Canada's fragmented health care system faces a critical challenge: electronic systems that cannot effectively communicate with each other.

This lack of interoperability creates significant barriers for both patients and providers. Critical patient information often exists in isolated silos, leaving health care professionals without the tools they need to deliver informed, coordinated care. The consequences? Inefficiencies, medical errors and compromised patient safety.

National initiative to address interoperability

To address mounting concerns, four Canadian medical organizations came together in March 2024 to create the Digital Health Interoperability Task Force. Canada Health Infoway, the Royal College of Physicians and Surgeons of Canada, the Canadian Medical Association and the College of Family Physicians of Canada launched the initiative with three key goals:

• Improve patient care and safety through better-connected systems.
• Ease administrative burdens by connecting clinicians with essential resources.
• Foster innovation to drive widespread adoption of interoperable digital health tools.

"The advancement of Connected Care, or interoperability, means improving the ability of different digital health systems to communicate, exchange and use personal health data seamlessly and securely," said Rashaad Bhyat, MD, Task Force co-chair and senior clinician leader at Canada Health Infoway. 

Major challenges identified by the task force

The task force's investigation revealed several critical challenges. In some rural and remote areas, poor internet connectivity can significantly hamper effective health information sharing. But problems extend far beyond infrastructure. Clinician burnout can be exacerbated by administrative tasks, including time-consuming data gathering and sharing that reduces time for patient care. Current electronic medical record systems often lack automation and flexibility, while non-integrated portals require multiple sign-ins and manual processes.

The investigation also identified significant gaps in data standards. The absence of consistent nomenclature and exchange protocols, coupled with outdated privacy and data governance policies further complicates information sharing. Different attitudes to data sharing also pose a challenge. Some clinicians and organizations are reluctant to share data, limiting opportunities for collaboration among health care teams.

"The challenges vary significantly across regions and provinces, depending on all these factors,” said Samuel Ogunbiyi, MBBS, MD (Research), FRCS (Edin), FRCSC, Task Force co-chair and Royal College Council member. “Some areas face hurdles with outdated systems, while others grapple with administrative burdens or resistance to change. It’s a complex landscape, and each region has its own unique starting point for progress."

Dr. Samuel Ogunbiyi

Recommendations to transform Canada’s health system

After eight months of intensive work, the Digital Health Interoperability Task Force Report was released in November 2024, identifying five key recommendations to transform Canada's health care system:

1. Provide guidance. Federal, provincial and territorial governments must commit to a comprehensive five-year plan to improve interoperability, overseen by a new National Health Data Governance Council. This council must be empowered to drive accountability and establish timelines and cross-jurisdictional commitments, ensuring all regions adhere to a unified framework.
2. Accelerate commitment. The task force calls for accelerated federal policy and legislative efforts to drive comprehensive health data interoperability. This includes mandating data and technology standards for clinical data exchange, as outlined in Bill C-72, while creating a national framework for modern health data stewardship that ensures appropriate data sharing, access and privacy protection. Such efforts must respect Indigenous health data sovereignty and ensure patients retain ownership of their health data.
3. Erase barriers. Provinces and territories must address barriers preventing health care professionals from participating in health data interoperability initiatives.
4. Support clinicians. Medical associations and clinical societies should develop best practice guidelines and advocate for strategies to address identified barriers to interoperability. This includes developing regional strategies to address workflow challenges, training needs and resource requirements identified by the task force.
5. Stimulate innovation. Canada's research and development funding organizations must invest in ongoing digital health innovation. This includes developing strategies for data standardization, curation and AI-driven report generation to support clinician participation and reduce workload, while addressing current EMR limitations to better meet health care team needs.

Preparing physicians for a digital future

For physicians preparing for these changes, Dr. Ogunbiyi recommends getting better acquainted with current EMR systems. "If for whatever reason physicians are still on paper for part of their practice, they should look to moving away from that," he said. "Keep an eye out for education modules about AI integration into workflow patterns, particularly around dictation and AI scribes."

Looking ahead, Dr. Ogunbiyi envisions significant progress within the next decade: "In five to 10 years, a patient should be able to see their health care provider, and that provider can access all the patient's visits in the community and in tertiary institutions. If that patient crosses to a different province while on holiday and needs care, the health care provider there can access all their records — and the patients themselves can access all their records too."

A health care system built on connection

The vision is clear: a health care system where patients and their care teams have seamless access to the information needed for the delivery of high-quality care, regardless of their location. By addressing the current fragmentation in health care technology, these recommendations aim to create a more connected, efficient and equitable health care system for all Canadians.

"The health care system is evolving fast, and clinicians have to embrace a certain amount of change to continue to lead and be effective," Dr. Ogunbiyi said. "Moving forward, technology will have a bigger role in what we do, particularly with the advent of AI. But we should always remember that AI will never replace the clinician — AI will support what we do."

Read the Digital Health Interoperability Task Force Report from November 2024.