Canada’s Electronic Health Record Gap: Patients Deserve Better

To: Healthcare observers
From: Tingting Zhang
Date: June 5, 2025
Re: Canada’s Electronic Health Record Gap: Patients Deserve Better

In today’s digital age, information access is easy and fast. With a few clicks, you can check bank balances, track investments, or even monitor fitness data in real time. But when it comes to health information, we remain stuck in the past.

Across Canada, patients are often expected to remember vaccination histories, repeat tests because previous results are inaccessible, and risk medication conflicts because prescription records aren’t shared.

These redundancies create more than inconvenience; they introduce health risks through unnecessary radiation exposure and increased likelihood of infection. They also impose significant costs on our healthcare system: Overused testing can lead to longer wait times, consume clinicians’ time, and waste limited health resources. For patients, the burden includes missed work, transportation challenges, and lost time – all because the right information isn’t readily available.

According to the Commonwealth Fund Survey, only 33 percent of Canadians have accessed their health records online in the past two years, far below the international average of 44 percent. Similarly, a 2023 Canadian Digital Health survey found that fewer than 40 percent of Canadians (excluding Quebec) accessed personal health information online despite strong demand: four out of five survey respondents expressed interest in viewing lab results, medication history, or immunization records online.

The benefits of electronic health records (EHRs) are clear. They enhance the quality of care, improve patient outcomes, reduce medical errors and unnecessary tests, and lead to greater efficiency and cost savings. They also empower patients to make informed decisions and better manage their health. More than 80 percent of Canadians with access to EHRs felt more informed about their health, nearly half avoided at least one healthcare visit, and one-third avoided an emergency department visit due to this access.

Yet Canada is an EHR laggard. While billions have been invested in digital health infrastructure over the past few decades, progress has been painfully slow. Between 2022 and 2023, the percentage of Canadians accessing their health records online increased by only 3 percent, reaching 39 percent nationally. Access varies widely across provinces: Saskatchewan leads with 60 percent of residents reporting EHR access, while Manitoba and Newfoundland and Labrador trail at just 14 percent. Ontario falls below the national average at slightly over one-third.

The digital divide is not just geographic. Canadians in households earning $100,000 or more annually are far more likely to access health records online (46 percent) than those earning under $50,000 (33 percent) – exacerbating existing healthcare inequities.

A significant barrier is the lack of standardization and interoperability across Canada’s fragmented healthcare systems. EHR initiatives range from single hospital systems to regional networks and province-wide platforms. These systems often operate in silos – limited by specific vendors or confined within sites of care – making information sharing challenging.

Some provinces have made notable progress. Nova Scotia and Newfoundland and Labrador have launched province-wide health portals that allow residents to access their health records. New Brunswick’s MyHealthNB app goes a step further, enabling patients to create and share a standardized Patient Summary with healthcare providers during unplanned or emergency situations – locally, interprovincially, or even internationally. Nova Scotia has also enacted legislation to consolidate health records into a comprehensive EHR database, while regulating electronic medical record platforms to ensure interoperability between hospitals and primary care settings.

Provinces with more fragmented approaches, such as Ontario, need to learn from their Atlantic counterparts. Rather than continuing with voluntary participation models that have clearly fallen short, these provinces should follow Nova Scotia’s regulatory approach: set clear, enforceable standards that require all providers and EMR vendors to meet interoperability standards and contribute data to a unified provincial portal. This would enable every patient to access their complete health record, regardless of where they receive care.

The lack of integration comes at a high cost. According to Canada Health Infoway, addressing interoperability could resolve $2.4 billion in inefficiencies, potentially saving clinicians and patients millions of hours while reducing hospital readmissions and redundant tests.

Provincial governments also need to commit adequate funding for infrastructure upgrades while providing healthcare providers with training, incentives, and change management support to ease the transition to integrated systems. For patients, mobile-friendly portal designs and targeted digital literacy initiatives are important to successful adoption. The most effective provincial strategies often combine strong regulatory frameworks with practical implementation support.

Globally, healthcare systems are undergoing rapid digital transformation. Australia and the United Kingdom are building large-scale public electronic health records. Denmark, Israel, and the Netherlands have taken further strides by deploying AI on medical records for predictive analytics to support clinical decision-making and improve patient outcomes. In contrast, Canada remains the only OECD country unlikely to regularly use EHR data for national health monitoring within the next five years.

As things stand, no one benefits. Patients suffer from fragmented care. Healthcare providers struggle with information gaps. The inefficiency of the system costs billions of dollars. So why aren’t we moving forward more quickly? Canada cannot afford another decade of inaction while other countries reap the benefits of integrated, data-driven health systems.

Tingting Zhang is a Junior Policy Analyst at the C.D. Howe Institute.

To send a comment or leave feedback, email us at blog@cdhowe.org.

The views expressed here are those of the author. The C.D. Howe Institute does not take corporate positions on policy matters.

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