What This Means for Vendors and for Us, Their Customers

Yesterday I explained that the PCMR is not just a shopping list; it is a blueprint for a new way to manage primary care records. Today, the next question is clear: what does this blueprint mean for our current vendors and for us (those who rent/buy/use their software and services)?

Three generations, one badge

The established platforms include TELUS PS Suite, which has been the main choice for a long time and is used by about a third of community doctors, and Accuro, which covers about a quarter. These systems are deep, mature, and trusted by thousands of practices every day. They were designed for an earlier era of clinical workflow, and these vendors are already investing in newer platforms to help users move forward. Many of their installs run on local office servers.  Some clinics have moved to a hosted environment online, but their EMR instance remains separate from others.

The web-based generation includes OSCAR Pro, which holds about a fifth of the market and is now part of WELL Health/WELLSTAR. It has a large and loyal community. In the past, each clinic had its own separate installation, but this product is shifting toward the shared approach the province wants. The product is adapting quickly.  And their new EMR will be cloud-native.

The cloud-native platforms include TELUS CHR and a few newer players (ie: Avaros, Cerebrum, Juno, Myle – see the full list of certified vendors here). These were built in the last decade with patient tools, automation, and open connections built in from the start. This generation is closest to where the province is heading.

Should you rebuild or adjust? It depends on which generation your platform belongs to.

Everyone wants to know: does meeting this RFP require a complete rebuild of the EMR, or just some adjustments? The real answer is that it depends on which part of the system you look at.

• As for the essentials, everyone already has them. That is what certification provides. This part is just routine maintenance.
• Creating one provincial system at a large scale is a major change for the established platforms. You cannot just turn thousands of separate copies into one shared system. For the cloud-native platforms, this is more of an adjustment than a complete rebuild.
• When it comes to AI and full integration, this will be a new build for everyone. No company has this in production yet. That is why the RFP allows vendors to commit to a timeline instead of requiring it from the start.

Taken together, the direction is clear. The largest players in the market are already modernizing. TELUS is trying to move PS Suite and MedAccess users to CHR, and WELL is investing in cloud products and a new, brand-new EMR. The RFP also gives other vendors like Accuro the chance to bring their newest platforms forward instead of relying on older ones.

The main challenge for established vendors is not the quality of their software, but the scale of change the entire system is being asked to make. This time, the province is providing funding and a plan to help clinics through the transition.

And what about us, the doctors and nurses who are years into an EMR system?

For most physicians, this will not feel like shopping for a new brand. Instead, it will feel like one of these situations:

• Your current vendor moves you to an in-house solution with the same company and help desk, but with a newer product. This is the easiest type of migration.
• The app marketplace becomes your way out, offering scribes, decision support, and patient tools that you can add without needing a separate purchase order each time.
• Portability finally becomes real. You will be able to move to a new EMR more easily.  For once, the fine print works in your favour. Moving will be affordable, easy, and enabled by new laws (Bill S-5) and regulations.

The likely outcome is consolidation