Twenty-five years after Canada committed to building a national electronic health-record system, more than 70 per cent of electronic health information is still not shared among health-care providers — despite the fact that more than nine out of 10 physicians use electronic medical record (EMR) systems.

Fortunately, the technology to fix this is not the problem. Several EMR systems are already in use, and tools for interoperability (allowing different software platforms to communicate with each other) have been developed. Most recently, the Health Application Lightweight Protocol known as HALO was developed by Canada Health Infoway in partnership with Ontario Health, British Columbia’s Health Services Authority and Hamilton Health Sciences.

The HALO protocol is designed to cut through Canada’s fragmented medical record systems — connecting physicians to their patients’ complete health information across platforms, avoiding duplicate testing, reducing delays and preventing medical errors.

So the tools to improve access to care, reduce administrative burden and ensure timely treatment already exist. The question is whether anyone is making sure they are used.

A tool without a mandate

In March 2023, the Conference of Deputy Ministers of Health endorsed the Pan-Canadian Interoperability Roadmap, a strategic plan to enable hundreds of incompatible EMR systems to communicate securely with each other, so that, for example, a physician in Hamilton can access what a specialist in Toronto already knows about their shared patient. 

On paper, this is exactly what Canada has needed for decades. In practice, however, there is a question the roadmap does not adequately answer: how will we ensure these tools are actually used — especially when provinces are allowed to make participation voluntary?

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