Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Physicians & Subscribers
    • Benefits for Canadian physicians
    • CPD Credits for CMA Members
    • Subscribe to CMAJ Print
    • Subscription prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Physicians & Subscribers
    • Benefits for Canadian physicians
    • CPD Credits for CMA Members
    • Subscribe to CMAJ Print
    • Subscription prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Instagram
  • Listen to CMAJ podcasts
News

E-health progress still poor $2 billion and 14 years later

Paul Christopher Webster
CMAJ July 14, 2015 187 (10) E309-E310; DOI: https://doi.org/10.1503/cmaj.109-5088
Paul Christopher Webster
Toronto, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading

Progress on a pan-Canadian electronic health record system remains poor despite more than $2 billion in federal investments since 2001, lamented presenters at e-Health 2015, Canada’s largest annual e-health conference.

Bedevilled by a lack of uniform national technological standards, many electronic health information systems cannot interoperate with other systems. As a result, interprovincial sharing of digital health information continues to be halting, according to four senior software executives and medical experts who spoke at a June 2 session dedicated to “rants” about Canada’s e-health problems.

“Ten years ago, the big topic was interoperability. Ten years later, it’s not a lot different,” said Mike Checkley, president of British Columbia-based QHR Technologies Inc., a leading software vendor in Canada’s $500-million electronic medical records market. “I’m pointing my fingers at both my vendor colleagues and my government friends.”

In a landscape where each province insists on its own health information software specifications, and vendors are required to submit their products for testing in each province to prove their conformance with provincial technical standards, “there’s a ton of obvious duplication,” Checkley noted. “Each time it’s different government people — really nice people — over and over again.”

The decisions that led to the creation of Canada’s fragmented electronic medical record (EMR) landscape, Checkley said, were made by provincial and federal agencies that invested in incompatible EMR systems.

The result of those funding decisions, Checkley said, is that there is “no functioning EMR across Canada.” The time has come for governments to work on interprovincial harmonization, he added.

That appraisal drew strong support from another presenter at the “rants” session, Dr. Alex Singer, a University of Manitoba clinician researcher. Canada Health Infoway, the federal crown corporation that has spent more than $220 million on salaries and internal administrative costs since 2001 in an effort to forge a “national health infostructure” by distributing approximately $2 billion in federal grants, has “failed to ensure it invested in interoperable systems,” said Singer. “Infoway funds things but doesn’t manage them. There’s a big leadership gap.”

Figure

Duplication of efforts and a lack of interoperability have plagued attempts to have a pan-Canadian electronic health record system.

Image courtesy of Dieter Meyrl/iStock

Dr. Allen Ausford, an Edmonton family physician who helped create Alberta’s EMR system, offered a similarly blunt assessment. The federal government should use financial incentives to force the provinces to purchase interoperable systems, Ausford suggested, before noting that the US government uses financial penalties to ensure its e-health subsidies achieve predetermined goals.

“Let’s use pay-for-performance measures as a carrot and sequester transfer payments as a stick,” Ausford suggested. “Let’s have a single national shared information framework.”

Diane Gutiw, director of consulting (health) for Montreal-based CGI Inc., agreed that Infoway’s investment strategy has promoted eleven separate e-health jurisdictions with differing technical standards. “Every time we try to come up with a universal pan-Canadian standard, we really just wind up with yet another standard.”

In many instances, Gutiw said, efforts to ensure compliance with government standards negatively affects efforts to use digital health information to achieve benefits for patients and providers. “It’s infuriating when we take the data we have and have to make it comply with standards that are way ahead of the system. We’re starting to throw money away.”

Gutiw argued that e-health officials must now begin to focus their efforts strictly on pragmatic solutions to interoperability.

Not only is the idea of a pan-Canadian system moribund, but progress on electronic health record use remains lackluster, conference delegates learned.

According to Infoway officials who spoke at the conference, as of last January, only about 20% of all potential users of digital health information systems across Canada were actually employing them routinely.

According to a 2014 national physician survey, fewer than 80% of physicians nationwide exclusively use electronic records to enter and retrieve patient clinical notes. Those figures put Canada second-last in a survey of primary care physicans’ use of EMRs among 11 nations according to the Commonwealth Fund. Unsurprisingly, Canada ranks second highest among the 11 for the percentage of sicker adults who experienced coordination problem with medical records.

PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 187 (10)
CMAJ
Vol. 187, Issue 10
14 Jul 2015
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
E-health progress still poor $2 billion and 14 years later
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
E-health progress still poor $2 billion and 14 years later
Paul Christopher Webster
CMAJ Jul 2015, 187 (10) E309-E310; DOI: 10.1503/cmaj.109-5088

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
E-health progress still poor $2 billion and 14 years later
Paul Christopher Webster
CMAJ Jul 2015, 187 (10) E309-E310; DOI: 10.1503/cmaj.109-5088
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • A national electronic health record for primary care
  • Google Scholar

More in this TOC Section

  • Saying goodbye to CMAJ News
  • National survey highlights worsening primary care access
  • How Canadian hospitals are decreasing carbon emissions
Show more News

Similar Articles

Collections

  • Topics
    • Canadian government
    • Health technology

 

View Latest Classified Ads

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • CPD credits
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Advisory Panels
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions
CMAJ Group

Copyright 2023, CMA Impact Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: [email protected]

CMA Civility, Accessibility, Privacy

 

Powered by HighWire