Canada’s public healthcare system is highly regarded, but clinicians and hospital staff are increasingly facing burnout due to administrative burdens, inefficiencies, reduced clinical staff and fragmented access to patient data. Healthcare professionals spend significant time daily on tasks like manual data entry and navigating disparate systems, slowing decision-making and care delivery, which ultimately impacts diagnosis and the overall patient experience.
Another major issue is the fragmented nature of Canada’s healthcare system, with each province and territory operating its own set of healthcare systems and standards. This decentralization leads to significant gaps in healthcare data sharing, resulting in inefficiencies and redundancies that hinder patient care. All these challenges highlight a critical need for healthcare transformation through data interoperability and EMR integration.
The need for interoperability
Interoperability in healthcare enables different information systems, devices and applications to access, exchange, and use data seamlessly across various settings. By adopting standardized data models and communication protocols, systems like electronic health records (EHRs), laboratory platforms (LIS) or imaging systems (PACS) and laboratory platforms can share data in real time, ensuring that patient information is easily accessible to healthcare providers.
According to a 2019 Commonwealth Fund survey, only about a third of doctors share essential information like patient summaries, lab results or medication lists with other providers, limiting the continuity of care. This lack of data sharing contributes to the overall inefficiency and fragmentation in the system.
To address these challenges, the Canadian government introduced the Connected Care for Canadians Act in 2024. This act aims to improve patient safety and enable Canadians to securely access their health data, empowering them to make informed healthcare decisions. The goal is to create a modern, connected healthcare system where information flows seamlessly between providers.
Understanding interoperability in healthcare
Interoperability in healthcare enables different information systems, devices and applications to access, exchange and use data across various settings so they "speak the same language". This standardization of data and communication protocols enables EHRs/EMRs, laboratory systems and other other clinical management software, commonly used in healthcare facilities in Canada to interact seamlessly. This capability forms the backbone of a more efficient, data-driven healthcare system.
At the core of this process is data modeling, which structures information in a standardized, universally understood format. For example, standards like HL7 (Health Level 7) and FHIR (Fast Healthcare Interoperability Resources) are widely used frameworks that allow different healthcare systems to exchange data efficiently. These frameworks ensure that patient information from different sources and formats can be shared and interpreted accurately across systems.
Interoperability frameworks also rely heavily on APIs, which serve as secure channels for real-time communication between different systems. By using APIs, hospitals can allow EHRs /EMRs to pull patient data and present it in a more digestible way for clinicians. This way they no longer need to sift through pages of data and access a comprehensive patient profile instantly while eliminating the delays and inefficiencies associated with paper-based records or long digital files.
EMR and EHR systems in Canada also play a critical role in shaping the interoperability of healthcare data across the country. As there are a few key vendors who amass the entire market share, cross-platform interoperability amongst vendors may require custom integrations due to their proprietary structure.
Security and privacy are essential considerations in healthcare interoperability, especially with sensitive patient data. In Canada, data privacy regulations like PIPEDA (Personal Information Protection and Electronic Documents Act) must be followed when sharing patient data. Incorporating technical elements into interoperability solutions to ensure privacy and compliance are essential as data moves between systems.
The method of hosting interoperability solutions is another important factor to consider. Cloud-based EHR systems support interoperability by offering scalable and centralized data management. Cloud platforms provide a unified infrastructure, making it easier to integrate and exchange data between hospitals, clinics, and third-party systems. However, many hospitals may choose to employ a hybrid approach, using a combination of on-premises and cloud systems. This hybrid model requires careful integration to ensure seamless data exchange and interoperability across all platforms.
Improving patient outcomes and system efficiency
It’s important to understand the interdependencies of patient outcomes and HCP wellbeing and overall healthcare system efficiency in Connected Care in delivering coordinated, high-quality care. Every healthcare professional involved in a patient’s journey, the Circle of Care, whether it’s a primary care physician, specialist, pharmacist or nurse, relies on timely, accurate information to make informed decisions. At the same time, by streamlining information flow and reducing the duplication of efforts, Connected Care creates operational efficiencies that directly benefit the healthcare system.
Better patient outcomes and system efficiency are two sides of the same coin: when HCPs have seamless access to shared data, they can deliver faster, more precise care, reducing costs and enhancing the overall quality of service. Interoperability is the key to unlocking these dual benefits, ensuring that all providers in the Circle of Care can work together to improve both patient care and operational performance
There is also a significant financial benefit to Connected Care. According to Canada Health Infoway, a modernized health system with connected care could save approximately $500 million annually by reducing administrative tasks and improving care coordination. These savings not only benefit the healthcare system financially but also allow providers to spend more time with patients, leading to higher-quality care and happier HCPs.
How to start the interoperable journey
Implementing a fully interoperable healthcare system across an entire hospital can be a complex and daunting task. To ease the transition, hospitals can start with pilot programs in specific departments, such as the emergency department or radiology. This phased approach allows for testing the interoperability system, identifying potential issues and refining the implementation process before scaling.
Before investing in new technologies, hospitals and clinics should assess their existing infrastructure to identify gaps in data-sharing capabilities. With the introduction of Bill C-72 and its accompanying Pan-Canadian Interoperability Roadmap, HCP must strategically evaluate their IT and procurement decisions to ensure long-term interoperability. This national initiative, which could become a legal requirement in the long term, aims to create a standardized system for collecting and sharing health information across the country, with the broader goal of building a more connected and efficient Canadian healthcare system.
In addition to technical hurdles, organizational challenges including resistance to change and resource constraints are most likely to arise. Additionally, the cost of implementing and maintaining interoperability solutions can be substantial. To address these challenges, healthcare organizations must develop a comprehensive implementation plan that considers both technical and organizational factors. Collaboration between healthcare providers, technology vendors, and government agencies is also essential for successful interoperability initiatives.
A systemic change in the Canadian healthcare system
We do also want to point out that for Canada to fully realize the benefits of interoperability, all relevant stakeholders must see it as a strategic priority rather than just a technical upgrade. From hospital boards and regional health authorities to local clinics must recognize that investing in interoperable systems is an investment in the future of healthcare and better patient outcomes for Canadians. Interoperability should be embedded in the governance of healthcare organizations, with clear goals and objectives to ensure that the investment delivers long-term value.
Significant financial investment and cross-province collaboration is imperative in our collective endeavor. Standardized approaches to interoperability, supported by government grants, public-private partnerships, and other financial incentives, are crucial for offsetting the initial costs of implementing interoperable systems. These investments are necessary to ensure that healthcare systems across Canada can communicate effectively with one another, regardless of geographical or administrative boundaries.
By working together, provinces and territories can develop common procurement requirements, pre-qualify vendors for interoperability solutions, and align their digital health strategies. This collaborative approach is critical to deliver a seamless, interoperable healthcare system that is responsive to the needs of all Canadians.
Working with Star and local experts
At Star, we are committed to helping hospitals in Canada navigate the complexities of interoperability and healthcare IT modernization. With our deep technical expertise and knowledge of the Canadian healthcare system, we are your end-to-end partner, from initial system assessment to defining a tailored interoperability strategy to implementing digital solutions, as well as working with vendors and platforms to ensure compliance. Together, we can build a healthcare system that works better for everyone – a system where Connected Care is not just a vision but a reality.
