Those who oppose the New Brunswick EMR monopoly are starting to find their voice. The government-sanctioned but unpopular Velante program has been rejected by most doctors in the province, but people in other professions are starting to take note of this unfortunate and wasteful state of affairs, and add their two cents worth. We need a provincial EMR system with some choice of software, which fosters and encourages interoperability of computer systems.
The last thing we need is a walled garden jealously guarded by self-serving profiteers.
Of particular note is this thoughtful letter I received from a New Brunswick based Information Technology expert with thirty years in the business.
Charles Depow of Woodstock was kind enough to permit me to publish his comments.
Dear Dr. Varty,
After working for 30 plus years in the information technology field, I am at a loss on the current procurement process for Electronic Medical Records (EMR’s) in NB. My experience includes 5 years overseeing electronic messaging for North America for a large multi-national frozen food company including their Y2K testing. This electronic messaging included electronic messaging to banks for payroll deposits. For that multi-national frozen food company I was also responsible for implementing freight systems that were totally electronic using electronic messaging at every stage of the order process through to payment to the freight carrier.
Add to this several years on the Architecture and Infrastructure Special Interest Group of Canada Health Infoway (CHI), more as a listener than an active participant, but well aware of what is happening in the electronic health record development. Several courses on Privacy and Security and Electronic Messaging given by the National Institute for Health Informatics (NIHI) and Canada Health Infoway have further added to my knowledge of current electronic health record processes.
With this experience and knowledge I am at a loss as to how the province is handling the EMR implementation process. Some disturbing facts to me:
The Request for Proposals (RFP) for an EMR package for New Brunswick was a total farce. It asked for requirements that few packages in the world could meet, let alone a Canadian or provincial package. There was no opportunity for a New Brunswick package to enhance their offering to meet these unrealistic requirements.
The province gave a monopoly to a private company. We all know that monopolies mean higher costs and stifle innovation!
The New Brunswick Medical Society (NBMS) states that it is responsible for the integration of existing packages into the electronic health record. Why? The province has paid for a company to implement and maintain their HIAL package. HIAL stands for Health Information Access Layer which is the system that takes electronic messaging and processes it accordingly, much like a post office. Why is the medical society taking on this responsibility?
The president of the NBMS states they do not have the resources to integrate existing EMR’s in the province’s system. The messaging requirements are well documented by CHI and CHI has a test site for members to test and have their messaging approved to Canadian standards. There should be little if any cost to the medical society?
Canada Health Infoway has created software to create these electronic health messages and the package is free to anybody in the world. This was done to help companies move to the Canadian standards. Standards that are recognized world-wide.
Existing packages in the province are already certified by CHI to send and receive electronic messages in other provinces. What is the reluctance of this province to work with these vendors?
There were 14 companies sending electronic messaging to the Department of Health before this monopoly was given to a private company. They will no longer be able to work in NB although most of them are NB companies.
It is my experience, that if, the province was to publish its electronic messaging requirements and set the bench mark for companies to meet, we would be helping information technology in companies already existing in the province. Instead we are not even allowing them to be part of this new and exciting field. What a shame!