FAQs 1. What is PITO? - British Columbia Medical Association

FAQs
1. What is PITO
2. Can I start buying hardware and software now and submit my request for funding once
PITO is operational
3. What products and services will be available from PITO
4. When and how can I sign up
5. What EMR products are eligible for PITO funding
6. Who is eligible for funding
7. How will PITO handle the registration process if physician registrations exceed PITO
capacity
8. When will the EMRs and other technology components be ready for implementation in
physician practices
9. Who is choosing the hardware and software for electronic medical records
10. Am I eligible if I already have an EMR If I move to a new EMR, what are the
transition options
11. With the 70/30 split of costs, is there a maximum that PITO will pay out
12. What happens at the end of the six year PITO mandate, would I inherit all future costs
13. Will the EMR be fully integrated with my local health authority systems
14. Will I be able to get electronic lab results and PharmaNet in my area What about
eReferrals and order entry
15. What measures is PITO taking to ensure privacy of personal information
16. Why was a hosted application service provider (ASP) model chosen
17. Where can I get more information
1. What is PITO
PITO is the Physician Information Technology Office of British Columbia. PITO was set up by
the BCMA and BC Government as part of the 2006 Agreement.
PITO’s primary job is to support the implementation of electronic medical records in physician
offices across BC. PITO will assist physicians during implementation, and will coordinate the
disbursement of IT funds to physicians as defined in the Agreement.
Over the term of the six year agreement (1 April 2006 to 31 March 2012), funding for PITO is as
follows:
• Year 1 - $3 million
• Year 2 - $8 million
• Year 3 - $14 million

• Year 4 - $15.5 million
• Year 5 - $22.4 million
• Year 6 - $24.9 million
• Plus an additional $20 million in one-time funding to be paid out over the term of the
Agreement
PITO is governed by a six person steering committee, with three practicing physicians appointed
by the BCMA and three members by Government. The PITO Steering Committee is currently
recruiting a PITO Program Director. The intention is to have a Director in place by early 2007.
The PITO office will be established in Vancouver at the BCMA building 1665 West Broadway.
2. Can I start buying hardware and software now and submit my request for funding once
PITO is operational
PITO is working to establish a list of qualified electronic medical records (EMR) software and
computer hardware. Physicians should consider delaying related purchases until the PITOapproved
product lists are established. By delaying purchases, physicians can ensure they will
qualify for eligible PITO funding and confirm that their system will work with other services
such as lab results, Diagnostic Imaging (DI) reports, and electronic prescriptions.
3. What products and services will be available from PITO
As described in the Agreement, the collection of products and services available from PITO will
include:
• EMRs (Electronic Medical Records) for physician offices
• Secure high speed internet and secure email for physician offices
• Availability of Chronic Disease Management functionality within EMRs.
• Training and technical support for physicians with EMR, Internet, email and other technology
available through the program
• Support for physicians in their offices as they implement new systems, or transfer from their
pre-existing hardware and software.
4. When and how can I sign up
The immediate focus of activity is on setting up PITO and publishing the Request for Proposals
(RFP) for EMR vendors to establish the PITO-qualified EMR vendor list. As the RFP process
nears conclusion, in late spring 2007, the physician sign-up process will be defined and initiated.
5. What EMR products are eligible for PITO funding
One of PITO’s initial tasks is to develop a list of approved EMR software for use in physician
offices that are applying for PITO funding. This process is being undertaken to ensure that all
approved EMR software meets certain minimum clinical, privacy, and security standards and to
ensure that these systems work with each other as well as regional and provincial programs

already in place. Only EMR systems on the approved list will be eligible for funding.
6. Who is eligible for funding
All independently practising physicians in BC are eligible for this program. This includes GP’s
and specialists whether they are in solo or group practice. The program is voluntary, and terms
and conditions will apply for funding. These policies will be defined by the PITO Steering
Committee and made available to all physicians before the sign-up process begins.
PITO funding is available where:
• actual costs are incurred by the physician,
• other sources of funding have not already been provided (e.g. research funds, health authority),
and
• other sources of funding are not mandated by legislation or policy.
7. How will PITO handle the registration process if physician registrations exceed PITO
capacity
Registration for PITO funding will occur on a quarterly basis. If applications exceed capacity, a
lottery will be used to select the successful applicants for that phase. During the pilot testing
phase, registration may be primarily for larger groups of physician practices who are prepared to
proceed together. However, individual practices will be given equal priority for the remainder of
the project.
8. When will the EMRs and other technology components be ready for implementation in
physician practices
The date that PITO-approved EMRs will be available for selection by physicians and funding
under PITO is not yet set as it depends on the procurement process and how long it takes the
chosen vendors to fill any gaps in their product.
It is anticipated that the successful EMR vendors will be selected by late spring of 2007 and
enter into PITO conformance testing as soon as they address any gaps in their solution. Vendors
will begin conformance testing at varying times over the proceeding months depending on their
readiness, starting as soon as a month or two after the successful vendors are identified. Other
components of the PITO solution may be ready for implementations in pilot projects prior to the
EMR.
9. Who is choosing the hardware and software for electronic medical records
The PITO Steering Committee will manage the selection through a formal government RFP
process. An evaluation team made up of practicing physicians and their office staff, as well as
Ministry technical staff, will review the proposed products. This group will use objective
evaluation criteria to determine which products and services will be selected. The process will
proceed as follows:
• PITO will ensure that all necessary clinical and technical requirements are documented and

approved by the PITO Clinical Advisory Group.
• PITO will prepare the RFP for vendors. All vendors will be eligible to respond and be
evaluated.
• Members of the Clinical Advisory Group (CAG), Ministry staff, and BCMA staff will evaluate
the EMR respondents using rigorous clinical functionality demonstrations, validation testing,
reference checks, and site visits.
• The selection team will recommend the top vendors for qualification on PITO's qualified
vendors list. PITO has set a maximum of six for the number of vendors that may be approved.
10. Am I eligible if I already have an EMR If I move to a new EMR, what are the
transition options
Physicians who adopted an electronic medical record system (EMR) prior to the PITO project
will have access to funding on the same 70/30 split basis (70% PITO government, 30%
physician). The Early Adopter Program provides bridge funding for up to 18 months of ongoing
use of an existing full clinical use EMR, contingent upon conversion to a PITO-approved EMR
at the end of that period.
Other financial supports include monthly funding for access to the PITO Private Physician
Network and a one-time funding of up to $3,500 for new hardware, both contingent upon
conversion to a PITO EMR.
Upon conversion, these physicians will then be eligible for funding for implementation and ongoing
monthly costs on the same 70/30 split basis.
11. With the 70/30 split of costs, is there a maximum that PITO will pay out
PITO will contribute a maximum of 70% of eligible costs for the hardware and software
implementation. There is a limit to how much money is available in total, and per-physician
limits will be required to ensure even distribution of funds. These policies will be defined by the
PITO Steering Committee before the physician sign-up process begins. A similar cost sharing
model is currently used as part of Alberta’s Physician Office System Program (POSP).
12. What happens at the end of the six year PITO mandate, would I inherit all future costs
The funding for this agreement expires in 2012. Prior to then, the BCMA and Government will
determine the availability of ongoing funding through the negotiation process.
13. Will the EMR be fully integrated with my local health authority systems
The EMR will not be fully integrated with the local health authority hospital systems. However,
physicians will be able to access the health authority clinical information systems through the
secure network if the health authority has granted them access.

14. Will I be able to get electronic lab results and PharmaNet in my area What about
eReferrals and order entry
Access to electronic lab results in your EMR (from your local health authority or private lab) and
access to PharmaNet will be included in PITO implementations as they become available.
Additional content (e.g. diagnostic imaging reports and expanded PharmaNet) and functionality
(e.g. order entry) will be made available as they are developed.
15. What measures is PITO taking to ensure privacy of personal information
PITO considers the privacy and security of patients’ personal information to be the utmost
priority and will work to achieve the highest possible level of security. PITO is working closely
with practicing physicians and the MOH’s privacy office. Both the BC Office of the Information
and Privacy Commissioner and the College of Physicians and Surgeons of BC are providing
input and oversight to ensure that sound privacy principles and practices are embedded
throughout the PITO program, from hardware and software requirements to legal agreements and
technical architecture. Data stored for a practice in a hosted EMR will be controlled by the
physician and/or practice following BC privacy legislation and requirements of professional
practice.
The PITO Steering Committee has set up a Privacy Working Group, which includes practising
physicians, College representatives, BCMA staff, and Ministry privacy experts, to thoroughly
examine all related privacy issues.
Appendix C of the 2006 Agreement includes the commitment to create a core data set that will
be defined by physicians. A core data set is a list of key patient information such as allergies,
known conditions and medications that would be important to know in an emergency situation or
shared to support continuity of care.
The core data set can be shared among physicians, at their discretion, to support patient care and
can also be grouped together anonymously for health system analysis. Specific steps are being
taken to ensure the privacy of data for the core data set:
• Rigorous privacy and security mechanisms will control the exchange of these data among
physicians (i.e., between EMRs).
• Physicians, the College of Physicians and Surgeons, the BCMA, and the MOH are actively
involved in designing and/or approving how the core data set is configured to uphold patient and
provider privacy, and the approach will be reviewed by the Office of the Information Privacy
Commissioner.
16. Why was a hosted, application service provider (ASP) model chosen
An application service provider is a company that delivers software programs and other services
over a network instead of being located on the physician’s own computers or servers in their
office. PITO’s EMR software will be kept in a professionally managed third party ASP model.
This approach will facilitate reliable delivery of data such as lab results, etc. to the physician's
office and ensure that the data on EMR servers is held securely to protect patient confidentiality.
Using an ASP will also relieve the physician of the burden of managing the security and

eliability of the servers, backups and networks. PITO is currently addressing means of ensuring
reliable access to the ASP server.
Funding will only be provided for hosted EMRs, although PITO will evaluate the practicality of
this requirement in remote areas where network reliability is uncharacteristically low and may
identify alternatives that still maintain the spirit of the Agreement.
17. Where can I get more information
Additional information about PITO is available on the BCMA member website.
Or, contact the PITO Program office by telephone at 604-638-2946 or e-mail at info@pito.bc.ca.