As a very satisfied user of the Optimed Accuro EMR program, which I use to run a paperless office hosted my own secure server, I was very disappointed with the choice of vendors for the PITO program. With over $100 million to fund this program (more than the amount allotted for specialist microallocation) I believe this money is being misused. I have written to the PITO program director Jeremy Smith and to many BCMA representatives. 

Instead of addressing my concerns I have been told that “we look forward to your future cooperation.” My concerns are as follows. The readers can make their own conclusions.

1. Instead of using this money to support physicians in their use of their EMR of choice the BCMA and BC government are in effect endorsing six vendors who meet the needs of the government and not physicians. There has been some controversy with some members of the steering committee[1] and the vendor selection process has been far from transparent. Endorsing these companies suppresses competition and physician choice and ultimately may cause other vendors to fold, though their software may be superior.

2. The BCMA web site[2] extols the virtues of the ASP, but other information[3] suggests that the real reason for hosting information on a third-party server is to extract “anonymized ‘core-data’ for planning health care priorities”—in other words, to use physicians as data collectors for government purposes.

3. The maligned office-based server[2] is neither time consuming to maintain nor insecure. The likelihood of being hacked is actually less than if information is stored on a public Hotmail-type ASP server with a public address. Physicians maintain complete control of their intellectual property.

Members of the BCMA should demand more transparency in the PITO process and question the narrow-minded selection of ASP based-vendors with an agenda of core data extraction. The $108 million should be used to support physicians who implement or have already implemented fully functioning EMRs and not to subsidize vendors who meet the narrow ASP criterion. 

-Hamish Hwang, MD
Vernon

References

1. www.cbc.ca/cp/national/071210/n1210158A.html [9] (accessed 17 December 2007).
2.www.bcma.org/members/2006NegotiationsNews [10] (accessed 17 December 2007).
3. www.bchimps.bc.ca/mswordfiles/Ed%20Session%20documents%2006/Dalal%20and%20Smith.ppt [11] (accessed 17 December 2007).