不良研究所

Almost all Canadian physicians now use electronic health records (EHRs). A new study out of the University of 不良研究所 published in the found that those records are often disconnected between clinics, hospitals, provinces and territories, leaving clinicians without access to the information they need.

The regular use of EHRs by physicians rose from 36 per cent in 2009 to 95 per cent in 2024. Researchers found that widespread adoption has unfortunately not translated into connected care. 

鈥淏ecause jurisdictions didn鈥檛 take a long-range planning perspective, nearly all have major deficits in connectivity between their EHR鈥檚鈥�, says , MD, senior author of the paper. 鈥�That means patient鈥檚 health information is siloed in different software programs, each designed by different vendors with different standards. It leaves patients鈥� health records fragmented across separate systems, and it鈥檚 leaving clinicians without access to the information they need. It's all harming patients.鈥� 

Over the course of two years, the researchers investigated EHRs across every Canadian province and territory, focusing on how well connected they are, the term for which is interoperability. Interoperability is the secure, accurate and meaningful exchange of information between different systems and organizations.

They found that nearly all jurisdictions lack interoperability between hospitals, community specialists and primary care. In practice, that means that information entered in a family doctor鈥檚 office cannot be viewed by other clinicians in the hospital or community caring for the same patient.

A more detailed look at each province and territory鈥檚 performance can be viewed on the .

Why disconnected records cause harm

鈥淎s a patient, health data matters because it guides how a health-care system cares for you,鈥� says Sunand Kannappan, BHSc'21, a medical student and first author of the study. 鈥淲hen records are disconnected, clinicians do not have the full picture. That can really harm patients.鈥�

Connected records would allow emergency departments, clinics, family doctors and specialists to access up-to-date information about the patient in front of them. This information helps clinicians order the right tests and offer safe treatments.

But, when records are disconnected, clinicians are forced to rely on faxed letters, mailed documents or patients remembering their own medical history. The study also found gaps in patient access to their own records and the ability for health systems to use data for planning and improvement.

The researchers identified eight key barriers that need to be addressed including the lack of interoperability legislation, vendor data-blocking behaviours and data-privacy concerns. 

鈥淚t is possible to overcome these barriers,鈥� says Manns. 鈥淭he problems are clear. Better-connected health data would benefit patients, clinicians and the overall health system.鈥�

New legislation could help connect records

Earlier this year, the federal government reintroduced the , which aims to prevent vendors from data blocking and requires common standards for sharing health information across systems.

The authors say the legislation is an important first step, but provinces and territories also need to build the governance, standards and infrastructure needed to make connected records a reality.

鈥淐anada has made major progress moving from paper to digital records," says Kannappan. 鈥淭he next challenge is making sure those records can follow patients wherever they receive care. We need to see provincial standards, clear implementation requirements and the technology infrastructure needed to support effective use of electronic health records. This cannot be solved by individual clinics or hospitals alone. It requires system-level leadership.鈥�