Re: PITO vendors

I must correct a quote attributed to me in Dr Tom Elliott’s BCMJ letter of 2008;50:292-293 and provide some key facts.
I was asked to present an update on PITO at the 30 January 2008 meeting of the Society of Specialist Phy­sicians and Surgeons. Dr Tom Elliott asked whether the six EMR vendors selected for PITO were achieving the market share that they had expected.

In response, I indicated that we had high pent-up demand and large numbers of physicians who had already selected from among the six; however, the vendors would not be allowed to implement through PITO until successfully completing conformance testing as per the PITO requirements. 

I indicated that the process was de­layed by 4 months while government completed its review of the EMR procurement process to ensure the process was completed properly, and that I was pleased that the review was conducted and showed no problems.

I at no time suggested that any privacy concerns or any concerns regarding the BC government eHealth program were causing any slow uptake of the PITO-approved vendors. In fact, that couldn’t be further from the truth. To the contrary, we received applications for PITO from 1346 physicians in February to be among the first 500 to start in the first 6 months. 

Many of them have already successfully implemented their PITO-qualified EMR. Others have chosen from among the six vendors and are waiting now only for the vendor they chose to complete the final step of the approval process—conformance testing—before implementing their EMR. While this process takes time, it is one of the many important steps introduced to avoid the challenges experienced in adopting EMRs prior to PITO.

I agree with Dr Elliott that market forces and market share speak volumes, and the choice of EMRs re­mains entirely with the physician. At best estimate, over 80% of BC physicians using full-function EMRs are using products from the six vendors selected for PITO. 

Collectively, these six vendors also have exceptionally strong market presence elsewhere in Canada and worldwide. These figures would suggest that these companies are in fact meeting BC physician needs, further supported by anecdotal feedback from the first 500 physicians selecting EMRs through PITO.

The PITO program was carefully designed based on international evidence and input from dozens of BC physicians in order to help BC get past the current 8% to 15% uptake of EMR and closer to the near 100% EMR adoption in countries such as New Zealand, Denmark, and the UK. 

Physician feedback from initial PITO implementations has reinforced that the program is well on track. The next application period will be available 15 August to 26 September for implementations starting between October and March, and we anticipate at least another 500 to 1000 applications (www.pito.bc.ca).

—Jeremy Smith
Program Director, PITO