International Connectathon aims to improve health IT connectivity

Writing about Canadian healthcare in the February 7, 2025 edition of the Globe and Mail, columnist Andre Picard states: “Our health information systems are pitiful, marked by a lack of access and interoperability.”

Ouch! To be sure, Canada’s unconnected EMRs and EHRs have driven doctors to exhaustion by forcing them to search for data in countless repositories. They report spending excessive hours looking for computerized information – something that has contributed to physician burnout.

Lately, however, significant advances have been made in connecting various systems so that physicians can quickly find the information they need – including patient histories, test results, allergies and medication records.

On this front, healthcare IT experts gathered in Toronto in February for the annual, international Connectathon – an event that brings teams from around the world to solve the challenge of healthcare IT connectivity. Over 150 interoperability specialists from around the world worked through the week on solving health IT connectivity problems.

The Connectathon – organized by a global body called IHE – has been held annually for 25 years, but this was the first time it was staged in Canada. It’s a sign of the importance Canadians are placing on improving the interoperability of health IT systems.

“We now have an interoperability roadmap – it was announced two years ago by Infoway,” said Attila Farkas, an AI strategy specialist with Canada Health Infoway. He explained that the roadmap shows what’s needed for connectivity but doesn’t mandate participation.

It’s up to the vendors to use standards from the Canadian roadmap, and from international organizations like the IHE. Connectathons and other forums give them the opportunity to pair up and test what they’ve devised.

“We’ve got 26 different vendors represented here on the floor, testing 30 different systems,” said Michael Nussbaum, a well-known Canadian healthcare IT consultant and a board member of IHE International.

Not only do companies test connectivity solutions at the event, but they’re also vetted by IHE and Infoway representatives to make sure they do indeed function as claimed.

“One of the big things we do is testing,” said Nussbaum. “Interoperability doesn’t mean anything unless you can demonstrate it.”

During the Connectathon, vendors who pass the tests under supervision of IHE monitors are given “seals of approval” for various forms of interoperability. They can then assure their customers that their systems do indeed work as advertised, and that they have earned IHE endorsement.

Participants in the Toronto Connectathon included MEDITECH and Epic, along with software from many other companies that are used by clinicians. Oracle/Cerner, another dominant hospital information system, has regularly participated in previous Connectathons.

And in this age of smart devices, vendors of medical equipment and consumer devices are participating, as well. They want to ensure their gear can integrate with the leading software systems.

A major focus of participants at the Toronto gathering was the International Patient Summary – a synopsis of key patient data, including medications, allergies, problems, immunizations and test results.

The goal is to find a way of extracting this information from various databases that contain it and packaging it in a form that’s easily accessible and transferable.

“People around the world are seeing the importance of the International Patient Summary,” said Nussbaum.

He noted that it was recently used in the annual Hajj, in which 2 million Muslims made the annual pilgrimage to Mecca. These visitors are often elderly, and they’re traveling in the 55-degree heat of Saudi Arabia. When they need medical treatment – such as care for stroke, heart attacks and other emergencies – local hospitals and clinics benefit from access to their histories.

In 2024, a coordinated effort was made to enlist the International Patient Summary, and many of the religious pilgrims participated. Before travelling, they allowed their records to be scanned and represented by a QR code, an innovation that enabled medical authorities in Saudi Arabia to obtain the medical data they needed quickly and easily.

That kind of innovation provides better medical outcomes for patients and makes things easier for medical practitioners. “We’re learning a lot from our international partners,” said Nussbaum. “It’s this kind of innovation that could reduce burnout for physicians in Canada, too.”

For its part, Canada is at work on creating a Canadianized form of the International Patient Summary called the Pan-Canadian Patient Summary (PS-CA), which was tested by health IT vendors at the Toronto gathering.

“Several jurisdictions are already implementing it, and New Brunswick is one of the leaders,” said Farkas. He noted that New Brunswick’s Ministry of Health, in partnership with a Canadian company called VeroSource, have recently created and deployed the PS-CA.

The benefit? It’s portable and patients can carry the code with them as they travel to different care providers within the province. The long-term goal is to enable its use across other provinces and even internationally.

Still, it’s not so easy to create these solutions, as various sessions held during the Connectathon showed. At one of them, a speaker was asked how to be sure the data contained in the IPS is correct and hasn’t been tampered with.

“These are real-world problems,” said Farkas. “You must make sure the solutions are secure and trustworthy. We’re brainstorming to come up with solutions.”

Another major stream of the conference consisted of work on e-referral and e-consult systems. Referrals and consultations with specialists are often mired in telephone calls and even fax transmissions. The goal now is to create closed-loop, electronic systems that quickly communicate between GPs and specialists and which also keep patients informed.

A challenge is that doctors in clinics and hospitals use a variety of systems. The e-referral and e-consult solutions must break down these walls and talk to each other.

It should be noted that other initiatives are occurring across Canada to address the healthcare IT connectivity gap.

Project AMPLIFI, in Ontario, is connecting the IT systems of nursing homes to hospital EHRs, enabling data to be transmitted much more easily when patients are transferred from LTC to hospital and back again.

Funded by the Ontario Ministry of Health, the initiative was launched in a pilot project that connected the PointClickCare system used by St. Joseph’s Villa, a nursing home in Dundas, Ont., with St. Joseph’s Healthcare Hamilton, which uses Epic.

The pilot was so successful that Ontario quickly gave the green light to roll out the solution across the province. Since then, the project has expanded to include many nursing homes using PointClickCare and hospitals running on Epic, Oracle and MEDITECH.

Meanwhile, the major hospital vendors – Epic, Oracle and MEDITECH – have created their own interoperability initiatives in Canada. They’re enabling these formerly disparate systems to communicate with each other.

One of the benefits of the Connectathon is that it’s international, and Canadians can learn from the experiences of countries around the globe. Farkas asserted that European countries are at the leading-edge of the International Patient Summary. “They’re driving much of what’s happening. We’re watching them very closely.”

Representatives of European nations were at the Toronto event, including a speaker from Austria. The next Connectathon, coincidentally, will be held in Vienna.

Blanda Helena de Mello, a representative from Brazil, noted in a presentation that connectivity efforts using the FHIR standard have improved health IT connectivity across the country – especially in the past five years. And while different Brazilian states and municipalities may use differing medical vocabularies, software has been deployed to “translate and understand” so that everyone speaks a common language, she said.

Daniel Doane, a consultant with the Pan American Health Organization, discussed an initiative to create interoperable health IT in countries connected by the highway that runs from Alaska to Argentina. Called the ‘Pan-American Highway for Health’, the project launched last October with 12 countries but hopes to expand to 35.

The idea is to deploy common standards so that health data can be shared more easily. One of its first projects is a Yellow Fever Digital Vaccine Certificate, and the group intends to make forays into cross-border telehealth. “The IPS is important for this,” said Doane.

What’s on the minds of the participants is migrant health, with thousands of people on the move each year throughout the Americas. Doane said PAHO’s efforts will be modeled on the European health experience, as much as possible. Doane quipped that his group has borrowed its theme song from AC/DC’s popular “Highway to Hell” and recast it as the “Highway to Health”.