MANDATORY EMR FUNDING ELIGIBILITY SCHEDULE

MANDATORY EMR FUNDING ELIGIBILITY SCHEDULE 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. 1. Provider certifies that the EMR Offering is Funding Eligible at the time of contract signing. 2. 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: (a) 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. MOH Group Name/Solo-Practitioner Name 1. 2. 3. 4. 5. 6. Site Name Site Location Number of MDs Site Lead MD Technical Implementation Date (b) (c) (d) 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. 1

(e) Release Notes available for all releases when the Release is made Generally Available. 3. You and Your Provider are obligated to complete all items outlined in the and 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. 4. 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 s quality assurance and beta testing processes and deemed fit by the 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 Generally Available is April 1, 2012. Technical Implementation Complete Technical Implementation Completion Date The Fix Release General Availability date is the date the offering is generally available after the has remediated any deficiencies under the current EMR Specification, completed the required Validation Process and has been approved by OntarioMD for release. 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. The date that the Technical Implementation Complete has been achieved. 2

Spec Release Fix Release Funding Eligible 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. 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 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. Initials for both parties 3

APPENDIX A VENDOR AND PHYSICIAN CHECKLIST Checklist s 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. A) EMR System Documentation B) EMR Modules Documentation C) Training Plan D) Fixed and Variable Costs E) Service Level Agreement F) User Acceptance Testing & Signoff s are required to identify the items which are the responsibility of vendors, and physicians both for requirements as well as implementation. A) EMR System Documentation 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 4

Documentation includes the following requirements. Please identify if the below items are vendor responsibility or physician responsibility to complete or provide the service. 1) 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. Desktops Laptops Mobile devices Memory Routers Antivirus Operating System Server Power supply Firewall Other - Specify 2) Network Bandwidth Requirements The will provide the physician with recommended network bandwidth requirements and will identify recommended providers where applicable. Upload and download requirements Data transfer volume requirements & data usage Network configuration and cabling requirements Other 3) Privacy and Security Requirements Secure server location Firewall (ASP) Firewall (Local) Other - Specify Configuration of remote access and security/passwords for all EMR users 5

4) 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. Specific licenses or providers must be identified. Operating System Licenses Database Licenses Client Access Licenses Drug Database licenses Antivirus VPN access Other - Specify 5) 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. 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 6

6) Data Migration Requirements: 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 Checklist Section A) EMR System Documentation 1 through 6, above completed. B) EMR Modules Documentation Provide the physician with documentation of the EMR modules, interfaces including special configurations and customization. 1) EMR Set-Ups for all EMR components and modules. Registration Scheduling Billing Encounters Templates Labs Prescriptions Referrals Data sharing Other - Specify Requirements for data access (permissions) to modules 7

for each clinic staff member 2) Document any instances of customization or special configurations for each implementation. Custom fields Calendars Schedules Identified clinic resources (exam and clinic rooms) Define work flow and create "tags" as appropriate, Pharmacy addresses and fax numbers 3) Interfaces to External Content Providers: 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 Checklist Section B) EMR Modules Documentation 1 through 3, above completed. 8

C) Training Plan Document the training content and activities 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 Checklist Section C) Training Plan, above completed. D) Fixed and Variable Costs Complete a cost breakdown of all goods and services 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 Checklist Section D) Fixed and Variable Costs, above completed. 9

E) Service Level Agreement Document the components of the service level agreement and any associated costs. (May include subscription or monthly fees) 1) Identify components of the service level agreement 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 Checklist Section E) Service Level Agreement, above completed. 10

F) User Acceptance Testing and Signoff Develop and Implement a user acceptance testing process and signoff process for each implementation. A) EMR System B) EMR Modules C) Training D) Fixed and Variable Costs E) Service Level Agreement A. EMR System installation and configuration is complete Installation of IT platform infrastructure is complete Installation test of EMR completed s 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. has signed off items with the vendor. B. EMR Modules installation and configuration is complete 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. has provided data validation and UAT testing 11

scenarios to the physician. User acceptance testing of EMR modules, interfaces and external content providers and any other applicable items is complete. has signed off items with the vendor. C. Training Training is complete as specified in the training plan Any additional advanced training sessions are scheduled has signed off on the training D. Fixed and Variable Costs has signed off on cost quotation E. Service Level Agreement Backup and recovery functionality has been tested by the vendor and is operational has tested that backups are encrypted has tested that data can be been restored from a backup has provided UAT test scenarios and data validation scenarios to the 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 Checklist Section F) User Acceptance Testing and Signoff, above completed. 12

Checklist s 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 A) EMR System B) EMR Solution Security C) User Acceptance Testing & Signoff A) EMR System EMR is in good standing at OMD (refer to OntarioMD.ca website) www.ontariomd.ca For physician who select McMaster University Department of Family Medicine: Selected Oscar Services Provider (OSP) is in good standing with the McMaster University Department of Family Medicine (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 Name: OSP Name (Oscar McMaster 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 13

must confirm the following items with the CISP and vendor for the Internet connection: Ensure that all internet and required Ensure the Internet service provider has network hardware and software (routers, installed and configured the following cabling etc) are installed and tested prior items: to the installation of the EMR. IP addressing scheme for LAN or wireless There is sufficient bandwidth for users at Network devices (printer, fax server, each location to support the EMR scanner, terminal server, health card The internet service provider has installed reader) a static IP address Workstations A firewall has been installed that restricts Wireless Access Point (WAP) access to the location's Local Area configuration (if applicable) Network (LAN) must confirm that the design of has obtained supporting remote wireless network meets privacy and access materials and user guides from the security requirements and encryption internet service provider Ontario MD review of activities outlined in the Checklist Section A) EMR System above completed. B) 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 Checklist Section B) EMR Solution Security, above completed. 14

C) User Acceptance Testing and Signoff Develop and Implement a user acceptance testing process and signoff process for each implementation. A) EMR System B) EMR Modules C) Service Level Agreement A. EMR System Installation and Configuration is complete: Internet browser shortcuts to www.ontariomd.ca are located on each desktop. Installation test of EMR completed B. EMR Modules Installation and Configuration is complete: 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) C. 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 Checklist Section C) User Acceptance Testing and Signoff, above completed. 15