critical Data') can be recovered quickly and with minimal loss.
5.      To develop and implement a business continuity plan so that in the event of the loss of the undersigned's premises and/or the servers upon which Critical Data is resident (for example, in the event of fire, accident or theft), the undersigned can continue in business using the Critical Data quickly.
6.      To develop and implement a system to provide daily off-site backups of Critical Data.

Data Migration
7.      To obtain, read and understand the Local EMR Vendors annual Data Migration test results.    
8.      To develop and implement a plan for accurate and speedy migration of Critical Data in the event that the undersigned changes to a different EMR.

Security
9.      To maintain the Critical Data encrypted to a strength of at least 128 bits, so that the Critical Data cannot easily be used if the undersigned's servers are stolen or compromised.
10.    To keep all keys for decryption of the Critical Data and all usernames and passwords safe from use by persons who are not entitled to access the Critical Data.
11.    To keep the servers upon which the Critical Data are resident safe from unauthorized access or tampering, either physically or remotely.
12.    To maintain local area network (LAN) security in order to keep the Critical Data safe from unauthorized access.  This shall include the use of a stateful packet inspection firewall and router at the perimeter of the LAN and monitoring of traffic in both directions in order to manage intrusion attempts.
13.    To keep anti-virus/anti-spam/anti-spyware systems in place and maintained with the latest spyware and virus signatures.

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21. If I choose an ASP EMR, why don't I have to join a Vendor Collaborative Network or sign an EMR System Management Independent Undertaking?

An ASP EMR provides much of the EMR infrastructure and support that is provided in a Vendor Collaborative Network or covered under the EMR System Management Independent Undertaking. The physician will be responsible for obtaining ASP EMR training, local IT and communication network support requirements, business continuity planning not covered by the ASP EMR and data and network security.

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22. At what point, or at which milestone is the EMR System Management Independent Undertaking Form due?

The EMR System Management Independent Undertaking Form can be submitted either when you submit your Vendor Contract Declaration or when you submit your Go Live Declaration. Once you have submitted the EMR System Management Independent Undertaking form, if you change your mind and decide to join a Vendor Collaborative Network, please advise OntarioMD of the change.

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23. When do I have to complete an EMR User Survey?

  • For physicians where an EMR User Survey was completed more than twelve months ago, an EMR User Survey must be completed.
  • For physicians where an EMR User Survey was completed less than twelve months ago, you are not required to complete the EMR User Survey again. However, you are required to complete the EMR User Survey no later than one year after you completed your last EMR User Survey.

For physicians to continue to receive funding under the EMR Enhanced Use Program, they must complete the EMR User Survey, or its successor, on an annual basis, no later than one year after the completion date of your last EMR User Survey.

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24. How is network connectivity provided under the EMR funding programs?

The programs include funding for physicians to acquire connectivity directly from a commercial Internet service provider. Connectivity must meet the ​eHealth Ontario Conne​ctivity Guidelines. Application Service Provider (ASP) EMR clients receive additional funding to implement a second Internet connection for business continuity purposes. Please speak to your Practice Management Consultant, practice IT lead and EMR vendor to assess your connectivity needs and costs.

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25. Does funding include a connection to the Internet?

Funding is provided to assist with the cost of implementing an ASP EMR and obtaining an Internet connection from a third-party Internet Service Provider (ISP).

The third-party ISP must meet eHealth Ontario's guidelines to ensure the connections meet each physician's needs for bandwidth, compatibility with the EMR chosen by the physician, business continuity, security (anti-virus software and a firewall), remote access and client / help desk support.

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